Vaginismus: Review of Current Concepts and Treatment Using Botox Injections, Bupivacaine Injections, and Progressive Dilation with the Patient Under Anesthesia
Vaginismus is a poorly understood condition affecting approximately 1–7% of females worldwide. This article aims to bring attention to this disorder and to review the use of Botox injections to treat these patients. Vaginismus, also known as vaginal penetration disorder, is an aversion to any form of vaginal penetration as a result of painful attempts and a fear of anticipated pain. It is involuntary and uncontrolled and functions much the same as any reflex to avoid injury. It is the most common reason for unconsummated marriages. The etiology is thought to be unknown. Numerous papers note a history of religious or strict sexual upbringing or aversion to penetration because of perceived pain and bleeding with first-time intercourse. Sexual molestation may be more prevalent in this group of patients. The Lamont classification is very helpful in stratifying these patients for treatment. Lamont grade 5 vaginismus is introduced. Vaginal Botox injections for the treatment of vaginismus has received increasing attention since the technique was first described in a 1997 case report. Plastic surgeons worldwide with their experience using Botox are well positioned to learn more about this relatively unknown entity and render treatment.
KeywordsBotox treatment for vaginismus Dyspareunia Painful intercourse Treatment of vaginismus Unable to consummate Unable to have intercourse Vaginismus Vestibulodynia
A grant received from Allergan provided free Botox for an FDA-approved study group of 30 patients. No compensation was given to the investigator.
- 1.Sims JS (1861) On vaginismus. Trans Obstet Soc Lond 3:356–367Google Scholar
- 3.Lahaie MA, Boyer S, Amsel R, Khalife S, Binik YM (2010) Vaginismus: a review of the literature on classification/diagnosis, etiology, and treatment. Woman’s Health 6:705–719Google Scholar
- 4.Goldstein A, Pukall C, Goldstein I (eds) (2009) Female sexual pain disorders, 1st edn. Blackwell, New YorkGoogle Scholar
- 11.Reissing ED, Hattori K, Davis HJ (2003) Vaginal penetration disorder: an empirically based and clinically relevant alternative for the diagnosis of sexual pain disorders. In: 30th Annual conference of the Canadian Sex Research Forum, Edmonton, AB, CanadaGoogle Scholar
- 14.Pacik PT, Cole JB (2010) When sex seems impossible: stories of vaginismus and how you can achieve intimacy. Odyne Publishing, Manchester, NH, pp 40–47Google Scholar
- 15.Pacik PT (2011) Vaginismus: the Lamont classification revisited. Poster presentation at the ISSWSH Annual Meeting, ScottsdaleGoogle Scholar