Vaginismus Medicine: Understanding Your Options for Treating Painful Intercourse
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A psychologist with clinical specialization and experience working with sub-clinical and clinical populations. Her areas of interest and expertise include anxiety-related disorders, mood disorders, psychotic disorders, addictions, sexual health and wellness, relationship issues, stress, and geriatric mental health.
Anoush Gomes is a seasoned Content Writer with over 10 years of experience, specializing in various writing styles such as medical content, creative writing, storytelling, and research papers. Anoush embarked on a unique journey, starting with pre-medical studies at the Dante Aligheri Academy and the University of Miami, where she earned a Bachelor's degree with a major in Biology and a minor in Psychology. Having pursued medical school and completed clinicals, Anoush transitioned to the world of medical content writing, where her passion for both healthcare and writing converged. Her writing skills encompass persuasive, narrative, expository, and descriptive styles, making complex medical concepts accessible to diverse audiences. Beyond her professional endeavors, Anoush is a multi-faceted individual with a rich tapestry of interests. A writer, artist, poet, avid reader, certified nerd, and hopeful author, she finds inspiration in the intersection of creativity and science. Whether crafting engaging medical narratives or weaving captivating stories, Anoush combines her diverse background and writing expertise to deliver compelling content that resonates with diverse audiences.
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Our experts continually monitor the health and wellness space, and we update our articles when new information became available.
Updated on 26 December, 2023
- Article was updated as part of our commitment to diversity, equity, and inclusion.
"The following blog article may discuss medical treatments and interventions. However, it is important to note that the information provided is for general educational purposes only and should not be considered as a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of a qualified healthcare professional for personalized medical advice.
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Vaginismus is a sexual pain disorder (a types of sexual dysfunction or sexual disorder) that affects many women, making it difficult or impossible to have intercourse or even undergo a pelvic exam. This condition can cause a great deal of emotional distress and affect a woman’s quality of life, but fortunately, there are several medications available that can help manage the symptoms of vaginismus.
Before we dive into the different medications used to treat vaginismus, it’s important to understand the underlying causes of this condition. Vaginismus is often caused by a combination of physical and psychological factors, such as past trauma, anxiety, or even an infection. It can also be a result of muscle spasms in the pelvic floor muscles or vaginal muscles, which can cause painful intercourse and pain during other types of vaginal penetration.
Types Of Vaginismus
Primary vaginismus: This occurs when a woman has never been able to have penetrative sex without pain or discomfort. It is often associated with anxiety or fear of sex and may be caused by a history of sexual trauma or negative sexual experiences.
Secondary vaginismus: This occurs when a woman who has previously been able to have penetrative sex experiences sudden pain or discomfort during sex. It can be caused by physical factors such as an infection or injury, or psychological factors such as stress, anxiety, or relationship concerns.
In addition to these two main types, vaginismus can also be classified as global (affecting all types of vaginal penetration) or situational (only affecting specific types of penetration, such as with a particular partner or during certain activities). It is important for women experiencing vaginismus to seek medical or psychological help in order to address the underlying causes and find effective treatment.
Medications Used In The Treatment For Vaginismus
Botox Therapy
Botox is a medication that is commonly used to treat wrinkles, but it has also been found to be effective in treating vaginismus. Botox works by blocking the neurotransmitter acetylcholine, which causes muscle contractions. When injected into the pelvic floor muscles, Botox can help reduce spasms and ease pain during intercourse or other types of vaginal penetration.
Botox is typically reserved for individuals who have tried other treatments without success, as it can be expensive and may require multiple injections. However, for women who are experiencing severe pain or discomfort, Botox can be a life-changing treatment option.
Antidepressants
Antidepressant drugs are a class of medications that are commonly used to treat depression, but they can also be effective in treating the vaginismus symptoms. Antidepressants work by increasing the levels of certain neurotransmitters in the brain, which can help regulate mood and reduce anxiety.
Selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine (Prozac) and sertraline (Zoloft), are commonly prescribed for the treatment of vaginismus. These medications can help reduce anxiety and improve mood, which can make it easier for women to relax and enjoy sexual activity without experiencing pain or discomfort.
