Vaginismus at a Glance
Vaginismus symptoms, vaginismus diagnosis, vaginismus treatment, vaginismus cure, what is vaginismus
Welcome to the home page of vaginismus which is designed to help women understand vaginismus, vaginismus symptoms, vaginismus diagnosis, vaginismus treatments and vaginismus cure. Additional detailed information can be found throughout this website and on our sister site VaginismusMD.
Education of patients and effective treatment has always been my goal. Though vaginismus was documented more than a century ago [Ref 1 Sims], little is taught about vaginismus in medical school, gynecology residencies and medical meetings. This lack of education compromises the physician who does not understand vaginismus and why a woman is unable to have comfortable intercourse resulting in dismissive statements such as “It is all in your head”, “Sex always hurts the first time” and “Try some lubes”..It therefore becomes incumbent for patients to self educate. Further, professionals familiar with vaginismus rarely stratify the severity of the condition. More severe vaginismus patients often do not respond to standard treatment programs and can waste a considerable amount of time being shuttled from one treatment to another. The lack of medical support forces women with vaginismus to seek information on the internet, yet here too there is considerable ignorance and misinformation. Seeing advertisements for lubes, dilators and books may help some women with the milder forms of vaginismus but does nothing to help those women who have severe penetration disorders. These are the women who order dilators but are unable to open the box. I have found that given the tools to understand vaginismus, vaginismus symptoms, vaginismus diagnosis, vaginismus treatment and expected vaginismus cure, patients are able to self assess their difficulty with vaginal penetration and painful sex.
I have devoted this part of my career to help women overcome vaginismus, restore their relationships and build a family. The letters of grief written to me by my patients tear at my soul and reinforce my desires to help these women and to make vaginismus more well known among health care professionals. Everyone on my staff shares these sentiments. As a doctor, I am able to use a variety of techniques to help cure vaginismus. Our multimodal program using Botox to calm the spastic muscles, progressive dilation under anesthesia to stretch the tight vaginal muscles, post procedure counseling and careful follow up has resulted in a high rate of long term vaginismus cure and is the only program in the United States to have received FDA approval for continued research in the field of vaginismus using the Pacik multimodal vaginismus treatment program. [Ref 2 FDA]
Let’s get started
What is vaginismus?
Vaginismus was re-defined in 2013 by the DSM 5 [Ref. 3 DSM] as a pelvic pain/penetration disorder. We use this new classification when helping women get reimbursement from insurance companies for vaginismus treatment. This new definition emphasizes that painful sex is only part of the problem and recognizes that any form of penetration can be extremely painful or impossible such as the use of tampons, finger, GYN exam and intercourse. In the most severe form of vaginismus, Pacik level 5 severe vaginismus [Ref Clinical Opinion 4], women are unable to tolerate any form of penetration. More information about the different levels of severity of vaginismus can be found by linking to VaginismusMD.
How common is vaginismus?
The prevalence of vaginismus is unknown likely because so many women do not speak about this even to their doctors. Commonly quoted figures are 1-7% of the world population. Studies have shown that about 30% of the world female population struggle with one of many sexual pain disorders.
Vaginismus diagnosis and vaginismus symptoms
There are a number of vaginismus symptoms that aid in vaginismus diagnosis. Perhaps one of the earliest vaginismus symptoms is difficulty with tampon use at a young age. The tampon cannot be inserted because of spasm of the vaginal entry muscle (bulbospongiosus). Another vaginismus symptom later in life occurs when a woman tries to have a GYN exam or intercourse and penetration is noted to be very painful or impossible. The vaginismus symptom that attempted penetration is like “hitting a wall” is very helpful in establishing a vaginismus diagnosis and helps rule out vulvodynia and vestibulodynia which are other sexual pain disorders. More information about vaginismus diagnosis and vaginismus symptoms can be found on the vaginismusMD.com website under vaginismus symptoms and by reading Dr. Pacik’s book “When Sex Seems Impossible. Stories of Vaginismus & How You Can Achieve Intimacy” available through our office or Amazon.com. Vaginismus diagnosis cannot be made under general anesthesia because under anesthesia all the muscles relax and the patient is told “nothing is wrong”. This is a false and further confuses the woman who knows something is wrong yet is unable to get the proper diagnosis and treatment. It is as a result of the vaginal spasm disappearing under anesthesia as all the muscles relax.
