Pelvic Pain Unpacked, Episode 7 — with Tamar Hill and Dr. Charity Hill, MD
🌿 Key Takeaways
- Pelvic floor dysfunction comes in two forms — hypotonic (too loose) and hypertonic (too tight) — and the treatments discussed here apply specifically to the hypertonic, discomfort-causing type.
- Valium (diazepam) suppositories are the most commonly prescribed treatment for hypertonic pelvic floor dysfunction, but come with significant concerns: sedation, tolerance, dependency risk, and major prescribing barriers.
- CBD suppositories work on both skeletal muscle (the pelvic floor) and smooth muscle (the uterus), while also reducing inflammation — without sedation, tolerance, or addiction risk.
- Access to care is one of the biggest challenges in pelvic health — CBD suppositories are available without a prescription, which breaks down a significant barrier for people who can’t find or afford a prescribing physician.
- Magnesium, combined with CBD in a natural suppository base, is a well-tolerated alternative to pharmaceutical muscle relaxers like Baclofen — and addresses a common mineral deficiency in pelvic floor patients.
If you’ve been dealing with chronic pelvic discomfort and your doctor handed you a Valium prescription — or if you’ve been searching for something that actually works without knocking you out — this conversation is one you need to hear.
In Episode 7 of Pelvic Pain Unpacked, host Tamar Hill of MedRoots — a company specializing in CBD products for pelvic discomfort relief, muscle discomfort, menopause support, wellness, and increasing pleasure — sat down with co-host Dr. Charity Hill, a physiatrist and pelvic pain specialist who also serves as MedRoots’ medical advisor. Dr. Charity Hill started her career in pain management and, over time, evolved into a focused specialty in pelvic care.
Together, they walk through exactly what pelvic floor dysfunction is, why the conventional pharmaceutical approach has so many limitations, and how CBD suppositories became a clinically grounded natural alternative — not out of trend-chasing, but out of years of watching patients struggle with inadequate options.
What Is Pelvic Floor Dysfunction — And Which Type Are We Talking About?
Pelvic floor dysfunction is an umbrella term. It simply means the pelvic floor isn’t working correctly — and there are two very different ways that can happen. Both males and females have pelvic floor muscles, and dysfunction can affect anyone.
Dr. Charity Hill: “There are two main ways it doesn’t work right. One is the pelvic floor just kind of stops wanting to contract — that’s painless, and usually the main symptom is urinary leakage. The other is when the pelvic floor is too tight. That’s the one we’re focusing on today.”
The first type — hypotonic, or too loose — is most common after childbirth. The pelvic floor muscles are too weak to hold properly, leading to leakage during high-pressure activities like sneezing, coughing, running, or jumping on a trampoline. In more significant cases it can progress to prolapse, where the support structures become so weakened that organs begin to descend. Prolapse is uncomfortable and disruptive, but typically not discomfort-causing in the traditional sense — and the medications discussed in this episode will not help it.
The second type — hypertonic, or too tight — is where chronic pelvic discomfort lives. The pelvic floor muscles are stuck in a state of excessive tension or spasm, and the symptoms that follow include discomfort during intercourse, burning sensations in the pelvic area, overactive bladder with urgency and frequency, difficulty starting urination, and trouble with bowel movements.
This is the type that Valium suppositories, compounded pharmaceuticals, and CBD suppositories are designed to address. And it’s important to note: always see a doctor first to determine which type of pelvic floor dysfunction you’re dealing with before pursuing any treatment.
The Traditional Pharmaceutical Approach — And Its Problems
For patients with hypertonic pelvic floor dysfunction, the most commonly prescribed intervention is a Valium (diazepam) suppository. Diazepam is a benzodiazepine — a class of drugs used as muscle relaxers and to manage tension and stress-related conditions — and it’s inserted vaginally or rectally to directly target the muscles of the pelvic floor.
On paper, it makes sense. In practice, Dr. Charity Hill has a long list of concerns with it.
Sedation is the biggest one. Patients are often in the most discomfort when they need to sit for work, care for children, or get through a normal day — and a medication that impairs their ability to function isn’t a real solution. For patients who take it rectally (either because vaginal administration isn’t tolerable or because they’re male), systemic absorption makes sedation even more of an issue.