Tricyclic antidepressants (TCAs), such as amitriptyline (Elavil) and nortriptyline (Pamelor), are also sometimes prescribed for the treatment of vaginismus. These medications work by blocking the reuptake of certain neurotransmitters, which can help regulate pain perception and reduce muscle spasms.
Anti-anxiety Medications
Anti-anxiety medications, such as benzodiazepines, can also be effective in treating vaginismus symptoms. These medications work by increasing the activity of a neurotransmitter called gamma-aminobutyric acid (GABA), which can help reduce anxiety and promote relaxation.
Benzodiazepines, such as diazepam (Valium) and lorazepam (Ativan), can be used to help women relax and reduce muscle tension in the pelvic floor muscles. However, these medications can be habit-forming and may cause drowsiness or dizziness, so they should only be used under the supervision of a healthcare provider.
Topical Anesthetics
Topical anesthetics, such as lidocaine, can be applied to the vaginal area to help reduce pain and discomfort during intercourse or other types of vaginal penetration. These medications work by numbing the area, which can help women relax and enjoy sexual activity without experiencing pain or discomfort.
Topical anesthetics can be applied directly to the vaginal area before intercourse or other types of vaginal penetration. However, it’s important to note that these medications can also reduce sensation, which may make it more difficult for women to achieve orgasm or experience pleasure during sexual activity.
Hormone Therapy
Hormone therapy may be prescribed for women who are experiencing vaginal dryness, which can contribute to pain and discomfort during intercourse or other types of vaginal penetration. Hormone therapy can help restore vaginal moisture and elasticity, which can make it easier for women to enjoy sexual activity without experiencing pain or discomfort.
Estrogen therapy, in the form of vaginal creams or tablets, is the most common type of hormone therapy prescribed for the treatment of vaginismus. However, it’s important to note that hormone therapy may not be appropriate for all women, particularly those with a medical history of breast cancer or other hormone-sensitive conditions.
Hormone therapy may take several weeks or even months to become effective, so it may not be a quick fix for women experiencing severe pain or discomfort.
Muscle Relaxants
Muscle relaxants, such as baclofen, can be prescribed to help reduce muscle spasms in the pelvic floor muscles. These medications work by increasing the activity of a neurotransmitter called GABA, which can help reduce muscle tension and promote relaxation.
Muscle relaxants are typically reserved for women who have tried other treatments without success, as they can cause drowsiness and other side effects. However, for women who are experiencing severe pain or discomfort, muscle relaxants can be an effective treatment option.
Muscle relaxants should only be used under the supervision of a healthcare provider, as they can interact with other medications and may cause serious side effects in some people.
What Besides Pain Medications?
Pelvic floor physical therapy: A physical therapist can teach the patient exercises to strengthen and relax the pelvic floor muscles, which can help reduce pain during sex and improve sexual function. These can include many types of pelvic floor exercise such as Kegel exercises.
Graduated vaginal dilation: This involves using a set of progressively larger dilators to help the patient become more comfortable with vaginal penetration over time. This can be done at home with guidance from a healthcare provider.
Cognitive-behavioral therapy: This type of cognitive therapy can help address any psychological factors that may be contributing to the condition, such as anxiety, fear, or past trauma.
Education and counseling: Learning about the anatomy and physiology of the vagina and sexual response can help reduce anxiety and improve communication with sexual partners.
Is Medicine Needed For All Vaginismus Treatment?
No, medicine is not always needed for all cases of vaginismus. Vaginismus is a condition characterized by involuntary muscle spasms of the pelvic floor muscles, which can make sexual intercourse, the insertion of a tampon, or pelvic exams difficult or impossible. The treatment approach for vaginismus can vary depending on the severity of the condition and the individual needs of the patient.
In some cases, psychological therapy may be the primary treatment option, as the condition may be rooted in psychological factors such as anxiety or past trauma. Cognitive-behavioral therapy, in particular, has been shown to be effective in treating vaginismus.
