Our team just went up to New Hampshire to learn a new treatment for severe vaginismus from a wonderful Doctor. He (and his caring staff) have developed a procedure which uses general anesthesia and botulinum toxin in order to help women over the first, most frightening hurdle of treatment.
When I am lecturing and trying to explain vaginismus , the analogy I use to describe how a patient feels is to compare it to what your reaction might be if I told you I was going to put a pen into your eye.
If I said to you,”Listen, I am going to put this pen in your eye. Not to worry, it won’t hurt a bit and actually it will feel good,” you would look at me as though I had three heads and run for your life.
Patients with severe vaginismus feel that way. Often with anti anxiety medications, behavior medication, relaxation exercises we can work with a woman to help her get those first dilators in. Sometimes it just doesn’t work and it’s just too hard.
This new procedure has the women under general anesthesia while a physician injects botulinum toxin (stops the muscles from going into spasm) local anesthesia(so that there is absolutely no initial pain) and put in a large dilator. The patient wakes up having the dilator in and that really is jumping the first few hurdles. There is still significant work for the patient. She has to work with dilators, get comfortable with the idea of inserting something into her vagina, internalize the idea that there is really no pain and then make the transfer to intercourse.
It doesn’t solve the whole problem, but it can be a big help and relief for the right patient and we are so glad that we will be able to offer it in our office as well.