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When we use Botox to overcome the vaginal spasm that occurs in vaginismus, our goal is for the woman to be able to have pain free intercourse. There is a high rate of success when Botox is used for vaginismus. Nevertheless this is not the entire answer, in that women who have never had intercourse are not necessarily fulfilled. Women need to understand their own bodies and what turns them on and also what does not. There is a learning process that is needed for both members of the couple.
These concepts are brought to light by the excellent book written by Mark and Lisa Carter entitiled "Completely Overcome Vaginismus". In this book the authors take the patient through the many considerations leading up to possible causes of vaginismus, and a step by step approach to overcome vaginismus using a series of graduated dilators, and the use of dilators prior to intercourse. Additional exercises are discussed to allow the woman to develop a greater awareness of their own sexual desires. For the patient who wants to move more quickly through the process, botox is useful in its ability to block vaginal spasm. When Botox is used in conjunction with the recommendations in this text, patients have one more modality towards the successful outcome that they desire.
This book as well as the dilators can be ordered from www.vaginismus.com. In our own practice this book has become a "must read" and our patients are encouraged to use the dilators after the botox begins to take effect. Generally botox is effective in about 5 to 7 days, but the process to achieve intercourse takes longer, generally about 3 to 4 weeks. We recommend that our patients move slowly through the process. Botox begins to wear off at about 2 1/2 to 4 months, so it is best to complete the process during that time frame. Once pain free intercourse is achieved, the vagina will remain dilated and usually repeat botox is not needed. At times a repeat dose is given if the patient needs a higher dose of Botox or if continued difficulties are encountered.
Peter T. Pacik, MD, FACSWe welcome feedback from those who have purchased, used, or reviewed our resources to help us improve and also to help others to have confidence in their value.
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