( GENITO-PELVIC PAIN DISORDER)
Vaginismus is an involuntary contraction of muscles around the opening of the vagina in women with no abnormalities in the genital organs. The contractions can prevent sexual intercourse or make it very painful. Any other form of vaginal penetration such as tampons, vaginal dilators, and gynecologic examinations are also painful or impossible.
1 Causes of Vaginismus:
- Emotional triggers- such as anxiety, fear of pain or pregnancy
- Physical triggers- such as infections, menopause, pelvic surgery, medication side effects, and insufficient vaginal lubrication.
2Symptoms of Vaginismus
- Fear, anxiety, and pain during vaginal penetration.
- Burning or stinging with tightness during intercourse
- Inability to use tampons or menstrual cups.
- Inability to tolerate a gynecology examination.
- Vaginismus frequently leads to marital problems, depression, and feelings of isolation.
Vaginismus is very much treatable and the treatment options include the use of vaginal dilators, relationship counseling, psychotherapy, behavioral therapy, lubricants and correction of physical triggers such as infections. Vaginal muscle training with kegel exercise can often be done at home, allowing a woman to work at her own pace in privacy, or in cooperation with her health care provider. Administration of intravaginal injections of BOTOX has been found to have a high success rate with long-lasting results. It works effectively as one of treatment because it breaks the cycle of Vaginismus. BOTOX temporarily reduces the hypertonicity of the pelvic floor muscles and weakens the spastic vaginal muscles which prevent penetration.
4How is Botox used for vaginismus?
Botox is injected under anesthesia using tiny needles. It could easily be injected without anesthesia also, as is routinely done when injecting other areas such as the face. The Botox dose is divided between the three important muscles of the vagina that can prevent penetration.
5How often is Botox used in the treatment of vaginismus?
Generally, only one treatment is needed even though Botox lasts only about four months. Once dilation is comfortable and intercourse is achieved, additional doses of Botox are rarely needed. Most patients do not need a second session once they have dilated and achieved intercourse.
6What are the Risks and Complications of Botox?
Botox, when properly used by trained personnel, is considered to be very safe and effective. Risks and complications are minimal. Very few cases of temporary stress incontinence and vaginal dryness have been noted which usually improves over a period of a few weeks.
7How to do Kegel exercise?
Follow these steps:
- To perform Kegel exercises, repeatedly tighten and relax your pelvic floor muscles, which control your vagina, rectum, and bladder.
- You can locate these muscles when you’re urinating. After you begin to urinate, stop the stream. You’re using your pelvic floor muscles to do this. You may feel them tighten and move. These muscles move as a group, so they all contract and relax at the same time.
- Practicing these exercises helps you control your muscles contract and relax.
- Empty your bladder.
- Contract your pelvic floor muscles, and count to 10.
- Relax your muscles, and count to 10.
- Repeat this cycle 10 times, three times a day.
- To successfully strengthen your pelvic floor muscles, don’t engage the muscles of your abdomen, buttocks, or thighs when doing these exercises.