Pregnancy Bliss | Reproductive Health Answers
In the western world, Botulinum toxin is mainly known for its role in cosmetic procedures used to prevent wrinkles of the face or to smoothen so-called frown-lines. Most people will know it by its trade name of ‘Botox’ or, to a lesser extent, Dysport. In 2007, in the United States alone, there were over 4.6 million ‘Botox’ procedures.
...and several others.
Botulinum toxin type A is injected in small doses of between 250 to 500 units into the affected pelvic floor muscle, usually the pubo-coccygeus. A few days after the treatment, the woman can and should be able to insert a tampon or a dilator without feeling any pain. Whilst that will be a good sign; it is painless intercourse that constitutes success. She should be encouraged and it is important that she should try that as soon as possible after the treatment. Ideally, the partner should be involved every step of the way since the woman will inevitably be anxious on that first post-treatment attempt.
It is important for the woman to be aware that the effect of the injection does gradually wear off. However, what has been observed is that, if after the first injection, the pain associated with intercourse disappears, and if she keeps sexually active, having penetrative coitus several times a week, the problem tends to stay away permanently. This is because the brain re-learns the new situation where sex is associated with pleasure rather than pain as was the case before. The reflex contraction of the pelvic floor muscles which was the original underlying problem does not therefore happen. Some women, however, will need to have repeat injections, usually every 4 - 6 months.
It is absolutely crucial for the doctor to conclusively rule out other causes of painful intercourse such as a thick hymen, vulvodynia, vestibulitis etc (discussed on previous page) before resorting to botulinum toxin. A careful examination of the external genitalia will easily establish this. If botulinum injections are used where the underlying cause is these other conditions, it is guaranteed not to work. That is sure to worsen the anguish of the long-suffering patient.
Success and safety:
Reported series of treatment show very encouraging levels of success as measured by successful painless penetrative sexual intercourse.
Where all else has failed, for a woman suffering from this quite distressing condition, Botulinum toxin injection should be given serious consideration.
Last update: February 2, 2013
Test should be confined to this area