WOMENS-HEALTH Messages for December, 1997: Re: unexplained chronic vaginal pain

Re: unexplained chronic vaginal pain

From: D. Ashley Hill, M.D. (anonymous@obgyn.net)
Tue, 30 Dec 1997 21:14:57 -0600 (CST)

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At Tue, 30 Dec 1997, anjali wrote:

The pain in the beginning was so severe that I >could not sit, stand or lie. Although it has subdued from that state,
>it still continues to be very painful.

anjali-

This sounds a lot like levator spasm, a condition that is somewhat difficult to diagnose. Another term for this is vaginal or levator trigger points. In this condition, the muscles holding up the genital organs, sometimes called the PC, or pubococcygeous, muscles, have tender areas of entraped nerves, leading to muscle spasm. The diagnosis can be tricky. I have treated a handful of cases, and have noted tenderness when my examining finger is pressed gently against one or both sides of the vagina, or when a rectal and vaginal exam are performed together. Treatment is injections of novocaine and steroids into the side of the vagina (which, actually, is very well tolerated and *instantly* curative of the problem). Your doctor may want to do a Medline search, or review the work by Dr. JC Slocumb (Am J Obstet Gynecol 1984;149:546). If your doctor(s) are not comfortable treating this, a chronic pain center, usually run by anesthesiologists, or a medical school gynecology department might be the next place to visit.

Another possibility is a somewhat controversial disorder called pelvic congestion syndrome, where the veins around the uterus and vagina swell, causing pressure and throbbing pain. This pain is usually worse at night, or after standing long periods of time.

Good luck with your treatment. Please let us know when you are feeling better, and what your doctors found. I hope that you are successfully treated as soon as possible.

-- Ashley Hill David Ashley Hill, M.D. Associate Director Department of Obstetrics and Gynecology Florida Hospital Family Practice Residency Orlando, FL http://www.gate.net/~dahmd

I apologize, but I am unable to answer personal e-mail due to time constraints.

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