If you have pelvic pain, it’s quite possible that you sometimes have flares of pelvic muscle spasm. It doesn’t show on a laparoscopy, or with ultrasound or on a blood test. We all know how painful cramps in the legs are, well this is like a cramp inside the pelvis. The type of pain that comes on suddenly, might be described as ‘stabbing’, is felt on one side of the lower abdomen, or both sides, or up the vagina, or up the bowel, or into the back, or down the front of the leg. It’s better with a heat pack, like all tight muscles and can be worse with particular movements. Sometimes it’s so bad that women go to an emergency department for help.
A diazepam suppository is a small white, waxy, bullet-shaped pellet that can be inserted in either the vagina or the bowel. It can help relax the muscles and settle the spasm. They aren’t suitable for regular use, but can be useful for occasional bad days when you have a flare of pain. The other name for diazepam is valium. Many years ago, it was used for back muscle spasm, but it went out of favor because some people took it regularly, it lost it’s effectiveness for them, and they became addicted to it. This is much less of a problem when it is only used occasionally for bad pain.
The suppositories need to be stored in a refrigerator, or they may melt, especially in warmer parts of Australia. Other types of suppositories are only inserted through the anus into the rectum, but the diazepam suppositories can be used in either the vagina or the rectum.
Diazepam relaxes muscles but can also make you sleepy, so they MUST not be used if you are driving or operating machinery.
To use the suppository:
If diazepam is used often it becomes less effective. It also has potential for addiction when used regularly. However, occasional use – maybe once a month if needed, or once daily for 2-3 days when you are having a difficult time with pain – is unlikely to cause these problems. If you need to use the suppository more than this, then you should see your doctor again to discuss your pelvic pain further.
Remember that it is important to manage pelvic muscle spasm in other ways. These include:
Diazepam suppositories can’t be bought from a normal pharmacy. They need to be made for you at a compounding pharmacy with a script from your doctor. The script should read ‘5mg diazepam suppository in a fatty base’. The pharmacist will make the suppositories for you, so may need 1-2 days warning. The cost is not covered by the PBS, so it is best to enquire about cost prior to ordering them.