Research Review: Vaginal Valium

I had a patient ask recently about the use of valium suppositories for pelvic pain due to tight muscles.  Specifically they were concerned about whether or not the medication would be felt in the rest of the body.  

At the moment I didn't have a good answer, but I promised to look into it. Fortunately I found an excellent study that addressed this exact question.   I was so interested in the result that I wanted to share with the rest of my patients!

The study is:  Vaginal Diazepam for Nonrelaxing Pelvic Floor Dysfunction: The Pharmacokinetic Profile, and it was published by Larish, Dickson, Kudgus, McGovern,  Reid, Hooten, Nicholson, Vaughan, Burnett, Laughlin-Tommaso, Faubion, and Green in the Journal of Sexual Medicine in 2019.

The take-home points are:
 

• "Vaginal [valium] is frequently used to treat pelvic floor tension myalgia and pelvic pain despite limited knowledge of systemic absorption."

• Vaginal administration of valium results in lower levels of the medication in the rest of the body than does taking it orally, but it stays in your system longer.

• With daily use "accumulating levels would occur ... and steady-state levels would not be reached for up to 1 week "

• Intermittent use is suggested for participation in physical therapy and intimacy.

 
Here is the study abstract if you want to check it out yourself-
https://www.jsm.jsexmed.org/article/S1743-6095(19)30427-8/fulltext
 
I hope that this was of interest to you!  f you would like to discuss this further, don't hesitate to reach out.
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