On March 9, 2010, the nationally syndicated The Dr. Oz Show featured a segment on “Vaginal Panic Attacks” (what a clever title).  On Feb 18^th, 2 weeks after having my baby daughter (Zoe), I was contacted by one of Dr. Oz’s researchers who told me Dr. Oz wanted to do a segment on Vaginismus, an involuntary spasm of the muscles surrounding the vagina. The spasms close the vagina making everything from inserting even a Q-tip to a pelvic exam and intercourse virtually impossible.

I was thrilled because this subject, along with all the other pelvic floor disorders, needs to be publicized, so that everyone knows it is a true diagnosis, that there is a cure and that it is not just ‘in your head.” 

Dr. Oz’s researcher told me that he knew nothing about the topic and didn’t realize that it even existed.  He was shocked when I told him the prevalence: that one in four women suffers from Pelvic Floor Dysfunction (Prevalence of Symptomatic Pelvic Floor Disorders in US Women JAMA. 2008; 300(11):1311-1316).  He was even more surprised when I mentioned how little the medical community apparently knew about vaginismus and pelvic floor disorders and how successful physical therapy is for treating these conditions.

I sent the researcher the book I wrote, Heal Pelvic Pain, and spent more than six hours explaining vaginismus and pelvic floor dysfunction, what vaginismus is, what and where the pelvic floor is, what pelvic floor dysfunction is, how to diagnosis these conditions, their signs and symptoms, the prevalence, the causes, treatment options (including manual therapy, relaxation techniques, biofeedback, stretching, strengthening, muscle re-education, etc), and more.

I asked the researcher what my role would be on the show, since vaginismus is primarily a muscle disorder and physical therapists are the experts in the musculoskeletal system. The researcher said he was not sure yet, that he had to confirm the script with Dr. Oz and the editors. I was concerned because this is a major issue that needed PT expertise and I wanted to be sure it was all properly reported and all the questions answered.

The researcher finally called me back saying no PT would be featured in the segment and, from my personal perspective, the show would not credit my book, nor the information I provided.

However, he said, the show was being filmed the next day, Feb 23^rd, and he could offer me VIP passes.  I responded that wasn’t addressing the issue, but said I would be happy as long as the show promoted the awareness and the importance of a proper diagnosis and proper treatment, with physical therapy being the number one treatment for muscular disorders, such as vaginismus.  He responded that the segment will be ‘very good’.

I was, and still am, thrilled that the subject was airing on national television, but I was less than thrilled that they didn’t talk about the importance of physical therapy, which I stressed over and over again.  The focus of the segment was on biofeedback, which is just a small piece of this complex puzzle. The thing I feared most was mistakes. The informational script I provided was the show, except there were a few mistakes made, and that was my overarching concern.

The biggest mistake was that Dr. Oz stated that “your doctor will do the biofeedback.”  I believe most doctors do not even know that there is such a thing as biofeedback for the vaginal or rectal muscles.  And, I don’t know one single medical doctor that does biofeedback and I know and consult with more than 200 doctors who are familiar with pelvic floor disorders and vaginismus. 

Their comments to me are typically, “I rule out any organic problems and then send the patients to PTs, the experts on musculoskeletal disorders, for a proper diagnosis and treatment.”  Another big mistake that he made was when he suggested you see your OB/GYN for a proper diagnosis and treatment.  Unfortunately, the majority of Ob/Gyns are not educated enough on the musculoskeletal disorders that can occur in the pelvic floor region, in order to give the person a proper diagnosis and treatment plan.  (The pelvic pain community is working on this though.)  The correct suggestion Dr. Oz should have made was that the sufferer should seek out a specialist in pelvic pain and pelvic floor dysfunction and then he could have offered the websites to locate these specialists, such as, but not limited to:

www.pelvicpain.org

www.apta.org/womenshealth/findapt

www.nva.org

www.ic_help.org

My response to the researchers and editors was a pleasant but truthful letter, describing what I have written here.  I expressed my disappointment that they did not have a true expert on the show. I felt I had an obligation to write the letter (pleasant as it was, I was upset) about the lack of recognition for all the time that I spent helping them with the segment.

(I must say, in fairness, the Dr. show added this line to their site where the video of the segment ran: It reads: Special thanks to Amy Stein, MPT, BCIA-PMDB Beyond Basics Physical Therapy, LLC for contributions to this segment. I appreciated that.  You can see the video segment by going to http://www.doctoroz.com/videos/vaginal-panic-attacks

 I also listed 10 different ideas for topics on pelvic floor disorders that they could do in the future with a real expert. By the way, some of these articles are on the gyn site and I will be adding the others over the course of the year. Here they are:

• prostatitis with no infection, which accounts for 95% of prostatitis diagnoses, where the cure is PT (Male)
• pregnancy/post-partum pelvic pain, back pain, incontinence. EDITOR’s NOTE: see articles on this site.
• children that ‘still’ wet their bed or have major constipation issues commonly have pelvic floor muscle incoordination
• better sex for more years—through strengthening exercises
• back pain, sitting pain, tailbone pain, abdominal pain, vaginal, penile/scrotal, rectal pain….
• Bowel disorders: Irritable Bowel disorders, constipation….
• Bladder disorders: leakage, bladder pain, urgency/frequency(what has been called gotta go, gotta go, gotta go)
• Older women and men should know that it is NOT normal to leak because you are older and it is NOT normal to get up more than 1 time at night!!!  These both CAN be muscular problems and PT can fix these musculoskeletal disorders

There are more, but Dr. Oz and his researchers will have to read www.ourgyn.com (March, 2010)