Affording Pelvic Floor Treatment on a Limited Budget

affordable pelvic floor therapy
Dr. Riva Preil with a patient on the Upper West Side, NYC

The Real Cost of Getting Care

Treating gynecological pain is challenging. First, there’s receiving a proper diagnosis, which is often not an easy feat. Next, there is putting together the right medical team. And then, if this wasn’t hard enough, there is figuring out how to pay for it all.

That last part can be the most frustrating. It’s something I touched upon in a prior  blog post, and it’s something that’s fortunately being addressed in the news recently: The Guardian recently profiled Jennifer Vargas, a 35-year-old woman who has shelled out, to date, about $15,000 to treat chronic vaginal pain. That’s a year’s worth of rent in some states!

Why Does It Cost So Much?

So why is it so expensive?

Well, for starters, not all providers will take your insurance. And while it is easy to say, “Just go to someone who will,” you need to have a special rapport with anyone who treats such an intimate part of your body, particularly a gynecologist or pelvic floor physical therapist. You are also seeing them more often than most providers. So while you may be able to ignore it if your in-network dentist is a little short with you during your annual visit, that can be harder to do when you are seeing a pelvic floor therapist for months at a time.

And the fact that you are seeing them so often is another reason why the cost adds up. It could cost several hundreds of dollars a month alone, just on physical therapy, if you can’t find a competent in-network provider.

You may, like Vargas, need to see more than one provider at a time. Or maybe you need medication, surgery, yoga, nutritional guidance and dilators. You may need need to travel, as patient SB who had pudendal neuralgia did. Or maybe you need to pay for childcare while you receive treatment.

On top of that, many with pelvic pain are unemployed or underemployed because they are unable to work or are very limited in their work abilities due to their medical issues and pain.

The Good News: You Have Options

But I’m happy to report there are ways to help you access the care you need and deserve, regardless of your income.

Talk to Your Therapist About Your Budget

First of all, don’t be ashamed to tell your therapist you’re on a budget. Yes, ideally, they may want to see you more than once a week at the beginning, but they might be able to space out appointments and work with you on creating a schedule that fits your budget. You can also do homework with dilators to stay on track in between sessions.

Ask About a Payment Plan

If your therapist doesn’t take your insurance, you should inquire about a billing plan. They may be able to work something out or offer a sliding scale option. Of course, it is never comfortable to discuss money, or lack thereof, and no one wants to be anybody’s “charity case.” But that is not how your physical therapist views it. Your therapist became a therapist because they want to help you get better. I often say in the course of these conversations with patients that I didn’t choose physical therapy to get rich. You know, I would have become a finance bro if that was my goal in life! I became a PT because I genuinely want to make a difference in people’s lives and help them feel better in their own bodies.

This Conversation Should Never Feel Awkward

These conversations shouldn’t be awkward. If they are, and if your PT doesn’t make you feel safe to be vulnerable and raise this topic, you may want to reconsider your choice of PT.

Check Your HR Benefits

If you are employed, inquire with your company’s HR department if there are any stipends allotted towards healthcare. Sometimes your company will provide reimbursement if you show them a receipt. Your therapist will be more than happy to provide that.

Consider Care Credit

Care Credit is a credit card you use to pay for various forms of care, like physical therapy. You pay monthly, so it is less overwhelming.

Save on Medications with GoodRx

GoodRx can make medications more affordable, up to 80%! Coupons are free and accepted at pharmacies you’re already using, like Walgreens and CVS. It’s not health insurance, so you don’t need to apply through your job and your income is irrelevant.

Don’t Skip the Superbill

Superbills are an important part of the insurance process that a lot of people are not familiar with. Even if a provider is out of network, you can submit it to your insurance company. If you have out of network benefits, you may be eligible for reimbursement.

Look Into the Aziza Project

The Guardian highlighted how the nonprofit Aziza Project is helping fund some medical costs for people with complex gynecological problems, so it’s worth looking into, especially considering that they offer free, remote consultations.

Take Advantage of Free Consultations

If you are at the beginning stage of your journey and are unsure about which pelvic floor therapist to go to, take advantage of free phone consultations so you don’t waste money on a therapist you don’t vibe with. This is a service I am proud to offer.

