What is Vaginismus?
Vaginismus is a condition in women when intercourse is either very painful or impossible. Vaginismus is defined as an involuntary contraction of the vaginal musculature. This usually results in the failure of insertion including tampons, digits, gynaecological exams and intercourse.
What are the causes?
This has been believed to be psychological (fear and anxiety of penetration) or some physical conditions can contribute to the spasm of the vaginal muscles resulting in vaginismus.
- Urinary Tract infection
- Yeast infection
- Lichen Sclerosis/Planus
Menopausal changes – Dry vagina
Following pelvic surgery
Abuse- Sexual assault
Non – Physical causes
- Fear of sex
- Past sexual abuse or trauma
- Partner issues
- Negative thoughts towards sex
- No cause
Why does it occur?
The reason why the vagina seems to tighten is because of a strong band of muscle in the first third of the vagina. The muscle which can be the most troublesome in vaginismus is called the ‘pubococcogeus muscle’ and is part of the pelvic floor. The expected pain associated with penetration causes an involuntary contraction of this muscle. Therefore, sex can be uncomfortable, painful and sometimes impossible.
Types of Vaginismus
Vaginismus is very common and can happen to any woman at any stage in her life including those who have already enjoyed a successful sex life.
Vaginismus may be primary in nature, or secondary. It is also important to understand the differences between primary vaginismus, in which a woman has always had pain with intercourse, or has never achieved intercourse; and secondary vaginismus, which occurs later in life.
If primary, the woman has never been able to have penetrative intercourse without pain, or never been able to achieve penetrative intercourse. It may also be discovered when first attempting to use tampons, or at the first gynaecological examination or smear.
Secondary vaginismus describes these symptoms developing in a woman who has previously been able to allow penetration. In this situation, a precipitating cause, whether organic or psychological, may be easier to detect.
How common is it?
Community estimates of the prevalence of vaginismus are 0.5-1%. This increases to 4.2-42% in specialist and clinical settings
When reading vaginismus overview, a number of medical terms may be used that need to be understood, such as vulvodynia and vestibulodynia. These conditions may be associated with vaginismus, but more often they are misdiagnosed in patients with vaginismus
Mild cases of vaginismus may respond to a number of treatments.
- Vaginal dilators
- Sexual counselling
- Behavioural therapy
- Vaginal oestrogens in postmenopausal women.
How Does Botox For Vaginismus Work?
The treatment utilizes BOTOX, injected into the pelvic floor muscles to relax the area and break the pain cycle. Botox works on vaginismus by relaxing the contracting vaginal muscles that are obstructing penetration. The treatment usually takes place under local anaesthesia or sedation depending on the degree of vaginismus.
The injections are given at the vaginal areas causing spasm and obstruction steering away from anus and urethra in order to avoid incontinence.
Approximately 10 days after the initial treatment, you can begin dilator use in conjunction with physical relaxation therapy.
Usually only one Botox injection is necessary although Botox effect lasts around four months. It is effective in 90% of the women.
For further enquiries, please contact
Dr. A S Arun MD DNB CCST, FRCOG, FRANZCOG
Waikiki Specialist Centre
221 Wilmott Drive
Tel: 08 95500300
Fax: 08 95929830