Then there’s the tolerance problem. Benzodiazepines are pharmacologically known to become less effective over time as the body adapts. And where tolerance develops, the risk of dependency follows. Benzodiazepine withdrawal can be genuinely dangerous, and Dr. Charity Hill is direct about the fact that she doesn’t want to put patients in that position.
The prescribing logistics add another layer of difficulty. Because diazepam is a controlled substance, many states require paper prescriptions, multi-factor authentication, and frequent renewals — creating a heavy administrative burden that makes many physicians reluctant to prescribe it at all. It’s also not an FDA-approved use of Valium, which means prescribers can be audited for using it this way. And for patients whose jobs require drug testing — law enforcement, certain healthcare roles — benzodiazepines in their system simply isn’t an option.
Other compounds sometimes used alongside or instead of Valium include Baclofen (another muscle relaxer, widely tolerated but also sedating), gabapentin (formerly a controlled substance, can cause burning sensations when applied topically — an unfortunate side effect for patients already dealing with pelvic burning), and nerve discomfort agents like duloxetine. In practice, these are often combined into what Dr. Charity Hill describes as a “witch’s brew” — multiple ingredients layered together because both patients and providers are desperate for relief.
The Full Spectrum of Treatment Options
Pelvic floor dysfunction treatment follows a general escalation from least to most invasive:
Mindfulness and meditation sit at the entry level. Pelvic floor physical therapy is considered the gold standard for both types of dysfunction — a skilled therapist can identify whether you’re hypotonic or hypertonic and treat both effectively through hands-on manual therapy. The limitation is access: urban areas often have months-long waiting lists, and rural areas may have no providers at all.
From there, the escalation moves through local medications like suppositories, oral medications for nerve discomfort, injections and nerve blocks, Botox injections (administered intravaginally, with a risk of flipping from hypertonic to hypotonic and causing urinary leakage — not offered to males), and surgery at the most extreme end when a structural issue like endometriosis, a cyst, or a hernia is identified through workup.
Dr. Charity Hill is clear that CBD suppositories fit into the suppository tier of this spectrum — a targeted, local intervention that can bridge the gap while patients wait for PT access or navigate a care system that often moves too slowly.
Why Diagnosis Takes So Long
Getting an accurate diagnosis for pelvic floor dysfunction is harder than it should be, and the healthcare system’s incentives don’t help. The pelvis is complex, the conditions within it overlap significantly, and there’s often financial pressure on providers to see patients quickly and move on.
Dr. Charity Hill: “There is a lot of what I would call medical PTSD that people show up into my office with — because they’ve been dismissed, invalidated, or not believed.”
The diagnostic path typically involves being bounced between gastroenterology, urology, and gynecology, with imaging that frequently comes back normal and no clear answer at the end. Interstitial cystitis — a discomfort condition of the bladder — is one of the most frequently misdiagnosed conditions in this space.
Her recommended strategy: find a pelvic floor physical therapist first, even before you find the right physician. PTs in this specialty tend to have a strong local network of physicians who actually understand and take seriously pelvic conditions. If you’re navigating care in an area Dr. Charity Hill doesn’t serve, she’ll often say: “Find your pelvic floor PT — then build your specialist network off of theirs.”
For finding a qualified pelvic PT, she points to pelvicrehab.com, the Herman and Wallace website. Their training program is well-established, thorough, and emphasizes the manual therapy that patients actually need. Another resource for finding discomfort-focused physicians is the International Pelvic Pain Society.
How CBD Suppositories Entered the Picture
The origin of Dr. Charity Hill’s interest in CBD for pelvic floor dysfunction traces back to a medical conference around 2016–2017, where a physician from Chicago presented data on CBD suppositories for dysmenorrhea — severely discomfort-causing, disabling periods. The presentation focused on the abundance of cannabinoid receptors on the cervix and showed compelling results: CBD suppositories significantly reduced menstrual discomfort in the vast majority of patients treated.
The data was never published — at the time, CBD was technically illegal, and legal restrictions likely prevented formal publication — but the clinical logic resonated immediately.
Dr. Charity Hill: “I knew cannabinoids worked as an anti-inflammatory and as a muscle relaxant. It clearly works to control both skeletal muscle and smooth muscle contractions. So I was very interested, but I didn’t know how to get them.”
