Menopausal Vaginismus

MenopauseMenopausal Vaginismus, which is a common cause of painful sex at midlife and beyond, is initially caused by the dryness and thinning of the vagina due to a drop in estrogen. When a woman has less estrogen, there is less vaginal lubrication; the vagina is less stretchable and more prone to tearing. This results in the menopausal woman feeling vaginal tightness during sex with pain, burning and/or soreness. In many cases, the problem starts with small tears called microtears that cause inflammation and irritation leading to more discomfort and bleeding of the tissues with any penetration of the vagina. During this time, intercourse is possible but often results in pain and burning after, which is called dyspareunia. Artificial lubricants seem to do a poor job replacing natural lubrication. As the condition gets worse, the patient appears to develop vaginismus, and when examined, appears to have the same spasm of the entry muscle as seen in the primary vaginismus patients.

Hormone Replacement in combination with the Botox Treatment Plan for Menopausal Vaginismus

Generally, if a menopausal woman can be started on hormone replacement and a topical estrogen cream such as Estrace or Vagifem, I find the aging tissues become more robust, and the vagina is better able to handle penetration. The spasm can be treated with the Botox program, which includes Botox vaginal injections and progressive dilation under anesthesia together with post procedure counseling as is done in our primary vaginismus patients.

A Menopausal Vaginismus Patient’s Story

Mary’s Story: I was 56 years old when I recently had the treatment for my Vaginismus. I found out about Dr. Pacik’s treatment through my primary care physician who knew what a struggle I had been going through for about 6-7 years.

I believe that once I hit menopause certain things changed in my vaginal area, which made intercourse EXTREMLEY difficult. To the point I would cry. I was so frustrated because I did not want to lose this intimacy with my husband who was very, very patient. But the truth was we had to stop having sex!!! I felt very alone and felt I had lost a major part of being a woman.

When I initially went to Dr. Pacik I was so amazed that there were so many others who shared this issue called Vaginismus! To find out there was a procedure that would cure me and that it was NOT painful totally amazed me.

My husband came with me for the procedure and Dr. Pacik helped to explain to him what he was doing and what had been going on with me. This was so helpful.

It has been just about 5 months since I have had the procedure and I use one of the dilators every other night and it has worked like a charm. I will probably continue to do this out of my own fear that I don’t want to go back to the way it was, but Dr. Pacik helps you determine where you are going and what to expect. He is very caring and totally understands where we have been and learns from us all as he goes. I am so lucky that I found Dr. Pacik and could reclaim my womanhood!

Response from another patient to Mary’s Menopausal Vaginismus Story

Thank you for sharing the article about Mary and her struggles with Menopausal Vaginismus. I’m 59 years old and was diagnosed with secondary vaginismus and have been in menopause for 4 years. I can relate to many aspects of Mary’s difficult journey, but was able to have pain-free, enjoyable sex with my husband for many years. We have been blessed with two children. I started to have some pain with intercourse in peri-menopause. This progressively got more and more painful, until when in full menopause the pain became unbearable and I was eventually diagnosed with vaginismus.

In desperation, I went online searching for a solution and came upon Dr. Pacik’s website. I had the Botox procedure 90 days ago and am so very happy I did!! The first month of dilating went really well for me and I was able to dilate up to #5 pink glass for at least one hour without any pain. At day 19 post procedure, my husband and I tried intercourse and were able to insert only 3″ but that was definitely a good start. At day 25 and after dilating with #5 pink dilator for 2.5 hours, we tried again and had successful, full penetration. This was painful for me, but less so than the first attempt and I was SO excited and elated!

Then at day 32 things started to go downhill. Dr. Pacik and his team often said that the early days post procedure could be a real roller coaster ride and boy were they right. I got a vaginal infection and struggled with it for a month. The lube I had been using started to give me problems, as did every other one I tried until I came upon Pure Coconut Oil. It works wonderfully for me and I’m so happy that I am back on track dilating comfortably as before with the #5 pink.

Dr. P. and his team are wonderful and continue to guide me along my path to pain-free intercourse. Best wishes to all the women with menopausal vaginismus. In sharing our stories we can support and help each other!

Menopause is neither the end of your life or your womanhood

Menopause in womenIt is important to remember that menopause is roughly one-third of a woman’s life. This is a time that one can experience the joys of sex without concern about pregnancy. Women are quite capable of enjoying their sexuality well into older age. If you are experiencing menopausal vaginismus, it is recommend that you contact our office to learn more about our Botox treatment program that includes progressive dilation under anesthesia and the important support we give to all of our patients with both counseling and follow up.

The Botox treatment program can restore your sex life in midlife for the menopausal vaginismus woman!

Contact Us

If you have any questions about our Botox treatment for vaginismus and progressive dilation under anesthesia, please contact us via our contact us form.

Dr. Pacik

About Dr. Pacik

Peter Pacik, MD, FACS is a recognized pioneer in treating patients with Botox for vaginismus and the author of When Sex Seems Impossible: Stories of Vaginismus and How You Can Achieve Intimacy. He has been in practice for over thirty years and belongs to a small group of prestigious surgeons who are double board certified by both the American Board of Surgery and the American Board of Plastic Surgery. In 2010, Dr. Pacik received FDA approval to continue his study to treat vaginismus using intravaginal injections of Botox together with progressive dilation under anesthesia.
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