Benzodiazepines for Pelvic Pain?
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Benzodiazepines, anti-anxiety medications like Xanax and Valium, are now being used by some women vaginally to treat pelvic pain. OB/GYN Dr. Leah Millheiser joins The Doctors to explain why this is being done and why she believes this is a disturbing trend!
Dr. Millheiser says she is seeing pelvic floor hypertonic disorder in her practice on a daily basis. This is when there are chronic spasms of the pelvic floor. While benzodiazepines are used to treat acute muscle spasms, they are not going to work in the vagina. Women are typically getting these in suppository forms made at a compound pharmacy.
There was one study which did see some improvement for high-tone pelvic pain, however, the patients in that study were also using pelvic floor therapy and trigger injections, so it can’t be determined where the improvement actually came from. A newer study compared benzos in the vagina to placebos and didn’t see any improvement whatsoever. Dr. Millheiser and her colleagues recommend against it since the literature is showing there is probably no benefit. Additionally, there are the questions of is it safe? How does it work? Is there a potential for addiction?
Plastic surgeon Dr. Andrew Ordon notes it’s unknown how much of the benzos are getting into the system and it’s a slippery slope, especially when combined with any other drugs or alcohol. Psychiatrist Dr. Ish Major agrees, saying Valium is one of the most addicting medications they can prescribe.
To illustrate how serious the situation is, The Doctors pull up some comments from message boards where women were asking about and okaying sticking benzo pills directly up their vaginas. Dr. Ish notes that it's unknown how those pills are going to get absorbed. “Would you put a Tylenol up there if you had a headache? No!” Dr. Ish jokes.
What causes this pelvic disorder and how can women treat it? Dr. Millheiser explains it can begin from a young age, when children learn to hold in their urine, over time, it can lead to high-tone function. It can also occur in women who have had pelvic trauma, pelvic surgery or endometriosis since the natural reaction is to tense up the pelvis to avoid pain. Even women who practice Pilates or other exercises that keep the pelvic floor tight may develop this disorder. She advises those women to relax their pelvis in between exercises.
She says pelvic floor therapy is the mainstay of treatment. If that doesn’t work, Botox injections in the vagina or trigger point injections can also be used. For now, keep the benzos away.