Update on vaginismus.

We’ve been using botulinum toxin now for over a year and it may be time to give you some of my impressions. They are not in any particular order… they are just things we’ve learned along the way, but I think they can be helpful in thinking about botulinum toxin as a treatment option:

  • For the right patient it works really, really well! What we have discovered is that for a patient whose pain is primarily tight muscles and who have the fear that goes with the pain, the botulinum toxin can bypass months of scary and overwhelming dilator work.
  • It’s really not such a big deal. The entire procedure take 15-25 minutes and seems to have little to no side effects at all.
  • “Waking up” from the procedure with the large dilator inserted is an exciting and moving experience for women who have, until then, not been able to insert anything into their vagina.
  • It will not work if your pain is primarily from hormonal imbalances or structural issues.
  • You really need to be ready to address the problem and face a solution if you are thinking of botulinum toxin. Otherwise, the fear of penetration is just overwhelming.
  • A supportive partner can make a big difference! It’s great to have someone cheering for you.
  • If you’re single and avoiding dating because of your fears of sex, botulinum toxin can change your life!

I wish more women knew about the possibility of botulinum toxin — for that matter, I wish we knew about it before we did. But I suppose, as with most things, better late than never. But now, a year and a half later, I have to say that I’m a believer.

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