Login / Create an Account

Phone646.355.8777


 

Vaginal diazepam has been used by patients who have pelvic pain as an "off-label" drug option yet there has been little research to support its use. Recognizing that conditions such as painful bladder syndrome (PBS)/interstitial cystitis (IC) may be complicated by pelvic muscle dysfunction, the use of diazepam (brand names include Valium) aims to target the muscle overactivity. 

 

In the September/October issue of Urologic Nursing, Donna Carrico, MS, WHNP, and Kenneth Peters, MD, report on the effects of vaginal diazepam on 21 women (mean age of 40) who were diagnosed with urogenital pain. Women completed assessment scores at baseline and at one month after being treated with vaginal diazepam. 2-10 mg ("...as needed for symptom relief...") was prescribed to be used up to every 8 hours. Most women started at 5 mg unless they reported high sensitivity to most medications. Although patients had the option to have the medication compounded into a cream or suppository, all patients chose to utilize the oral tablet inserted vaginally. (It was either inserted whole or crushed and mixed with vaginal lubricant to be inserted into the vagina.) The women recorded weekly their dose, usage, and pain score on 0-10 Visual Analog Scale (VAS) as well as any adverse effects that occurred over the month. A serum diazepam level was recorded at the end of the 4 weeks for the 15 women who were using vaginal diazepam at least daily, and these levels were found to be in the normal range.

 

VAS scores decreased on average from 4.8 to 3.4, average vulvar Q-Tip level decreased from 3.3 to 1.2, and vulvar pain levels decreased at one month follow-up as well. Only 1/3 of the women reported a side effect of drowsiness, otherwise no side effects were reported. Interestingly, some patients found it helpful to insert the medication vaginally 1 hour prior to engaging in intercourse so that pain was reduced.

 

The authors are quick to point out that this research was not conducted as a controlled trial, and there is no proposed protocol for the use of vaginal diazepam. What this research does assist with is establishing that the off-label use of diazepam vaginally in those suffering with urogenital pain may have few side effects and may offer benefits. Because pelvic pain often does not have a target organ as a cause, and because pelvic muscles are involved in most urogenital pain cases, it makes sense to address the involved muscles. Of course, pelvic rehab practitioners are well-trained to address the muscles via direct releases as well as through the use of other modes, yet having assistance of pharmacology may be a useful tool for the patient.


Upcoming Continuing Education Courses

Coccyx Pain - Torrance, CA
Mar 28, 2015 - Mar 29, 2015
Location: HealthCare Partners - Torrance

Hip Labrum Injuries - Houston, TX
Mar 28, 2015 - Mar 29, 2015
Location: Women's Hospital of Texas

Pelvic Floor Level 1 - Seattle, WA (SOLD OUT!)
Apr 03, 2015 - Apr 05, 2015
Location: Swedish Medical Center Seattle - Ballard Campus

Myofascial Release for Pelvic Dysfunction - Tampa, FL
Apr 10, 2015 - Apr 12, 2015
Location: Florida Hospital - Wesley Chapel

Lymphatic Drainage for Pelvic Pain - Scottsdale, AZ
Apr 11, 2015 - Apr 12, 2015
Location: Evolution Physical Therapy

Assessing and Treating Vulvodynia - Minneapolis, MN
Apr 11, 2015 - Apr 12, 2015
Location: Park Nicollet Clinic--St. Louis Park

Pelvic Floor Level 2B - Columbus, OH (SOLD OUT)
Apr 17, 2015 - Apr 19, 2015
Location: Ohio Health

Athlete and the Pelvic Floor - New York City, NY
Apr 18, 2015 - Apr 19, 2015
Location: Kima - Center for Physiotherapy & Wellness

Pudendal Neuralgia Assessment and Treatment - Salt Lake City, UT
Apr 18, 2015 - Apr 19, 2015
Location: University of Utah Orthopedic Center

Finding the Driver in Pelvic Pain - Milwaukee, WI
Apr 23, 2015 - Apr 25, 2015
Location: Marquette University

Pelvic Floor Level 1 - Durham, NC (SOLD OUT!)
Apr 24, 2015 - Apr 26, 2015
Location: Duke University Medical Center

Sexual Medicine for Men and Women - Fairlawn, NJ
Apr 24, 2015 - Apr 26, 2015
Location: Bella Physical Therapy

Bowel Pathology and Function - Kansas City, MO
Apr 25, 2015 - Apr 26, 2015
Location: Saint Luke\'s Health System

Pelvic Floor Level 1 - Los Angeles, CA (SOLD OUT)
May 01, 2015 - May 03, 2015
Location: Mount Saint Mary’s University

Pelvic Floor Level 2A - Seattle, WA (Sold Out!)
May 01, 2015 - May 03, 2015
Location: Swedish Medical Center Seattle - Ballard Campus