Vaginismus is a condition affecting women in which involuntary muscle spasms make any vaginal penetration painful or impossible. The severity of the condition varies from person to person. Many women with vaginismus are unable to tolerate sexual intercourse, gynecological exams, and even insertion of tampons. Patients often describe the feeling of “hitting a wall” upon attempting penetration. It is estimated that about 7% of women worldwide are affected by vaginismus, although the number may be higher due to underreporting.

The causes of vaginismus are largely unknown and depend upon the individual who is affected. Common contributing factors are fear of painful sex, past sexual trauma, and a belief that sex is shameful. Vaginismus can also have physical causes such as yeast infections, childbirth, menopause, or radiation for cancer. The cause often depends on whether the patient has primary or secondary vaginismus. For patients with primary vaginismus, penetration has always been painful and/or impossible, while those with secondary vaginismus were previously able to achieve pain free penetration, and developed vaginismus at a later time.

It is important to note that regardless of the underlying cause of the condition, the resulting muscle spasm caused by vaginismus is a reflex that cannot be consciously controlled. It is believed to be a bodily reflex to protect the body from experiencing pain. Similar to an eye reflexively blinking to protect itself from contact, the vaginal muscles tighten to prevent potentially painful penetration. As such, a similar treatment plan involving the use of Botox in conjunction with graduated dilators has proven successful for most patients, both those with primary vaginismus and those with secondary vaginismus. Although therapy is a healthy approach to dealing with underlying issues related to vaginismus, it is typically not successful in curing the physical symptoms, as many women can attest. Unfortunately in previous years (and even still today), doctors were uninformed about vaginismus, and would often recommend therapy or relaxation techniques to deal with the symptoms. These solutions, of course, cannot cure the involuntary vaginal muscle spasms caused by the condition. Those physical symptoms must be treated by a physician who is knowledgeable about vaginismus and the latest treatment options available.

Dr. Peter Pacik has been treating patients with vaginismus for over ten years. His treatment program has a reported success rate of over 90%, and is the only program in the U.S. to have received FDA approval for continued research. Dr. Pacik’s typical treatment plan involves a short anesthetic (about 30 minutes), during which the patient is given an injection of Botox just under the lining of the vagina. Botox causes the entry muscles of the vagina to relax, allowing the patient to be progressively dilated. The patient’s use of dilators to stretch the vaginal muscles after the Botox injection is crucial to successful treatment. Patients who only receive Botox injections, and do not use dilators after the procedure, are unlikely to experience the success seen with patients who complete a comprehensive treatment plan with dilation.

Although in the past vaginismus has not received the attention it deserves, modern treatment has been life changing for the women who suffer from the condition. Successful treatment often means that women are able to use tampons for the first time, have sex for the first time, or have children – something they previously thought they would never get to experience. Vaginismus is not simply an inconvenience, it can prevent women from enjoying healthy sex lives and even from starting families.