The Bottom Line

It’s easy to feel overwhelmed when you realize how expensive pelvic floor healthcare costs. You might decide it’s easier and more economical to simply live with the pain. But remember that untreated pain has costs too: lost workdays, more money spent on pain medications, missing out on special events.

Yes, it takes a lot of effort to determine how to best afford pelvic healthcare, so much that it can feel like a second job. But the work is worth it when you consider how priceless the end goal is. And, you deserve to feel great in your own body and to live your beautiful life to the fullest.

 

Is Pelvic Pain Preventable?

Can Urinary Urgency, Pelvic Floor Dysfunction and Vaginal Pain Be Prevented?

You’ve probably been hearing a lot about pelvic floor dysfunction and pelvic pain—because people like me don’t stop talking about it (you’re welcome). You may be wondering, “Okay, Riva, we get that YOU see the world through the lens of PFD, but how common is it really?”“Can we talk about preventing pelvic pain?” Let me share some stats.

Research shows that at least a minimum, 30% of women have a pelvic floor disorder. So do 16% of men. Meanwhile, up to 25% of women have vestibulodynia (pain in the vestibule—the area around the urethra and vagina). And nearly 10% of women in their forties suffer from urge urinary incontinence.

Surprised? These aren’t always conditions doctors warn patients about. That’s why I’m here!

The good news? Many of these issues may be preventable. And the tips below aren’t just good for your pelvic floor—they’re good for your overall health and well-being.

Curb Constipation

Straining puts unwanted pressure on the pelvic organs. I’ve treated patients who developed prolapse (organ descent) after years of pushing and using faulty toileting mechanics.

Constipation can feel embarrassing, but there’s no room for shame here. It affects about four million people! You might have accepted it as just the consequence of a busy life, but that shouldn’t be the case! Chronic constipation burdens the pelvic floor, especially when you need to strain or push to pass a bowel movement. 

Remember: peeing and pooping should be passive. No straining required.

Constipation can be occasional or chronic. Chronic constipation may last more than over 12 weeks. Talk to your doctor for a treatment plan, and also consider more water, more fiber, and regular exercise.

If you have irritable bowel syndrome (IBS), you may hesitate to add fiber since it can upset your stomach. If that’s the case, speak with a nutritionist who knows IBS well. They can help you find safe ways to include fiber.

Stop Smoking

We all know smoking is bad news. The biggest fear is cancer, but smoking also increases your risk for pelvic floor disorders.

A 2020 study in the International Journal of Urology found that urgency and urge incontinence were more common in smokers and ex-smokers than in non-smokers. A study in Neurology and Urodynamics also found a possible link between urinary urgency and smoking.

The Michigan Institute of Urology explains why: frequent coughing (common in smokers) puts downward pressure on pelvic organs. Smoking also irritates the bladder—both big problems for pelvic health.

Run Right

Running is fantastic exercise. It can prevent cancer, protect your heart, and improve sleep. But it’s not without risks. One of them is pelvic floor injury.

As I told Runner’s World, good form and proper shoes are essential to protect your pelvic floor. If you’re unsure, work with a personal trainer who knows running mechanics.

One quick tip? Run with a slight forward lean. This prevents excess strain on the pelvic floor.

Choose the Best Birth Control

Thankfully, we live in a time with many birth control options. But what works for one person may not work for another.

Research in the journal Sexual Medicine shows that combined hormonal contraceptives can increase the risk of hormonally mediated vestibulodynia (pain in the vestibule). Why? Because these contraceptives affect estrogen and testosterone levels.

Many of my patients have seen pain improve with estrogen/testosterone creams prescribed by their doctors. Oral contraceptives can also cause other side effects, such as vaginal bleeding and weight gain—factors that may contribute to pelvic floor dysfunction.

The Takeaway

Pelvic floor dysfunction, urinary urgency, and vestibulodynia can be incredibly tough to live with. And yes, some of these lifestyle changes—like quitting smoking—are difficult. But they are possible.

We work hard to prevent heart attacks or skin cancer because we want to live longer. We should protect our pelvic floor for the same reason: quality of life. Both matter.

You deserve a life full of happiness and health—especially pelvic health.

Wanna learn more? Check out my previous blog – How to Press Fast Forward on Your Pelvic Floor Recovery

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732-595-1DPT (1378) | riva@revitalizephysicaltherapy.com

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