Vaginismus: The Unspoken Truth

Vaginismus is a condition of sexual pain that affects about 1-7% of the world population, yet few health care professionals are familiar with this. It is the most common reason for unconsummated marriages. Women are loath to discuss this with friends, family and doctors. They surround themselves by walls of silence. Though this condition has been known for over 150 years, few physicians have any training in this common disorder.

Vaginismus is a non-medical sexual pain disorder that is differentiated from medical pain disorders such as genital herpes and lichen sclerosis. The etiology is mostly unknown. Their seems to be a reflex that starts with the perception that vaginal penetration will be painful, resulting in spasm of the entry muscle of the vagina. The brain says “pain”, the vagina says “no entry”.

Vaginismus is distinguished from other non-medical sexual pain disorders such as vulvodynia (pain involving a portion of the vulva) and vestibulodynia (pain involving the vestibule). When a patient complains that intercourse is like “hitting a wall” this is almost diagnostic of vaginismus and spasm of the entry muscle, the bulbocavernosum.

Recent strides in our treatment center involving the use of intravaginal Botox injections and dilation under anesthesia have over a 90% success rate. Because there is so much fear and anxiety associated with vaginismus, severe cases of vaginismus cannot be treated without sedation or anesthesia. Once the muscles are unable to spasm as a result of Botox injections and stretching is done with vaginal dilators, fear and anxiety are replaced with a determination to succeed in achieving intercourse.

A recent text written by Peter T. Pacik, MD, FACS, member of the American Society of Plastic Surgeons, discusses current concepts and treatment of vaginismus using Botox. The FDA has approved a research protocol to Dr. Pacik to study this further.

In November 2010, Dr. Pacik wrote a book When Sex Seems Impossible. Stories of Vaginismus & How You Can Achieve Intimacy” and is available through

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

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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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