perineal pain.

I've had perineal pain for about 8 months. I am post menopausal and been diagnosed with vaginal atrophy and overactive bladder. I have tried amitriptyline... over active bladder meds... using ovestin cream for atrophy but nothing seems to work. It Seemed to come on suddenly. I'm 62 and this is really impacting on my life as unable to do the things I used to.

[CockeyMoor]

Have you got a Rectocele? . I have vaginal atrophy, recurrent UTIs, overactive bladder and a moderate Rectocele.

I get a lot rectal pain? Not sure if that is classed as perianal. It wakes me from sleep every morning. Just make sure you do not have a Rectocele causing your issues. Mine was diagnosed during a Cystoscopy.

[Hidden in reply to CockeyMoor]

As far as I'm aware I dont have a rectocele.....I've been examined numerous times and nothing has ever been mentioned.... 😊

[Hidden in reply to CockeyMoor]

I've not had a cystoscopy although I have a urology appointment next month.... so will see...

[Skye22]

What works for me is internal/external vaginal trigger point therapy which is done by my specialist bowel/ bladder physio.

i have levator ani syndrome and a rectocele which causes painful spasms in my pelvic floor. Therapy doesn't eradicate pain but it makes pain more manageable. Hope you find a treatment that works for you.

[Nearlygaveup in reply to Skye22]

hi there. I think I am suffering from this also, I would like to know more about the treatment. After 4 years of no sleep, vaginal pain and spasms constantly I also have a urology appointment in a couple of weeks. I still have had no diagnosis although my interior is like a load of rocks one of which prevents me emptying my bowel which I have to now do with irrigation system. It's been an eye opener reading all the suffering. I hope you all and me too get some answers and relief.

[Hidden in reply to Nearlygaveup]

Its a minefield.... on top of everything else I've now noticed that ovestin vaginal cream for atrophy is causing intense burning and irritation... So I'll be stopping that. Sorry to read you are having to use an irrigation system.... It seems that the health professionals often don'thave answers for many of us.... 🙄

[grumpyold in reply to Hidden]

I have vaginal atrophy and an over active bladder too. My GP prescribed Vagifem pessaries. They didn't cause itching or burning but after a couple of months, my boobs got really tender and I became bloated, so I stopped using them.

Then I found a natural alternative called BalanceActiv Moisture Plus (soothing relief from dryness, atrophy and discomfort.) They are free from parabens so may not cause you itching or burning. They are hormone free too, so I get on better with them than with the hrt aspect of the Vagifem pessaries I had before.

I cut them into thirds, as you don't need a complete pessary every time you use one. After a few weeks of use, I only need a third, once or maybe twice a week.

I get them from Amazon. They cost about £10 for a box of ten, but a box lasts me ages because I only use a third each time. Maybe worth a try?

[Suecoo66 in reply to grumpyold]

Replens is really good, you can buy a tube that comes with an applicator. It's about £11 in Superdrug

[Agnessa]

I’m in premenopausal stage and having a pelvic pain for 17 months now. A year ago I was I was diagnosed with pelvic floor dysfunction due to muscle spasm. My symptoms are rectal pain, sitting pain, issues with bladder (overactive bladder). The life changed after I read the book written by Dr Wise and Dr Anderson “A headache in the pelvis”. This book is a “bible” for patients who suffers from pelvic floor muscle dysfunction. I was taught his method called Wise-Anderson protocol and for the last 7 months I’m following this protocol at home in addition to PT sessions. What helped me the most is a relaxation technique with the trigger points release method. It took few months from day 1 to get some relief but I’m so glad that I didn’t choose approach with the Botox injections suggested by another doctor. Another good book that helped me is “Heal pelvic  pain” by Amy Stein. This one describes some good exercises to reduce the pelvic pain symptoms. I feel much better now, the rectal pain is gone and the bladder issues are almost gone as well. The sitting pain is still there but less intense. I’m not taking any medications now. I highly recommend to read this book, it helped so many people. 

[Hidden in reply to Agnessa]

Thank you for that.... I will look into the books you mentioned. I'm taking a nerve pain med/amitriptyline but it doesnt seem to be helping. Sitting definitely triggers things... driving is the worse. Yesterday I had anal pain...today bladder.... Obviously something is triggering it all. I've not had the opportunity to see a specialist physiotherapist and doubt it will be offered on the NHS...!

[Nearlygaveup in reply to Agnessa]

thank you, have ordered

[Agnessa]

What I have learned from my research: it’s a stress related condition. The symptoms will be different: rectal pain, sometimes bladder, burning/ itching, vaginal pain /discomfort . But the root cause is the same: muscle spasm that’s triggered be the nervous system. The relief will come when you will learn how to tell your nervous system to calm down and relax. It’s a key point. Another important note is to learn how to release the trigger points. If you’ll find a good physical therapist, it will complete the puzzle and the symptoms will start fading. You will need to keep this routine daily for months but it will get better. Hope you will feel better soon!

[Hidden in reply to Agnessa]

I'm just watching some YouTube clips about the Wiseman Anderson protocol.... Very interesting and I can totally relate to long term anxiety and pelvic pain. My only release is when asleep....or if I have a diazepam.... My anxiety levels are chronic .. There are loads of videos on all of this on YouTube so will continue to watch them. Thank you for flagging this up...😊

[Suecoo66 in reply to Agnessa]

If you are menopausal it's not stress related it's caused by low estrogen

[Agnessa]

Everything related to relaxation will help: warm bath, sauna, massage. Take a look at his website, it has tones of info/videos.

Website: pelvicpainhelp.com/about-us/

Wishing you the best..

[Hidden]

i will do. Thank you

[arojas25]

Have you tried the laser Monalisa . It will help with your vaginal atrophy.

[Suecoo66]

You need vaginal estrogen pessaries. Vaginal atrophy causes the bladder to be over active. Vagifem is available on prescription or if you want to buy it yourself get Gina from Boots.I've also recently got cbd lubricant which has helped with internal pain. There is a lady on Tiktok who does lives who gives a lot of info on VA.