Vestibulodynia, also known by the older term vulvar vestibulitis, means pain in the vestibule just outside the vagina.
Definition of Vaginismus
Vaginismus is when severe, painful spasm of the vaginal muscles prevents the ability to have pain free intercourse due to the involuntary and uncontrolled fear of penile penetration.
Confusion in Diagnosis of Vestibulodynia from Vaginismus
Women are often told that vestibulodynia is what causes the pain on attempted penetration when the real culprit is vaginismus and associated vaginal spasm.
One of my patients writes:
“I self-diagnosed that I had vaginismus. I never considered myself to have vulvodynia or vestibulodynia, but I can see how my doctor could misinterpret this pain during a GYN exam because of my high level of anxiety. I mentioned vaginismus to my doctor and she thought I was talking about vulvodynia or vestibulodynia and seemed unaware of vaginismus.”
Patient history is important in the diagnosis of vaginismus
“When I get the additional history that the patient has never been able to use a tampon and that attempted intercourse is ‘like hitting a brick wall’, I immediately suspect that vaginismus is at play and is the more important feature of the patient’s distress.”
Knowing where to inject the Botox when treating vaginismus
Distinguishing vestibulodynia from vaginismus is very important because Botox is effective for both conditions, but one needs to know where it is best to inject this drug. In vaginismus, the entry muscle is usually noted to be in spasm under anesthesia and it is the vaginal muscles that are injected. In vestibulodynia, the vestibule is injected.
Dr. Peter T. Pacik devotes most of his practice to the cure of vaginismus
As of March 2013, Dr. Pacik has treated over 220 vaginismus patients using Botox injections and progressive dilation under anesthesia. He is the only physician in the United States that has received FDA approval to continue his research using Botox in his treatment program. Dr. Pacik continues to have in excess of 90% cure rate using Botox for vaginismus and has noted that associated vestibulodynia disappears, as the patient is able to achieve intercourse.
If you have any questions about our Botox treatment for vaginismus and progressive dilation under anesthesia, please contact us via our contact us form.