I saw my doctor today for the steroid injections, specifically triamcinolone acetonide (Kenalog) mixed with lidocaine. If you read the literature you might see recommendations for methylprednilosone as the steroid but my doctor said that the reason she wanted to do Kenalog instead was because it's not as strong as the methylprednilosone and apparently the stronger the steroid, the more likely it is to cause vaginal tissue atrophy. So the injections hurt a lot but I was able to make it through it (I took a Vicoprofen t about half an hour prior to the injections). That was about 4 hours ago and now I am starting to have pain where the injections were. I actually just had a shooting pain down my leg. Jeez I hope I did not open Pandora's box of mysterious conditions with these injections. I just took a Vicoprofen about 5 minute ago. I don't even know how to rate my pain anymore. Sometimes I don't think it is that bad and then my doctor does the Q-tip test and I have pain all over.
We are going to do another set of steroid injections next Monday and then again on the Monday after that.
My doctor said if this series of injections doesn't help or doesn't help enough, then she will inject another steroid into the muscle in my buttocks. I forget which muscle specifically. She also said she could do the pudendal nerve block, but that I'd need to see an anesthesiologist for the caudal epidural or impar ganglion. It may be muscle pain, but it is also that the nerves have regenerated.
I asked my dr about a 6% gabapentin compounded cream but she said that it was unlikely it would work because it's not absorbed systemically. I also asked her about possible hormonal causes or links and she pretty much debunked that. I told her I had read of a lot of women who have this being prescribed testosterone creams, etc and she basically said there were no studies to support that theory.
I'm going to continue using the Estrace cream, taking 900mg of gabapentin everyday, and using the dilators. She also wants me to consider acupuncture and to seriously re-consider PT (physical therapy).
7 comments:
I was re-reading thru some of my entries today and when I read this the first thing that came to my mind was, "but the steroid injections we're doing now aren't absorbed systemically either." Huh. I'll have to ask my doctor about that one. I mean, injecting something is different than applying it topically, but it's not like the skin down there is that thick so though I'm sure injecting is more likely to have a more immediate effect, I'm not so sure it is THAT much different from applying topically.
Hi, I wanted to tell my story but won't make it long. I have been dealing with vestibulitis/lichen sclerosus for 15 years now. I have had vestibulectomy surgery, I've been on every topical medicine known, I have tried antidepressants and gabapentin, and also local steroid injections, all have failed. They may have helped but only for a short time. My last resort has been the three caudal steroid injections I have had and guess what, they were also short-lived. I had three and supposedly I have have one more (4 in a year.) I'm going to do it and see what happens. The anesthesiologist said if they don't help, he can inject alcohol as a true last resort but that will deaden the nerves meaning I won't feel intercourse. It's been so depressing and frustrating that I will end up doing the alcohol if the steroid fails because I can't live with the pain anymore. I just wanted to tell my story so people know they are not alone.
supposedly I "can have"
Anonymous- Just wondering when you were talking about alcohol injections that would deaden the nerves, it this a permanent thing. Ie would it mean that you would be pain free and not feel intercourse?
AnonymousApril 26, 2013 at 12:13 PM
Anonymous- Just wondering when you were talking about alcohol injections that would deaden the nerves, it this a permanent thing. Ie would it mean that you would be pain free and not feel intercourse?
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I just came across this blog as I've been dealing with a "sore spot" diagnosed as vulvodynia since the birth of my son in March 2016. I've gone through a variety of treatment options including estrogen cream, topical lidocaine, trigger point (steroid) injections, antidepressants and an outpatient procedure to remove the sore tissue. All this and a year and a half later, nothing has worked. My pain is the worst during intercourse to the point where it's barely tolerable. I'm frustrated and at a loss. I see some of you have considered or have gone through other treatment options (i.e. alcohol injections, botox, etc...) and I'm wondering if anyone else out there has any further insight or potential recommendations to explore with my doctor. Thank you for any feedback you can give me.
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