“Though not well recognized and poorly diagnosed by physicians, the precipitating event in secondary menopausal vaginismus is generally a lack of lubrication. Artificial lubricants seem to do a poor job replacing natural lubrication, and microtears of the vagina begin to form setting up a painful condition. As this gets worse the patient appears to develop vaginismus, and when examined, appear to have the same spasm of the entry muscle as seen in the primary vaginismus patients.”
“Generally, if these patients can be started on hormone replacement and a topical such as Estrace, I find the aging tissues become more robust, and the vagina is better able to handle penetration. The spasm is treated with the Botox program which includes Botox vaginal injections and progressive dilation under anesthesia together with post procedure counseling as is done in our primary vaginismus patients.”
I would welcome your comments and feedback on this important article.