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. Similarly, pelvic pain is like a cramp inside the pelvis. The type of pain that comes on suddenly, might be described as ‘stabbing’, and 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 people 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 its 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 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:
- unwrap the suppository from its wrapper
- insert it gently through the anus, past the muscles around the anus and up into the bowel, or high up in the vagina. This is easier if you wet the suppository with some water, or put a small amount of vaginal lubricant on the suppository.
- if you are inserting the suppository into the bowel, please empty your bowel beforehand.
- if you are having a period, it may be better to insert it in the bowel rather than the vagina.
If diazepam is used often it becomes less effective. It also has the 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:
- Seeing a Pelvic Physiotherapist with a special interest in pelvic muscle spasm. You can find a physiotherapist near you by checking our subscriber map under Find Help > Find a Healthcare Professional on this site. They can help you learn to release tension in these muscles. Your GP can provide a ‘Care Plan’ to help you with the cost of seeing a physiotherapist
- Regular, daily gentle exercise or yoga – and keeping moving. Exercise that aims to tighten core muscles should be avoided when this pain is severe.
- Doing the male or female stretches you can download
- Using the Pelvic Floor Muscle Relaxation Audio available from our online shop
- Reading about pelvic muscle pain under Information
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 the cost prior to ordering them.
