Is there a difference in the treatment for primary and secondary vaginismus?

[Heather34]

Hi ladies. Some of our forum members have described having pain-free intercourse and then developing the condition of vaginismus, which is defined as secondary vaginismus.

I personally had primary vaginismus for 15 years and could not tolerate any form of penetration. I had the coinciding fear/pain response with any attempts.

I’m wondering if forum members with secondary vaginismus could write about their experiences here.

For Dr. P, is your treatment program for secondary vaginismus different than your treatment program for primary? Could you share your experiences in treating patients with secondary vaginismus and what makes their condition different than primary vaginismus patients (i.e. less anxiety, etc.)?

[Dr. Pacik]

In both primary and secondary vaginismus there is pain with intercourse. When severe, intercourse is impossible in both conditions. In both conditions spasm is noted, mostly at the entry muscle and therefore both conditions are treated with Botox and dilators. The Botox weakens or paralyzes the entry muscle, allowing the dilators to do their job of stretching the muscle(s). The primary difference between the two is the level of fear and anxiety that is related to vaginismus. In primary, not only is there pain, but in the more severe cases there is considerable fear and anxiety to penetration. This degree of anxiety is much less or even non-existent in secondary vaginismus. For these women intercourse, or often any type of penetration is impossible because of the pain.