Understanding and Treating Vaginismus Publication:
This past year has seen monumental strides in the effort to get the condition of vaginismus more well-known and I want to share my 2014 Publication: Understanding and Treating Vaginismus.
I presented podium lectures regarding understanding and treating vaginismus at the 2013 annual meeting of the American Urogynecologic Society and again at the 2014 annual meeting of the New England Society of Plastic and Reconstructive Surgery. Most gynecologists and plastic surgeons are unfamiliar with vaginismus. Numerous questions after the presentations and further discussion followed. It is hoped that more physicians will take an interest in vaginismus. I find that physicians and therapists can get considerable educational information from my aforementioned 2014 Publication: Understanding and Treating Vaginismus and are better able to write letters of referral which helps with insurance coverage.
In addition, there is a Table of real-life remarks that my patients received from providers unfamiliar with vaginismus:
Table 2
What your patients do not want to hear (condescending remarks)
“Don’t be a baby”
“Can’t you just relax”
“It’s all in your head” (very common)
“Come back when you are more relaxed”
“Have a drink” (also common)
“You need to take a Valium before you come for an exam. It’s just because you are nervous.”
“You need to practice stretching your vagina”
“It’s just first time jitters”
“It will get better with time”
“Let me recommend some lubricants”
“You need to stop believing that your vagina is messed up because you are the one causing this and stopping yourself from having a normal sex life.” (This comment after successful treatment of severe vaginismus but crying because of the speculum exam.)
“The pain will go away after you have had sex a few times. You will get used to it.”
“There’s nothing physically wrong with you”
“There must be something wrong with your relationship”
“Just tell yourself sex won’t hurt and it will be okay”
“I won’t examine you again until you receive sex therapy. Here is the name of a sex therapist that I recommend. After you see her, you can come back to try an exam.”
These and many other condescending remarks do nothing to help the woman understand and treat vaginismus and only serve to disable someone seeking help.
The Botox multimodal treatment of vaginismus includes the injection of Botox into the spastic muscles and progressive dilation all done under anesthesia. There is no discomfort because a long acting local anesthetic is injected during the treatment. Post procedure counseling the next day generally takes about five hours and includes a comprehensive discussion including topics such as:
- How to dilate
- Keeping a daily log of dilation and sending this to Dr. Pacik for follow up
- Tricks in transitioning from dilators to intercourse
- Positions of pelvic floor comfort and overcoming anxiety related to intercourse
- Bringing romance back into the relationship
- Improving libido
- Lubricants
- Pregnancy
- Vaginismus aids and books to read
- and much more.
This program continues to be safe in over 300 patients treated.
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If you have any questions about our Botox treatment for vaginismus and progressive dilation under anesthesia, please contact us via our contact us form.
