Question: I am using Tylenol up to 4000mg per day, plus Ultracet 1 or 2 every 4 to 6 hours as needed for vaginal pain spasms. The dosage depends on the severity of the particular pain spasm, although because I have been on this medication and the tylenol for over three years now, both drugs are less effective this year in the smaller doses.
I would like to know if should consider trying Ultram for the more sever pain and continue with the 1000mg Tylenol for less severe spasms.

If so, what would the appropriate dosage be for the Ultram?

I have already discussed this issue with my primary care physician, several OPGYNs, a Urologist and most recently a Pain Specialist. We have ruled out numerous other medications and this one works well, but I am concerned that I am taking too much tylenol on the worst of days. (Very unpredictable frequency of spasms over the course of any given month, but daily occurrences at best under four, at worst over ten episodes.
I do understand there may be other injections available through the spine, but would prefer to stay with a medication that I can manage myself at home, if at all possible.

I would like to know what a doctor who specializes in treating pain in the vaginal pelvic area would recommend about dosage for this particular medication.

Thank you,

Thank you for your prompt and comprehensive reply.I will try the Ultram at 100 mg per acute spasms, up to four times per 24 hour day.

I am trying an oral muscle relaxant for more moderate discomfort, but it puts me to sleep almost immediately, so only good at night.

Thanks again.