Botulinum toxin procedure — How does it work?

When people hear about a medical injection being used in the vagina many think it is a “vaginal rejuvenation” procedure. Although plastic surgeons have made the use of this medical substance well known for the treatment of wrinkles, we have found it to also be a very successful treatment for vaginismus. Unlike the treatment of wrinkles where you need maintenance injections, the treatment of vaginismus is usually a one time out-patient procedure. The results for our patients have been overwhelmingly positive. Many patients are able to have intercourse within a couple of weeks and some within days!

Vaginismus is a condition in which the muscles in the vagina spasm involuntarily preventing vaginal penetration. This involuntary spasm can prevent women from inserting a tampon, undergoing speculum exams and having intercourse. Vaginismus is a major cause for unconsummated marriages.

Vaginismus Treatment Under Anesthesia is available to all patients with vaginismus. At our center, our patients will undergo an in-depth medical history and physical exam as well as a psychosexual history that focuses on all dimensions of sexual functioning. Our sexuality counselors work together with our medical staff to determine the level of anxiety, fear and/or pain surrounding vaginal penetration in order to provide the patient with the best treatment options.

Traditional treatment for vaginismus includes sexuality counseling and progressive dilation. We have great success with these treatment modalities with most patients completing treatment in 2-5 months. However, there is a subset of patients that does not respond to conservative treatment either due to severe pain or intense fear. In these severe cases, we often recommend the Vaginismus Treatment Under Anesthesia procedure along with sexuality counseling.

The procedure is done at an out-patient surgical center. The patient will be sedated with anesthesia so she won’t feel or remember anything. During the procedure a Pap smear is obtained (usually the first Pap smear for the patient) and the medication is injected into the vaginal walls followed by lidocaine to prevent pain after the procedure. A large dilator is inserted into the vagina at the end of the procedure. The patient will wake up in the recovery room with the largest dilator inside. This is usually a very happy moment for the patient as many simply do not believe penetration could ever be possible.

Patients leave the surgical center with dilators of different sizes. Progressive dilation is explained and after a follow up appointment the next day most patients will only need to use one or two dilators before attempting intercourse in the following weeks. Progressive dilation allows for the muscles to stretch and relax therefore when the medication wears off within 4-6 months, the muscles remain relaxed and penetration is comfortable.

We have successfully treated patients from all over the country as well as overseas! The bottom line is that there are many ways to successfully treat vaginismus. We can help YOU and please remember you are not alone. Many women find reading these testimonials written by other women about their experiences with vaginismus extremely helpful.