In general I try to avoid over-generalizing patient situations because I think each patient is an individual and needs to be treated as such. I’m much happier to speak with patients (or their referring therapists) on a case by case basis to help them come to the right decision. We get dozens of calls each month about the Botox treatment for vaginismus and are happy to talk things through. And you should feel comfortable calling us to see if we think Botox is right for you.
That having been said, vaginismus lives on a double continuum of tight muscles and fear, (think of an x axis and a y axis). So some patient’s muscles aren’t that tight but they have overwhelming fear and some patient have little fear but extremely tight muscles. Some patients have both. Usually the patient who are on the inside groupings can be helped with an appropriate combination of therapy and dilation work. But the ones on the outer margins often can’t and those are the patients for whom Botox is tremendously helpful.
However, it is really important to understand that Botox doesn’t “solve” the problem, it just jumps over the first few steps of dilation. When the patient wakes up with the large dilator in, they will still have to embark on the journey of getting their vagina to communicate with their brain. However, it is incredible to see how so many of these patient who were just too fearful to work even the smallest dilator, feel an overwhelming relief that, yes, their vagina is “normal” and that something can be inserted. Then they can get to work.
Finally, for patients who live in locations where they don’t have access to specialists in vaginismus (whether physical therapists, gynecologist, or therapist) or with access to a professional who can work with them hands-on to insert those dilators, and who have not succeeded on their own, this is a treatment that can get them “jump started” and allow them to move forward alone.
So if you are thinking that Botox may be right for you, please call our office and ask to speak to one of our staff about it. We are happy to take the time answer your questions, allay your fears and concerns and help you figure out if this is the right route, or there may be another better way for you to go.