Looking for a professional gynecologist in Bangkok to help with my dyspareunia

[star22]

So for a while I thought I had vaginismus but I went to a pelvic floor specialist in BNH and they said I was fine.

Since then my pelvic floor muscles are still tense and I suffer from dyspareunia.

Are there any specialists that can help me with this?

I also suffer from incontinence and constipation - not sure if that's related.

[Sheryl]

How old are you/are you past menopause? If so are you on HRT?

 

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[star22]

Im 25 haha, had no kids

Ideally I'm looking for a doctor who can help me overcome the dyspareunia using dilators and a bio-feedback mechanism? Not just telling me that everything's fine and then having the problem still persist at home...
 

[Sheryl]

 

Treatment has to be directed at the underlying cause.  So, atrophy can be ruled out. But I am puzzled by your statement implying vaginismus was ruled out. It cannot be ruled out by a doctor's examination and having found no abnormalities of the pelvic floor makes vaginismus more, rather than less, likely. Can you clarify why you think it is not vaginismus? Dilators and bio-feedback are used specifically for dyspaeurnia due to vaginismus and will not help if it is due to other causes.  Botox injections can also be helpful with vaginismus.

 

Are you adequately lubricated?

 

Is the pain near point of entry or deep inside?

 

Do you have painful cramps during your periods?

 

Any pain on urination?

 

 

[star22]

The pelvic floor therapist in BNH told me it wasn't vaginismus upon inspection - apparently.
 

Are you adequately lubricated? Yes

 

Is the pain near point of entry or deep inside? Entry

 

Do you have painful cramps during your periods? No

 

 Any pain on urination? No

Thank you for taking your time to investigate this btw ????

 

[Sheryl]

No way they can know this on inspection that I am aware of. They can verify that there is not a spasm at the time they examine you, does not mean there is not when you have sex.

 

However if it were vaginismus your partner would find penetration difficulty/feel resistance trying to go in.

 

If that is not the case then, given the pain is at entry point,  it may be vulvar vestibulitis AKA vulvodynia. Which is a fancy term for pain at the entrance to the vagina of uncertain cause. even in the West it is hard to find Gyns with much interest/experience in this and I don't know any in Thailand.

 

I suggest you try consulting Dr. Donna Robinson, a British GP, as GPs also encounter this.

 

https://www.medconsultasia.com/

 

You might also try a course of empiric treatment for yeast as one theory about this is that it is an over-reaction of the nerves to yeast.

 

Also look at what soaps you use and avoid anything other than pH approrpriate vaginal washes (non-perfumed).

 

 

[star22]

I already went to her, she said I had bacteria vaginosis but then it cleared and the problem persisted. Personally, I didn't really like the vibe from her clinic, she seemed rushed and unprofessional - trying to upsell me on various things. This may be only my personal experience but I have already visited her anyway.

I've had this for all of my life, and based on what you wrote above I'd be interested in getting a proper test done for vaginismus.

Any gynecologists you recommend in Bangkok?

[Sheryl]

There aren't any tests for vaginismus. It is a diagnosis based on clinical symptoms and exclusion (ruling out any other cause).

 

The ruling out other causes, you have already done.  If in addition to your feeling pain, your partner experiences difficulty in penetration (finds it hard to enter, has to push very hard) then that would tend to confirm the diagnosis.

 

I do not know of any gynecologists in Thailand with special interest or experience in treating vaginismus, unfortunately.

 

There are some plastic surgery  clinics which do  botox injections for vaginismus. 

 

https://www.kamolhospital.com/en/Vagina-Vulva-Surgery/Vaginism

does both  desentitization treatments and botox.  I have no feedback on this place but you could try it.

 

Although not specifically mentioned on their website there is also a good chance that Yanhee hospital has someone who can help, and you can do online consultations with them. This is a well known reputable hospital   www.yanhee.net

 

[star22]

Okay thanks, I'll look into it.

Anywhere you recommend to get a cervical cancer swab, that's not too expensive?
 

[Sheryl]

Any gyn can do a pap smear/thin prep.

 

The least expensive private option I know of is Medconsult Asia (1,650 baht for pap alone,  2950 for Pap + HPV, all inclusive) but as you indicate you don't like to go there then best I can suggest is St Louis Hospital. Will cost about twice that unless you do it as an add-on to a general check up package, as you'll  have a doctor's fee and hospital fee on top of the test cost.

 

Or else government hospital but will entail very long, crowded waits, language barriers and a lot of red tape.