BOTULINUM TOXIN FOR VAGINISMUS
Many of us are familiar with the use of botulinum toxin as a treatment for cosmetic reasons; it relaxes the muscles in the face so that smile lines and deep wrinkles do not appear. But it is the very action of releasing muscle tension that has led to its success for use in treating vaginismus. The botulinum toxin injections are administered to the muscles in the vagina which makes the muscles unable to tighten.
Over the last 10 years I have tried to have intercourse, but it had never been successful. It’s as though it gets to a certain point and then they cannot pass through; it feels like a brick wall. It isn’t that I have any fear around penetration, it just doesn’t work. Also, tampons were impossible.
When I saw my gynecologist 4 years ago, it was a nightmare!! The doctor could not get the speculum in, and I have been trying to stay away from gynecologists since then.
I have tried dilators for this problem, and actually went online and purchased a kit of them, but it was useless. I was never even able to insert even the smallest one. I found Maze Women’s Sexual Health online, and made an appointment to have the botulinum toxin procedure for vaginismus.
Once I had the procedure done, Melissa at Maze recommended that I follow up with physical therapy with dilators. I did, and I was able to put the small one in! From there, I continued to be able to get larger dilators in.
One of my guy friends knew that I was having the botulinum toxin procedure done, and he agreed to be my guinea pig to see if it was possible. I am happy to tell you that I accomplished it!!! It was difficult, and I did have stinging and it wasn’t very enjoyable, however, I DID IT. The hardest part was the initial insertion and towards the end the stinging had began to subside which makes me confident that after a few tries I may actually be able to enjoy sex like a normal adult. I am so happy; I honestly never thought this would be possible, especially after trying to climb off the table the day at Maze when Melissa tried to insert the little blue dilator!
I want to thank Melissa and everyone at Maze for helping me overcome this. It sounds so stupid that something like not being able to have sex can be so debilitating, but it really is. I know feel like I will be able to have a healthy relationship with someone one day and not just push everyone away. You all should be really proud of yourselves about what you do everyday.
– HS, Age 28 –
I am 24 years old, and have been living with vaginismus for as long as I can remember, though for the majority of that time I didn’t realize it. I always knew that I felt differently about having sex than many of the people around me as we got older and our sexuality became something that, in our teenage years, my friends and peers became more interested in. When tracing the roots of my vaginismus, I know that my experience with my first boyfriend, when I was 13, is a major factor. He was older than me, and as we became more attached to each other he became more controlling and abusive in physical, emotional, and sexual ways. Being so young and confused it seemed impossible to get away from him, and it very much shaped my early sexual feelings in a way that included fear, guilt, shame, anger, and pain.
During all of my relationships after this I became more interested in being sexual, but without ever having intercourse. I was able to enjoy sexual interactions but always avoided having sex, and never fully explained to my partners why, because I didn’t understand it myself. As I got older I was unable to avoid the fact that we were not having sex, but when I thought about it I imagined a painful and invasive experience that immediately turned me off in every way. My instinct to just avoid sex became involuntary and a reaction that was entangled in my mind as well as my body. I never used tampons, rarely even tried to insert anything inside of me, and avoided doctors appointments that would include this. My first gynecologist appointment that was to include a pap smear was a failure, because the doctor wasn’t able to put even her finger inside of me. Simply being at the doctor’s office and attempting this made me anxious, nauseous, and unable to relax at all. The doctor didn’t tell me anything other than “You just need to learn to relax, or it won’t work” and I always left the appointments feeling like a failure but not knowing why.
When I was 23 this issue came to a head when I started a new relationship and was sick of lying about my issues, hiding them, and constantly obsessing about them. I obsessed every day, endlessly about it. It made me miserable and took a toll on my self-esteem in ways that I couldn’t stand to live with. I finally took the steps and found a therapist who I told the entire truth to, the first time I ever told someone out loud what was going on, which was really the first step because it somehow made it even more real.
