Vaginismus is a condition in some women that makes intercourse very painful or sometimes impossible. It’s defined as an involuntary contraction of the vaginal musculature which often means women are unable to insert tampons, have intercourse or take gynaecological exams. This can be caused by fear and anxiety of penetration, or a number of physical conditions that can cause the vaginal muscles to spasm.
When attempted penetration takes place, the vagina seems to tighten involuntarily, causing pain. This is caused by the contraction of a strong band of pelvic floor muscle in the first third of the vagina, called the pubococcogeus muscle. This contraction can sometimes be so severe any form of penetration is impossible. Vaginismus is common and can happen to any woman at any stage in her life, even those who have already enjoyed a successful sex life.
Vaginismus can be either primary or secondary. A woman with primary vaginismus has never been able to have penetrative intercourse without pain, or perhaps has never been able to have sex at all. Primary vaginismus can be discovered when first attempting to use tampons or have a gynaecological examination or pap smear.
Secondary vaginismus develops in a woman who has previously been able to of these things. In this case, a precipitating cause might be easier to detect.
Vaginal dilators, sexual counselling, behavioural therapy, vaginal oestrogens in postmenopausal women and BOTOX injections can all be offered as treatment.
How does BOTOX for Vaginismus work?
BOTOX is injected into the pelvic floor muscles to relax the area and break the pain cycle by releasing the contracting muscles that obstruct penetration. Depending on the degree of vaginismus, a local anaesthesia or sedation is provided for the patient.Usually only one BOTOX injection is necessary and effects last around four months. About 10 days after the initial treatment, patients can begin to use a dilator in conjunction with physical relaxation therapy.
BOTOX is effective in 90% of women. This procedure is not Medicare rebatable and the cost of the treatment is between $1000-1500 depending upon the dosage of Botox used.
To find out more contact:
Dr. A S Arun MD DNB CCST, FRCOG, FRANZCOG
Waikiki Specialist Centre – 221 Wilmott Drive, Waikiki
Phone: 9550 0300
Urinary tract infection
Lichen Sclerosis/ Planus
Menopausal changes such as dry vagina
Post effects of pelvic surgery
Abuse – sexual assault
Non Physical Causes:
Fear of sex
Past sexual abuse or trauma
Negative thoughts about sex