In other cases, physical therapy may be recommended, including pelvic floor muscle relaxation techniques, biofeedback, and vaginal dilators. In some cases, medication such as muscle relaxants may also be prescribed to help with muscle spasms.
The treatment approach for vaginismus should be tailored to the individual and may involve a combination of approaches. It is recommended that individuals experiencing symptoms of vaginismus speak with a healthcare professional to receive an accurate diagnosis and appropriate treatment plan.
Vaginismus And Common Health Conditions: What Medications Then?
There are several health conditions that can cause vaginismus and therefore painful intercourse, including:
Endometriosis: a condition where the tissue that lines the uterus grows outside of it, causing discomfort and pain during sexual intercourse.
Here is a short list of medications commonly used for endometriosis:
Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen can be used to relieve pain associated with endometriosis.
Hormonal contraceptives, such as birth control pills, patches, and vaginal rings can help regulate menstrual cycles and reduce endometriosis-related pain.
Gonadotropin-releasing hormone (GnRH) agonists, such as leuprolide and goserelin, can reduce estrogen levels in the body and help relieve endometriosis symptoms.
Progestins, such as medroxyprogesterone and norethindrone, can help reduce endometriosis-related pain and slow the growth of endometrial tissue.
Aromatase inhibitors, such as letrozole and anastrozole, can reduce estrogen levels in the body and help relieve endometriosis symptoms.
Danazol, an androgenic steroid, can help suppress the growth of endometrial tissue and reduce endometriosis-related pain.
Pelvic inflammatory disease (PID): an infection of the reproductive organs that can cause inflammation and pain.
Here are some medications that may be used to treat PID:
Doxycycline: This is a tetracycline antibiotic that is often prescribed to treat PID. It can be taken orally or intravenously and is typically given for 14 days.
Ceftriaxone: This is a cephalosporin antibiotic that is often given intravenously in combination with doxycycline to treat PID caused by gonorrhea.
Metronidazole: This is an antibiotic that is often prescribed in combination with other antibiotics to treat PID caused by bacterial vaginosis or anaerobic bacteria.
Azithromycin: This is a macrolide antibiotic that is often given in combination with ceftriaxone or doxycycline to treat PID caused by chlamydia.
Vulvodynia: chronic pain in the vulva area that can cause discomfort during sexual intercourse.
Here is a short list of medications that may be used to treat vulvodynia:
Antidepressants: Tricyclic antidepressants (TCAs) such as amitriptyline, nortriptyline, and imipramine are often used to treat chronic pain conditions including vulvodynia. They work by blocking the reuptake of certain neurotransmitters, which can help reduce pain.
Anticonvulsants: Drugs such as gabapentin and pregabalin are anticonvulsants that have been shown to be effective in managing neuropathic pain, including vulvodynia.
Topical creams: Local anesthetics such as lidocaine or prilocaine can be applied topically to the vulva to provide temporary pain relief. Other topical creams, such as those containing estrogen or testosterone, may also be used to treat vulvodynia.
Hormonal therapy: Hormonal imbalances have been linked to vulvodynia, and some women have found relief with hormonal therapy. This may include the use of oral contraceptives or topical estrogen creams.
Interstitial cystitis (IC): a chronic condition that causes bladder pain and discomfort, which can lead to pain during sexual intercourse.
Here is a short list of medications that may be used to treat IC:
Oral medications: Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen, may help to relieve pain and inflammation associated with IC. Tricyclic antidepressants, such as amitriptyline and imipramine, can also be used to reduce pain and improve sleep quality.
Bladder instillations: A medication called dimethyl sulfoxide (DMSO) can be instilled directly into the bladder through a catheter. DMSO is believed to work by reducing inflammation and increasing blood flow to the bladder.
Immunotherapy: A medication called Bacillus Calmette-Guerin (BCG) is sometimes used to treat IC. BCG is a type of immunotherapy that stimulates the immune system to fight off bacteria and viruses.
Antihistamines: Some people with IC may benefit from taking antihistamines, which can reduce inflammation and bladder spasms. Examples include hydroxyzine and cetirizine.