After a few months of therapy I found out about the Maze Women’s Sexual Health while researching treatment options for vaginismus online, and heard about the botulinum toxin treatment. I read everything I could about it, talked to my doctor about it, and scheduled a phone appointment (since I don’t live in NY). It was very difficult to do, though it seems like such a simple thing. I was afraid and intimidated to face this issue, to keep telling my history to new people, and to take the risk of a procedure I’d never heard about before. After the phone call I had all of the information about the procedure, what would happen, how much it would cost, and felt generally more comfortable with the idea. The doctor I spoke to was almost able to guess my history immediately, the reactions I got from previous doctors, my fears about physical intimacy, and how much of a stress it put on my mind and relationships. She was so positive that I was a great candidate for the procedure and assured me that I should not be afraid, which put my mind at ease more and more. My main concerns that were a factor in my decision were that the procedure would somehow not work, it would be difficult to afford because my insurance didn’t cover it, I would have to travel to get there and spend two nights in NY, and mostly that I was still afraid to have to physically deal with this issue because of how long I had avoided it. Even though I was still very skeptical and unsure I finally decided to commit to going through with it.
The staff at Maze Women’s Sexual Health was very helpful in my decision-making process and went out of their way to assist my financial concerns and finding a place to stay before and after the procedure. I had my pre-op blood test and check-up at my local family doctor and was cleared for the procedure a week before going to NY. My mother and I drove to NY the day before the surgery, and the next morning we went to the surgical center. I was so nervous and still apprehensive about what to expect, though it had been described to me in detail I was still afraid because it was hard for me to imagine how it would feel because I always associated my vagina with nothing but pain.
At the surgical center a nurse from Maze, who I had previously been in contact with and felt comfortable with, got me ready for surgery and helped to keep me calm and relaxed before hand. She gave me a simple external check before the operation and I was sedated. While I was knocked out, there was an incision made in my hymen, I was given a topical anesthetic, botulinum toxin was injected in my vaginal walls to stop my muscle spasms, which allowed the largest vaginal dilator to be inserted. I was also given a pap smear, which was helpful because I was never able to go through with one without sedation and should have had one years before. When I woke up the nurse was there to help me learn to remove and re-insert the dilators, and I was amazed at being able to do this without pain for the first time in my life. I spent the day recovering with the dilators still in, which was somewhat painful as the sedation and anesthesia wore off, but it was manageable and worth it when I was able to fairly comfortably remove and reinsert the dilators as I needed to. That was the moment when I was finally able to face the fear of something being inside of me, and realize that if I wasn’t afraid of it and didn’t expect it to be painful it was completely manageable. I had a post-op appointment the following day with Melissa where she checked my progress with the dilators and helped me be more comfortable with them, and answered all of the many questions I had about what to do from that point.
In the four weeks since then I have, generally, used the dilators every day and it has gotten easier each time. Two and a half weeks after the procedure I had sex for the first time. It took some patience and preparation, but like using the dilators, it has gotten easier and easier every time after the first. I am currently making the transition from dilating often to having sex often, and I have never felt better or more confident about myself sexually. I have had multiple check-ins by phone and email with the doctors at Maze Women’s Sexual Health and they have been so supportive about my progress. The turning point for me after the procedure was learning to change my thinking, not changing my body physically. When I began to believe that I was capable of adapting to this process, it got rid of my fears about being in pain and gave me the ability to relax my body. For anyone considering this procedure or some type of vaginismus treatment, my best advice would be to consider what you would do about it if you weren’t afraid of your previous perception of the mental and physical pain associated with your body. My answer to that question was that I had to take the risk, and have faith in my ability to allow something new and good to happen in place of the memories of pain and discomfort. It hasn’t been an easy process in any way, but it’s been a completely rewarding one that I am so proud of overcoming.
– L, Age 24 –
I got married in May 2010. I had a very interesting sexual relationship with my partner before getting married, but we never tried to have intercourse. During our honeymoon we tried many times to have intercourse, but failed. Our sex life continued to deteriorate, every time we got in bed it started to feel like we were trying to execute a mission which always fails, so we stopped trying so much. After 6 months or so, I visited two gynecologists. One of them referred me to a therapist who started introducing me to the idea of dilation. We started with the smallest size which went fine and then she gave me the bigger dilator with which I could not dilate. At this time she has also identified me as a vaginismus patient. My husband started googling causes and treatments, and he found Maze Women’s Sexual Health and the botulinum toxin treatment they offer. First it sounded scary, but at the time I had no other option. I was losing all my self confidence and I felt like a freak that could not open her legs to anything, not even for a medical exam or even inserting a tampon.
I went there for first appointment, where I met with amazing doctors. They very friendly and very professional and they identified me as a vagnisumus patient as well, and offered me two kinds of solutions – one was continuous dilation and the other was the botulinum toxin which I had originally called about. They explained the procedure to me. Four months later, I scheduled the surgery and had the surgery, which went very smoothly. I was then able to start dilating with larger sizes of dilators which I never imagined I would be able to do, which led successfully to intercourse.
