I wrote about a flare-up a couple of weeks ago.
After a flurry of doctors' appointments and tests with my neurologist, gynecologist and physical therapist, as far as we can tell the pain is stemming from neuromuscular aggravation and some dryness.
As is typical for my pelvic health history, it was diagnosis by triangulation - using input from multiple health professionals to rule out various possibilities - and come up with the most likely scenario.
I'm now waiting for the compounding pharmacy to make me a new batch of topical estradiol, and will resume some gentle stretching and relaxation techniques that I've learned from my PT.
My gynecologist and I use a compounding pharmacy because the standard estradiol creams use a number of unpronounceable chemical ingredients as a base. To avoid the possibility of the base making things worse, I get my estradiol in a base of my choosing, in this case, organic shea butter. It takes longer to get since the pharmacists make it to order, but it is worth the wait. Not only do I greatly reduce the risk of irritation, but if my skin does get irritated it will be much easier to find the culprit with only two ingredients to consider (estradiol and shea butter) instead of ten.
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Notice how all of the actions I am taking are based on educated guesses. My neurologist, gynecologist and physical therapist all wish that they had one straight answer for me, but that is not how the human body works.
As a result, I assembled my treatment plan using suggestions from different sources: the estradiol cream from the gynecologist, the exercises from the PT, and I'm monitoring my symptoms for my neurologist to see if any of my medications may be involved.
As my PT reminded me at our appointment this morning, the best thing I can do is proceed calmly and without catastrophizing. Hopefully in a few weeks this will pass on over and I will be feeling just ducky in no time.