What It's Really Like To Get Botox For Vaginismus

Vaginismus is a medical condition that causes involuntary vaginal muscle spasms, and it can be treated with the same neurotoxin injections that relax wrinkles. Here, patients share their experience with the life-changing procedure.
Patient Perspective
Written by India Bottomley
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What It's Really Like To Get Botox For VaginismusDainis Graveris/Unsplash

By now, most people are familiar with Botox® being used to smooth fine lines and wrinkles (think: crow’s feet, frown lines, and horizontal forehead lines, to name a few) and reverse signs of aging on the face. You may even know that the neurotoxin is used to treat migraines, quell hyperhidrosis (read: excessive sweating), and ease the pain associated with temporomandibular joint (a.k.a.TMJ) disorder. But did you know that botulinum toxin type A (the active ingredient in Botox®) can be used to treat vaginismus?

Vaginismus is a rare medical condition that causes involuntary vaginal muscle spasms. It can inserting tampons and penetrative sex painful — and, in some cases, impossible. For some, it is a condition they have always had, while others can develop it later in life due to hormonal changes (i.e. menopause), emotional trauma, or no obvious reason at all.

Until recently, treatment often involved a combination of talking therapy sessions to address the emotional aspect of the condition and physical therapy and vaginal dilators to help the muscles adapt. The goal? Make intercourse possible or, at the very least, more comfortable. Now practitioners are using Botox® to paralyze the muscles that contract as a result of the condition with promising results.

Here, we outline everything you need to know about the procedure and hear from two patients about their experiences.

How Does Botox® Treat Vaginismus?

Botox® is a brand name for BoNT-A, which is a neuromodulator that relaxes muscles when it is injected. It is used therapeutically to treat a number of medical conditions, as well as being used for cosmetic purposes. For vaginismus, Botox® is injected into the vaginal muscles that contract to cause pain and prevent penetration. By paralyzing the muscles, it effectively treats involuntary contractions — such as those experienced by people who have vaginismus. There are three main groups of muscles that can be affected by vaginismus, but Botox® is generally injected into the bulbospongiosus muscle (i.e. the muscle that surrounds the opening of the vagina).

What Does the Botox® for Vaginismus Procedure Involve?

The technique is based on the same principle as cosmetic Botox®. The product is injected into muscles that are contracting when they shouldn’t be. Your practitioner will establish which muscle groups are causing the pain and inject them accordingly. On average, 200 units of Botox® are used during a session.

While needles in the vulva may signal discomfort, procedure pain is rarely a factor. Vaginismus Botox® treatments are carried out under local or general anesthesia. For some patients, general anesthesia is the best option because the condition would make it difficult to inject the local anesthesia that is needed. Either way, the procedure is usually an outpatient procedure.

Generally speaking, it takes patients four to five days to recover from the procedure, and the full effects of Botox® are realized around one week post-op. In some cases, the injection alone will be enough to allow for painless penetration. In other cases, the treatment will be combined with the use of dilators (to address physical discomfort) and therapy — in order to address the emotional issues that, of course, can’t be treated with a procedure alone.

How Many Sessions Are Needed to See Results?

More often than not, just one session is needed for patients to enjoy the full benefits of the procedure. This long-term relief occurs despite the fact that the Botox® only lasts three to five months — the initial treatment breaks the pain cycle associated with vaginismus. Once patients are able to have painless intercourse or penetration, the body tends to relax the muscles on its own. It is possible, however, to have multiple treatments, if results from the first procedure wear off over time.

Doctors report a 90 to 97 percent success rate for the procedure, and side effects are minimal. As with any procedure, there is a small risk associated with the anesthesia. The procedure-specific risks include the potential for bladder issues and, on rare occasions, patients report botulism-like symptoms including blurred vision.

Patient Perspective

We spoke to two patients who have undergone treatment for vaginismus with Botox®. Their experiences provide insight into how transformative the procedure can be and also offer tips for how to prepare and what to expect.

