Vaginismus Treatment


Vaginismus is a condition affecting a woman’s ability to engage in any form of vaginal penetration, including sexual intercourse, insertion of tampons, and penetration involved in gynecological examinations.  An involuntary reflex of the pubococcygeus muscle causes the muscles in the vagina to tense suddenly, which makes any type of vaginal penetration painful or impossible.  This involuntary muscle contraction can be mildly uncomfortable, or may cause searing or tearing pain.  The vaginismic reflex can be compared to the response of the eye shutting when an object comes towards it.

When Sex Hurts

It’s the most natural thing in the world and yet for women with vaginismus, sex is so painful it becomes impossible. To make matters worse, many women who have this condition don’t have a name for it. It’s just an unbearable pain and a feeling of dread that increases with every attempt to overcome it. “Part of the problem for women with vaginismus is they frequently feel that the condition is somehow their fault, which is obviously not true at all. Women with vaginismus may have no history of trauma to explain it. We frequently hear women say: ‘No one knew what to do about it. I was told it was all in the mind.’


Vaginal  Injectables

Vaginal treatment involves the injection of a form of muscle relaxant. The muscle relaxant is injected into multiple specific points in the tight, spasmed lower vaginal muscles.  The muscle relaxant acts as a selective muscle weakening and/or paralysing agent, and helps reduce nerve pain.

The effect is reversible but provides a temporary window of opportunity to rehabilitate and stretch the over contracted spastic vaginal muscles that are obstructing penetration. Very small needles are used to inject muscle relaxant into the three key vagina muscles that can obstruct penetration. Only the areas in the vaginal side walls that are palpably spasmed and sore are injected. Once these muscles can no longer tighten, it is usually possible to have comfortable intercourse. Once a woman experiences sex without pain, she can relax and begins to enjoy it. The vaginal muscles can then stretch and start to relax of their own accord.

Filler takes approximately 10 days to begin to work. By week 1-2 post injection it will be starting to have its effect on the muscle which will then reach a plateau at around a month post injection.

Usually, once the muscles have been relaxed, no further treatments are required, although some women benefit from a second or third treatment to fully and permanently relax their pelvic floor and vaginal muscles.

Sometimes treatment it is unsuccessful and some do not respond, in some cases is needed only one treatment and in some repeated treatments.

What are the side effects of muscle relaxant?

For the vast majority of women, there are no noticeable side effects of vaginal filler. The potential for a small muscle haematoma or infection exists, as with all procedures where a needle is used. There are case reports in the literature of bladder or bowel urgency or difficulty with controlling wind or incontinence. No filler injected near the rectum or urethra so the risk of these side effects is minimal. One article reported a case of vaginal dryness due to a parasympathetic partial nerve block. As the effects of filler only last 12 weeks, these rare side effects are completely reversible.

How many treatments are needed?

Unlike with using toxins for facial wrinkles, once the spasmed vaginal muscles are released often only one or two treatments are required. The muscles re-learn their previous relaxed state, intercourse is more comfortable and therefore continuing spasm is far less likely.


Frequently Asked Questions

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