When No One Knows What’s Wrong
When you have a pelvic floor issue, you are special. You are common, but you are still very special. Why? *Because you go to your doctor and tell them your complaints…and your doctor will not be 100% sure about what’s going on.
If you’re a female seeing your doctor, it’s possible that after a pelvic examination, you will be told that nothing is wrong. This happens a lot. The doctor is looking for some sign of infection, a cut, bleeding, anything to put their finger on. (Funny thing, they might not literally put their finger on anything because some doctors do not do exams.) Unfortunately, with pelvic floor dysfunction, the symptoms aren’t always visible to the naked eye.
You may repeat to your doctor that you feel irritation or stinging or burning or itching, but if they can’t see anything, they probably won’t do anything. I say probably because there are two other scenarios:
They might just assume you have an infection, despite negative tests or zero testing and go ahead and give you antibiotics or an anti-fungal.
Or, your doctor will say that they are familiar with your symptoms or they have had a patient in the past with your symptoms and they will prescribe you an appropriate medication or send you to pain management or even send you to pelvic floor physical therapy.
If you’re a male seeing your doctor, you are probably really familiar with the term “prostatitis”. Basically, this is inflammation in your prostate. Do you really have “prostatitis”? There are different types of prostatitis which are described based on how long you’ve had your “prostatitis” and whether or not you have an active infection. You, sir, will see a few scenarios:
Your doctor may go ahead and give you six weeks worth of antibiotics without doing any testing for infection and you will probably feel better for a few months, but if you don’t actually have “prostatitis”, trust me, your symptoms will come back.
Your doctor will test you for an infection and you test positive – you actually have an infection. You will then get antibiotics. Once the infection has been cleared, the urinary, bowel, sexual or pain symptoms might return a few months later. Why? Well, because your pelvic floor muscles may be in spasm or may be unable to relax as a result of the initial infection.
If your doctor does test you for an infection and it is negative, he might still give you antibiotics. Just as in the first scenario I provided, you will probably feel better for a few months, but your symptoms will come back. The antibiotics are creating an anti-inflammatory effect which is probably helping you to feel better. But, once you’ve completed your medication, your symptoms will likely return. This is all because your pelvic floor issues have not been addressed, let alone resolved.
The bottom line for both men and women is this: If you do not get relief with your current treatment plan or your doctor is not familiar with your pelvic symptoms, ask for more options. I am a pelvic floor physical therapist and I believe that we need to be part of the treatment plan for pelvic issues. On average, my patients see about eight different specialists before they end up seeing me. I strongly believe that very few people will get relief from pelvic symptoms without the assistance of a pelvic floor physical therapist at some point. So, if you are not getting the help that you need, ask if you can be referred to a pelvic floor physical therapist.
You have to ask.
Unfortunately, some physicians will not readily offer pelvic floor physical therapy as a treatment option. More unfortunately, some physicians do not believe that pelvic floor physical therapy can help with pelvic symptoms. This is your experience, so it’s really up to you to decide if it is helpful, especially if what you have tried so far isn’t making enough headway for you.
Please know that your doctor ultimately wants to see you get better. Consider the doctor’s point of view. It is always challenging to be given a patient with symptoms or a diagnosis that you are not familiar with. This is true for all healthcare providers. Your physician will either be excited to learn something new, or he or she may tell you there is nothing they can do. Both of these scenarios can be appreciated to an extent. You are either working with someone that will work with you, or your provider is being honest and doesn’t want to waste your time. If you get the latter response do not worry. Find a physician willing to help you. Then, turn lemons into lemonade. This is an opportunity for you to share what you will be learning with your physicians and then they will be better able to help other patients in the future.
*DISCLAIMER: There are some really great doctors out there who know exactly what’s going on. However, this is the minority.