Mary, 26, Austin, TX

Mary, 26, experienced vaginismus beginning her early twenties and had been unable to have penetrative sex until she underwent treatment with Botox®. After spending years trying to address the situation with a mix of physical therapy and dilators, she finally found a doctor who offered the treatment.

The AEDITION: When did you have the procedure, and how were the results for you?

Mary: I had the procedure just over a year ago. I had one treatment and chose to have general anesthesia to make the process as pain-free and relaxed as possible. The results have been better than I could have imagined. I was completely unable to have sex before the procedure. It was so painful and, honestly, really stressful and embarrassing. Now it’s as though I never had any of those issues. It took some time for me to become comfortable with the ‘new me.’ For a while, I was scared the progress would just disappear one day, but so far so good. If I ever did have issues again, I would absolutely consider having the procedure again.

The AEDITION: What happened during your consultation?

Mary: I found a female practitioner who was offering the treatment, which made me feel comfortable from the outset. We discussed the issues I had been having, and she carried out an examination. We spoke about the treatments I had tried, and she agreed that it was time to give something else a go. We spoke about the option of having the procedure with localized numbing, but I chose to have full anesthesia because I didn't want to associate any extra emotional stress with the issue. We set a date, went over how I would need to take care of myself after the procedure, and that was it.

The AEDITION: Do you have any advice for people considering Botox® for vaginismus?

Mary: If they’ve tried other methods and nothing has worked, I’d say find a reputable practitioner and make an appointment. I wish I had found out about the treatment sooner. It has truly changed my life. I’ve even found myself talking to friends about how amazing it is. I think it’s a shame that more people aren’t aware of it. It should be something that is spoken about much more because it really does change people’s lives. So, if you think it might work for you, have a consultation. And if you’re able to go ahead and have the treatment, I would totally recommend it.

Stephie, 32, Los Angeles, CA

Stephie, 32, had a condition known as secondary vaginismus, which is when vaginismus begins at some point after penetration had previously been possible. In this case, Stephie first experienced the condition after giving birth to her first child. Her gynecologist referred her to a colleague who specializes in treating the condition with Botox®.

The AEDITION: What led to you seek treatment?

Stephanie: I went through quite a traumatic birthing experience, and, as a result, I had a few lasting issues — one of which was vaginismus. I didn’t have any idea that I could even have that sort of problem after giving birth and was worried it was something horrendously wrong. When I went for a follow-up appointment with my gynecologist — who, thankfully, I have a great relationship with — I spoke to her about this issue I was having. She spoke to be about Botox® being the course of treatment she recommends for people in my situation. She referred me to a colleague who has an excellent reputation for carrying out the procedure, and I went from there.

The AEDITION: How did the procedure go? What was your recovery like?

Stephanie: I had the injections with local anesthesia. Without being graphic, I’d been through a lot ‘down there,’ so it wasn’t anything to write home about pain-wise. I went home to rest for the remainder of the day and then took it easy for maybe five or so days afterward. I waited 10 days before trying to see if the procedure had worked, and, thankfully, it had! It was amazing. It was like someone had flipped a switch. I felt so relieved that things were working again. It’s truly an incredible treatment, and I’m so grateful I was able to find out about it.

The AEDITION: Do you have any advice for patients considering Botox® for vaginismus?

Stephanie: If you have found the right doctor to carry out the procedure and they believe it could work for you, then 100 percent try it. I know a couple of other people who have had it too, and it’s worked incredibly well for all of us. Even with just local anesthesia, it wasn’t all that uncomfortable. While I had some discomfort in the days after, I was never in pain. Don’t let the idea of that put you off. The benefits far outweigh any of the temporary discomfort.

The Takeaway

A life-changing treatment option for women experiencing vaginismus, Botox® can provide long-term relief for the physically and emotionally painful medical condition. It is important to find a board certified provider who specializes in the treatment to ensure the best quality care.

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INDIA BOTTOMLEYis a contributing writer for AEDIT.

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