Vaginismus treatment and vaginismus cure
It is the goal of vaginismus treatment to result in vaginismus cure. The use of the Pacik multimodal program for vaginismus treatment incorporates the use of Botox to calm the spastic vaginal muscles, progressive dilation under anesthesia to stretch the tight vaginal muscles and extensive post procedure counseling and follow up to support the psychologic and emotional issues that accompany vaginismus [Ref 5 Pacik publication]. In this way vaginismus treatment addresses both the physical and psychologic vaginismus symptoms and has resulted in a vaginismus cure rate well above 90 % as reported in the scientific literature. More detailed information can be read by linking to vaginismus treatment.
Ineffective vaginismus treatment
In our practice the use of Kegel exercises, lubricants, topical anesthetics, anti-depressants, anti-anxiety medication, sedatives, excess alcohol, hallucinogenic drugs, muscle relaxants and hymenectomy do not appear to be helpful in the treatment of vaginismus. [Ref's 4 & 6]. Women who suffer from more severe vaginismus do not respond to “book therapy” and often comment that they order dilators but are “unable to open the box”.
Additional resources for vaginismus
Join the VaginismusMD Forum and introduce yourself. You will become part of an amazing community of women with vaginismus who support and teach each other. It will allow you to throw off the shackles of isolation, tear down the walls of secrecy and become a part of a vibrant community of women who are determined to support one another in their quest for proper vaginismus treatment and vaginismus cure.
Read the Stories section of VaginismusMD and the Stories section of Plastic Surgery PA . These anonymous stories tell the struggles women with vaginismus experience and help give definition and understanding to this condition. Vaginismus is involuntary and uncontrolled. The woman does not desire vaginismus and her condition is often misunderstood by their partners as noted in the men’s section of the Vaginismus MD Forum.
Read the book When Sex Seems Impossible. Stories of Vaginismus & How You Can Achieve Intimacy by Peter T. Pacik, MD, FACS available through our office or on AMAZON.
Contact our office to obtain questionnaires. Fill these out so we can review them and advise you. As I mentioned the diagnosis of vaginismus is made by history, so whether you are local or from far away, the history is the backbone of understanding your condition.
Start thinking how you can get the word out so that the world begins to understand that there is a condition called “vaginismus”. When vaginismus becomes as well known as erectile dysfunction, women and men will no longer be embarrassed about a condition that is common and fairly easy to treat.
Consider this as your beginning and expand from there. We are here to answer your questions and to help support you. As my patients say so often, “There is no such thing as a dumb question”.
Additional helpful links:
1. Sims, JS. On Vaginismus. Transactions Obstetrical Society of London 1861;3:356-367
2. FDA. Pacik, PT. (2010) Open Label, Single Center, Pilot Study of the Use of BOTOX Injections, Sensorcaine Injections and Progressive Dilation Under Anesthesia for the Treatment of Primary Vaginismus. ClinicalTrials.gov NCT 01352546
3. American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders (DSM 5). Washington D.C. (2013)
4. Pacik PT (2014) Understanding and Treating Vaginismus-a Multimodal Approach International Urogynecology Journal. In press.
5. Pacik PT. (2011) Vaginismus: review of current concepts and treatment using Botox injections, bupivacaine injections, and progressive dilation with the patient under anesthesia. Aesthetic Plast Surg. 35:1160-1164
6. Pacik, PT (2014) Sexual Dysfunction in Men and Women, Lipshultz L, Pastuszak A, Carson S, Perelman M. Springer, New York (in press).