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.

 

Sex after Abstinence: Why It Doesn’t Have to Be So Scary

Introduction

Being in a relationship is something to celebrate! But having sex after you’ve been abstinent (for example, because it’s your first time, because you’ve just had a baby, or because you had a medical procedure) can feel scary. This anxiety is perfectly valid because it’s based in reality. Yes, real psychological and physical challenges can arise when you have sex again. But you don’t have to be scared. You just have to be prepared!


Why Sex Might Feel Painful After a Break

Similar to the nerves many first timers feel, you might worry that sex will hurt when you resume it after a break. A lack of lubrication and increased anxiety—which is completely expected—can make sex feel physically painful, according to Romper. Fixing lubrication is pretty self-explanatory, but anxiety can feel more complicated.

We all reduce stress in different ways, but some general recommendations include mindfulness, yoga, and exercise. You may also want to tell your partner that it has been awhile. They should know how to make the experience less stressful. And if they don’t, don’t be afraid to tell them.


Returning to Sex After Pain or Diagnosis

Returning to sex after a pain diagnosis can feel even more complicated. First, ask yourself: are you even ready to return? It’s ok if you’re not.

Chronic pain does not erase your libido on its own, but pushing through pain can create negative associations with something that should feel fun and enjoyable. Fear and anxiety can also cause your muscles to tighten instinctively. This is your body’s way of trying to protect you. That tightening can make sex even more painful, and the cycle continues.

And THAT can be a real libido buster, because who wants to participate in an activity that hurts? (My blog post on dyspareunia is particularly helpful here.) You should talk to your medical team and pelvic floor physical therapist about exercises that can help you prepare, such as dilator work and hip stretches.

In addition, if a hormonal component contributes to your pain (for example, as some women on prolonged birth control may experience), or if you are postmenopausal, you may benefit from estrogen or estrogen/testosterone creams.


Bleeding with Sex: What It Can Mean

Believe it or not, bleeding with sex is not limited to only the first time. Many things can cause postcoital vaginal bleeding in sexually active folks, including more serious conditions like cancer and pelvic inflammatory disease, according to the Mayo Clinic.

However, you may simply need more lube, more foreplay, or a different type of birth control that isn’t hormonal. There may also be no clear reason! Although it can feel embarrassing to talk about, you should always tell your doctor if it’s happening so you don’t miss an important diagnosis.


When Desire, Identity, or Emotions Shift

At any point in your sexual life, you may notice less desire than you used to. You may also experience challenges related to trauma, shame, orientation, identity, or addiction. The person you were when you were having sex at 25 may not be the person you are when you return to it in your late thirties.

This is where a psychologist or sex therapist can help. Sex therapists are real healthcare professionals trained to support people with a wide range of concerns, from lowered desire to difficulty maintaining an erection.


Final Thoughts

Sex is one of the most beautiful parts of being human, but it should never cause pain. It may feel silly to prepare for it, but remember: you can’t fully engage in loving someone else before you love and care for yourself first!

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

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