Blog: Vaginismus: The Unspoken Truth

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    Hi ladies. Dr. Pacik recently wrote an interesting blog in which he describes how vaginismus is a non-medical pain disorder. As such, he indicates that it must be differentiated from medical pain disorders (i.e. genital herpes, lichen sclerosis) and also distinguished from other non-medical sexual pain disorders (i.e. vulvodynia, vestibulodynia). When I read this blog, I further recalled the language of a recent e-mail from Dr. Pacik in which he indicated that vaginismus is NOT a surgical problem. How many of us have visited gynecologists who suggested correcting vaginismus with surgery?

    I have had this occur upon visits to two separate gynecologists in the past. It’s very important to educate physicians further regarding the condition of vaginismus and to prevent unnecessary surgical procedures. Regarding such, Dr. Pacik writes:

    “Vaginismus is NOT a surgical problem
    I have become aware of patients having surgery to enlarge the opening of their vagina. This involves cutting through the spastic muscle at the opening of the vagina and rearranging the tissues to create a larger opening. Not only is there a long recovery period, but it does not work.
    Any time the vagina is cut painful scar tissue can form
    In the more severe cases of vaginismus, spasm of the entry muscle is routinely noted on examination. If you make a tight fist and try to insert the opposite index finger (which is impossible) this is similar to what the entry muscle looks like and how it behaves. This gives the effect of a “smaller opening” of the vagina. The difficulty with entry is due to spasm of the muscle. I have numerous patients who have had a hymenectomy, some have had two hymenectomies. None of them were cured of their vaginismus. Though vestibulectomy (surgical removal of the vestibule, the area just outside the vagina) has its proponents, surgical removal of the vestibule is an invasive procedure with a long recovery period and should only be attempted for certain indications.
    When a muscle is in spasm anywhere in the body it needs to be stretched, not cut
    It is for this reason that the Botox program for vaginismus is successful. The Botox (injected through tiny needles under anesthesia) weakens the muscle, relieves the spasm, while the dilators stretch the muscle. It is a relatively easy procedure with very few problems and a high rate of success of more than 90%. Of importance is that no surgery is needed.”

    I encourage your comments after reading the blog. I am especially interested in learning how many other women out there have also been falsely told that surgery would cure their vaginismus?

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