It took me and my husband a lot of research and courage to be able to go through this process because I live in a country where I had never even heard of botulinum toxin. I know it sounds like a cliché, but Maze Women’s Sexual Health changed my life. I am finally a normal woman and my relationship with my husband went back to magnificent again.
Finally, I just want to thank all the Doctors at Maze. Everyone I met has been a great help and I am really comfortable talking to them. I felt at ease the moment I stepped into the center for my first appointment up to this moment. Special thanks to Melissa who has been supportive all the way and an amazing friend.
– N, Egypt –
As with most major decisions or problems, it is not normal to find the right solution in the first place you look. By the time you find the Maze Women’s Sexual Health website and possibly read this testimonial, you will be ready for anything.
Please be willing to call the team at Maze to set up an initial consultation. You’ll start the process that I have just finished and I guarantee that every dollar you invest on travel to visit the office and to have the vaginismus (botulinum toxin) procedure will result in a wealth of happiness for you and your partner.
Like I mentioned, I just finished the treatment process with the assistance of Dr. Werner, Melissa and the others in the Purchase, NY office. Allow me to explain further…
My body was locked: like the barred gates of the Citadel. Nothing was going in and it was surprising that anything came out. By nothing I mean that growing up I never used a tampon, so this problem dates back for 16 years. Even when the time came for gynecological exams, the experience was excruciatingly painful and draining.
This fear of penetration and automatic tightness followed me to my honeymoon. One would expect a magical night of romance and hot passion. My husband and I simply looked forward to the hot breakfast buffet at the hotel where we were staying.
Over the course of our marriage, I attempted to solve my inability to have sex every which way: from discussing it with my family doctor and analyzing the issue with a handful of therapists, to reading books on intimacy / sexual desire and completing workbooks by delving into “attitudes and beliefs” / “misunderstandings” about sex.
After years of seeking out various attempts to solve this problem, my patient and supportive husband did a five-minute Internet search and came across Maze Women’s Sexual Health. It was at that point the trumpets blared, the choir sang and Vegas neon lights appeared around the computer screen. I exaggerate, but you can imagine how hopeful we both felt about this procedure.
I actually cried when I read the informational packet that was emailed to me, because I could not fathom having sex without pain.
Fast forward three months to my first appointment at Maze. Since I was traveling from out of town, the approach for my procedure was expedited. The first appointment included a physical exam and explanation of what to expect.
The following day the procedure was scheduled, where Dr. Werner and his staff did such a professional job with the entire procedure. I actually awoke from the anesthesia with a 6” dilator inside of me; by far the largest thing ever to break into the barricade.
Following the procedure, Melissa spent time with me individually to have me become acclimated in practicing with the various sized dilators. My reaction to the entire process was that I was simply floored.
I couldn’t believe how well I responded to the procedure and could get things to work. Imagine: no more pain or discomfort. At this point the worse thing going on was that I looked like a penguin, waddling around town with a dilator inside as I walked. That’s nothing!
One week after the procedure, my husband and I had sex for the first time. We are a little awkward in our movements, but with plenty of desired practice we will be just as good as the professionals. I truly appreciate my husband for his support and actually discovering this process exists.
The time and effort spent after the procedure is very important, especially in consistently using the dilators. The botulinum toxin lasts approximately three months, so we’ll see what happens at that point* I can definitely say that this process is producing more confidence in me, which is positive to apply to all areas.
Although I wish I could have come to Maze Women’s Sexual Health sooner, I am definitely glad to be at this point in my life.
Many thanks to Dr. Werner, Melissa and the Maze staff!
– C, Age 28 –
I am a 28 year old who never had intercourse in her life. I’ve been this way always. I was afraid of the pain, and getting pregnant. I had been afraid that there was nothing anyone could do.
At the last visit I made to my Gynecologist, he told me that it was all in my head…that I just needed to relax and it would happen.
That made me feel worse because I knew it was not that easy for me to just let it happen.
My boyfriend of 11 years, yes 11 years, was watching a show one day where they talked about many things including couples that were dating or were married for years and could never have sex. He told me about it and I started to cry. I thought I was the only one going through this, how selfish was I?
After he went to bed I decided to Google more info about this other couples. After searching, I bumped into an article that talked about Vaginismus, a condition that does not allow you to have sexual intercourse. I was amazed about the number of women that were going through this.
I was researching online for a place where I can find someone to talk to; a professional that could help me and my boyfriend get through this once and for all, and I found Maze Women’s Sexual Health.