This is a good moment to explain the muscle science, because it matters. The body has three types of muscle: cardiac (the heart), smooth (involuntary — lines the esophagus, uterus, and digestive tract), and skeletal (voluntary — the muscles that move your body, including the pelvic floor). CBD acts on both smooth muscle and skeletal muscle, meaning it addresses both uterine cramping and pelvic floor tension simultaneously. It also carries anti-inflammatory effects on the nerves throughout the pelvic region — bladder, uterus, and pelvic floor included.
The pelvic floor, as skeletal muscle, can technically be consciously controlled — but most people have never learned how, and when someone is in the midst of a discomfort-spasm cycle, that conscious control may not be accessible until the cycle is interrupted. That interruption is part of what CBD can help facilitate.
From Pharmaceutical to Natural: How the MedRoots Formula Evolved
After the Farm Bill passed in 2018 and CBD with low THC became federally legal, Dr. Charity Hill was eventually able to source CBD suppositories through a compounding pharmacy. Initially, she used them in combination with Baclofen. Over time, she began experimenting with removing the pharmaceutical components — and found the CBD alone was equally or more effective.
She replaced Baclofen with magnesium, a natural mineral and muscle relaxant that is extremely well-tolerated and addresses what she observes as widespread magnesium depletion in her pelvic floor patients. The result — CBD combined with magnesium and hyaluronic acid in a plant-based cocoa butter base — became the foundation of MedRoots’ suppository line.
By the time COVID lockdowns arrived and telemedicine restrictions were temporarily lifted, the formula was ready. Dr. Charity Hill could suddenly see patients across the country via telehealth — and because CBD is not a controlled substance, she could recommend MedRoots products without the prescribing barriers that made Valium so difficult to access. It became a way to reach people who had no local provider willing to help.
CBD vs. Valium: Why It Matters for Pelvic Floor Patients
The practical differences between Valium and CBD suppositories for pelvic floor dysfunction come down to a few core factors.
Sedation is minimal with CBD. Dr. Charity Hill reports that the vast majority of her patients tolerate it well during daytime hours — though she always recommends trying it at home first, just in case. There is no tolerance development and no addiction concern. It is not a controlled substance, requires no prescription, and is available to anyone — including people in rural areas, people who can’t find a provider, and people who have been waiting months for a PT appointment.
For people with a history of substance use or those who are drug-tested for work, CBD offers a path that Valium simply cannot. THC-free options within the MedRoots line are available for anyone who is highly THC-sensitive or concerned about drug test results.
The cost comparison is also relevant. Compounded pharmaceutical suppositories — Valium, gabapentin blends, Baclofen combinations — are rarely covered by insurance because they are not FDA-approved in their compounded forms. At $10 or more per suppository depending on location, the cost adds up quickly. HSA and FSA accounts may be usable for compounded pharmaceuticals; as of the April 2026 recording of this episode, they cannot yet be used for MedRoots products — but the over-the-counter accessibility and competitive pricing remain significant advantages.
Dr. Charity Hill: “Knowing that there’s something out there that people can buy over the counter with a suppository that may give you relief — that’s a really powerful thing for when you’re feeling powerless and in discomfort.”
One important note: CBD suppositories are not appropriate during pregnancy or while nursing. That topic deserves its own dedicated conversation, and the team flagged it for a future episode. And as with any intervention, they don’t work for everyone — nothing does. But for the many people who respond well, the feedback Dr. Charity Hill and Tamar Hill receive is consistent.
Tamar Hill: “I get emails every day — ‘Oh my gosh, this is a game changer for me.’ That’s really why we do this.”
Ready to Explore a Natural Alternative?
If you’re living with hypertonic pelvic floor dysfunction and looking for relief that doesn’t require sedation, a controlled substance prescription, or months on a waiting list, MedRoots has options designed with exactly your situation in mind. Our CBD suppositories — made with plant-based ingredients, magnesium, and hyaluronic acid in a cocoa butter base — are available without a prescription and trusted by pelvic health practitioners across the country.
📞 Call us: 833-797-7576 🌐 Contact us online: medroots.com/pages/contact
You deserve relief that lets you still live your life. Let’s find what works for you.
This article is based on Episode 7 of Pelvic Pain Unpacked featuring Dr. Charity Hill, MD, physiatrist and pelvic pain specialist. It is for informational purposes only and does not constitute medical advice. Please consult your healthcare provider before making any changes to your health or treatment regimen.