Why do you think it's so hard for people to get diagnosed? Stein: Many doctors, unfortunately, don't know a lot about pelvic floor dysfunction, or they just don't believe that the problems are muscular. A lot of pain patients, for example, have been to between five and ten doctors before being diagnosed.
More and more physical therapists are getting more involved in pelvic floor rehabilitation, but there are still few physical therapists who specialize in this condition.
Kavaler: I think a lot of these patients are just given pain medicines and other drugs. But I think that the most effective thing for the patient is to try to keep them off of medications. Number one, most of the medicines don't work and they are somewhat addictive. Secondly, this is a chronic condition that's going to come and go throughout people's lives. If there is something that can be done to manage this that's non-medicinal, it's better for the patient so they're not dependant on a doctor.
We're going to start a research project to see if patients have a response to physical therapy and how durable the response is. Certainly during therapy, patients seem to do well. But it would be interesting to see how long the results last, and if patients need to continue with therapy, or if they can maintain an exercise regimen at home.