I felt weird right before I made the phone call, but at the same time I was extremely excited and hopeful to find a solution to this problem I was having. I was also a bit nervous on my first appointment, but everyone was so nice and friendly that I felt at ease right of way
Since the dilators didn’t work out very well for me. I decided to go for a more unconventional treatment. The botulinum toxin treatment was the best approach for me because it helped me overcome the fear of having something in my vagina.
The treatment went as follows:
They put me to under conscious anesthesia for a procedure that took about 15 to 20 min.
After putting a topical anesthetic in my vaginal walls the doctor injected the area with botulinum toxin. After the muscles relaxed a large dilator was inserted and I woke up with it already inside. It was such an overwhelming experience waking up with the dilator inside of me. I felt accomplished.
Within a week and a half my boyfriend and I were able to have sex. It takes some getting used to. This is a new experience for me; for us. But we are working on it. I still follow up with the Nurse Practitioner, to see my progress. As for me, I feel amazing. I’m Happy. I feel like a woman.
Fear is a part of life. Lesson learned, you can get over it, with the right help and the right attitude, fear can be overcome. I would want other women to know that they should not let fear of the unknown control you. It’s never too late to search for help. I just wished I would’ve found out about my condition sooner.
Vaginismus is not something that people talk about. And if it wasn’t because of that show my boyfriend saw, I would’ve never done the research and I would’ve never looked for help.
It took me too long to figure out what I had was not all in my head. Don’t be afraid to get help. You are not alone.
– L, Age 29 –
Prior to my sophomore year in college, I had had three GYN vaginal exams over the course of three years, each ending in extreme pain and anxiety. Although, the doctor visits were horrible, I always hoped that my first experience with intercourse would be amazing because I would be relaxed.
My first experience with painful intercourse was when I was a sophomore in college, and when things didn’t go as planned, I thought to myself that it just was not the right moment, or the wrong guy.
After many failed relationships before the age of 25, I knew that the tearing, extreme pain that I was experiencing was going to ruin any chance of developing an intimate relationship. Being a young professional, a single girl in NYC with friends who are all engaging in sexual intercourse, wearing tampons, and having regular vaginal exams, it was very difficult when you are holding in an embarrassing secret that you cannot share with anyone, especially potential boyfriends.
I don’t know how the condition of vaginismus developed, but after reading online about similar women’s experiences, I found the Medical Center for Female Sexuality was close to my apartment, and could possibly offer me options.
I decided to explore treatment after I had realized that I needed to help myself before I could become comfortable in any relationship. After contacting Maze Women’s Sexual Health, and meeting with Kathleen and Shannon, I reviewed the various alternatives for treating this condition and decided that botulinum toxin was the appropriate choice for me, in eliminating my physical symptoms.
botulinum toxin injections seemed a little intimidating at first because it is a new procedure, and it is technically a surgical option. But, I was so comfortable with everyone at the Women’s Center, and it was nice to open up to professionals about my problem. Unlike most of their patients, I did not have a spouse or significant other to share the experience with, but this was also a positive aspect because I had time to become comfortable on my own.
When I arrived at the surgical center for the procedure, every step was explained to me, especially the dilator therapy. I was never in any pain, and even after I woke up from the procedure, I never felt the large dilator in place.
When I saw the largest dilator for the first time, I was so happy that I was able to achieve this first step with no anxiety. I quickly learned how to take the dilators in and out before I went home, and continued to use them for the first night. Using the dilators is not easy. It can feel very messy and sore at times, but it was never anything close to any pain I had experienced before the procedure.
When the botulinum toxin had taken effect after a week, I was able to use the larger dilators so easily, even in the bathroom at work. Working with the largest dilators really helped me in progressing to intercourse. About a month after the botulinum toxin injections I attempted intercourse for the first time, with a new guy, and was so happy that I had very little pain, just some burning and stretching, especially upon initial penetration.
I’m sure I was not the best partner ever, but was so happy to fulfill a part of my life that had been missing. Also, being able to use tampons is the best, since I am always out with my friends or on vacation.
I continue to use the dilators at least twice a week, and also continue to work on feeling comfortable with my body. I recommend visiting the Center to anyone with vaginismus. The regime for this therapy is intimidating at first, but can be life changing.
The support and aftercare I received from the center was very beneficial, and although being diagnosed with vaginismus was a challenging experience for me, overcoming it has really helped me gain even more confidence.
– M, Age 27 –