Help for Intimate Pain
As a hypnotherapist in Franklinville, NJ, who works with women with chronic pelvic pain, Loretta Sernekos, PhD, is intimately familiar with her clients’ symptoms. She has CPP, too. So she’s aware of how, in addition to all the ways they hurt, their distress is compounded by one terrible, frustrating fact: Even after extensive consultations, many still haven’t found the root cause of their problem or a treatment that works.
Their doctors, of course, haven’t either. What that means for Sernekos’s clients and the 15% of American women who suffer from CPP is that nothing can be taken for granted: not walking, sitting, having sex, going to the bathroom, even wearing a favorite pair of tight-fitting jeans, which can press in all the wrong places. “Thank God I love hippie skirts,” says Sernekos.
But unlike 1960s-inspired fashion, chronic pelvic pain is ready to be resigned to the past. “Women no longer have to settle for being debilitated,” says C. Paul Perry, MD, chairman of the International Pelvic Pain Society and an assistant clinical professor of obstetrics and gynecology at the University of Alabama at Birmingham. “We’ve made a lot of progress in the past decade in educating physicians about chronic pain.”
What doctors now know is that CPP is rarely due to just one problem. “Most women have three or more conditions, each of which adds to their overall discomfort,” says Richard Marvel, MD, director of the Center for Pelvic Pain at the Greater Baltimore Medical Center and an assistant professor of gynecology and obstetrics at Johns Hopkins School of Medicine. “If you treat just one cause, the patient won’t get much better.”
After finally seeking help at a pelvic pain center, Sernekos, for instance, learned she had several underlying conditions: generalized vulvar dysesthesia (pain anywhere in the vulva), vulvar vestibulitis (excruciating tenderness at the entry to the vagina), and a pelvic joint problem that pulls her pelvic floor muscles taut as a drumhead. A carefully tailored treatment regimen has made her 90% better: “I’m no longer in hell,” she says.
Still, to find relief, you’ll need to be your own educator and advocate. It’s essential that you understand some of the more common components of CPP, the subtle differences between them that even doctors miss, and how the various conditions interact with one another and exacerbate your symptoms. Familiarize yourself with the tests you’ll need, as well as the menu of conventional and natural therapies available to you. Most important, learn how to find a specialist who knows how to untangle the myriad, mysterious causes of your pain. Your first challenge: Learn why you hurt.
Five common conditions for which your doctor will test are:
1. Endometriosis
5 million women have it
Cells similar to the tissue lining the uterus migrate elsewhere and break down each month in sync with your period.
Telltale signs
Severe cramps, often coinciding with your menstrual cycle, that radiate to the lower back and leg.
How it’s diagnosed
Laparoscopy (a minimally invasive surgical procedure) to perform biopsies (removal of tissue samples for examination under a microscope).
Treatments
Frontline remedies include nonsteroidal anti-inflammatory drugs, such as ibuprofen and naproxen sodium, along with birth control pills and other hormones to shrink endometrial tissue. Your doctor may recommend minimally invasive surgery to remove or destroy endometrial growths or, in severe cases, a hysterectomy.