Here’s the truth. You cannot treat vaginismus without considering the patient as a whole. This means your doctor needs to understand your background, your upbringing, your previous intimate experiences if any, your personality, your fears, your relationship with your partner, your idea of sex and pleasure ……………………………..not just understanding the anatomy and structural abnormality of your vagina.
The spasm in the pelvic floor muscles and the muscles that surround the entrance of the vagina make it impossible for painless penetration. In primary vaginismus where a woman has never previously had successful vaginal penetrative intercourse, one needs to understand the root causes for this spasm. It’s not easy and it’s not quick to simply have these muscle relax on demand.
Many times when women seek treatment for vaginismus, they often feel they are running out of time as they are racing to conceive or they are pressured to have a child. Vaginismus is getting in their way and they would like to get over it as quickly as possible.
This is the “Quick Fix” conundrum!
What are some of the treatment options?
With all options below, there is one strategy we don’t negotiate on in our clinic. it is imperative that the psychological and social contributing factors that cause vaginismus is discussed. We delve into your history and your background and your attitudes towards sex and pleasure. And we work on it, at every visit we see you.
1. Dilator therapy
Involves the use of gradually increases sizes of dilators with topical painkillers. The painkillers or numbing gels are pivotal to break the pain cycle. So you understand that penetration can happen painlessly and this then boosts your confidence, shedding away the apprehension and fear that causes the vaginal spasms, allowing you later then to perform the same dilator penetration this time without the painkillers
Botulinium toxin has a role to play in treating vaginismus. As we have mentioned it is the spasm of the vaginal entrance muscles that makes it impossible for penetration to successfully happen. With Botox skilfully injected into the specific muscles that control the spasm of the entrance of the vagina, we can complete relax these muscle. These muscle then cannot be involuntarily contracted or spasm by the woman even when she has the feelings fear or anxiety when anticipating penetration. This then makes penetration more comfortable. With this realization, her confidence for successful penetration is boosted. Dilator therapy must continue after botox treatment and regular practice with dilators and continued consultations to discuss feelings around sex, pleasure and intimacy is important for overall success of overcoming vaginismus.
3. Sex Therapy
Sensate focus the core foundation of sex therapy. This teaches you how to touch for your own interest and inculcates self focus as the centre of all your sexual encounters. While touching your partner, touch for yourself rather than for your partner.
There is no real quick fix for vaginismus. Botox treatment is simply a catalyst to accelerate your progress and this allows you work through your psychological and social issues with some newer found confidence. Botox without dilator therapy and psychological therapy is not encouraged.