Diagnosis of vaginismus is made by external examination, abdominal or intravaginal ultrasound and MRI, among other techniques.
If a pelvic examination is performed it may reveal contracture of the perineal musculature and levator ani muscles with adduction of the muscles.
Treatment of vaginismus
Functional dyspareunia can be treated with counseling and psychotherapy. If the patient has a partner, she should also be interviewed.
Aesthetic medicine specialists advise precoital caresses, vaginal lubricant and, in menopause, sometimes laser vaginal rejuvenation is recommended.
In the case of organic dyspareunia, the underlying cause will be treated, whether it is a stiff hymen or cervicitis.
On the other hand, when vaginismus is caused by a strong contraction of the vaginal muscles without a functional or physical cause, the best treatment is botulinum toxin therapy.
Sometimes, in addition, it may be necessary the application of mild sedatives or other muscle relaxants that relieve emotional tension and help to avoid contractures.
Prognosis of vaginismus and treatment
Functional dyspareunia and organic dyspareunia disappear quickly after the causes are eliminated.
When vaginismus is primary, that is, without physical cause, the most effective medical treatment for vaginismus is the use of botulinum toxin, which is injected into the vaginal muscles that are involuntarily contracted in order to relax them and prevent involuntary contraction. The treatment is only medical, in consultation, on an outpatient basis, with local anesthesia using anesthetic cream of the area and through minimal injections in the vaginal musculature botulinum toxin is injected.
It takes 1-4 sessions of botulinum toxin to obtain a definitive result of vaginismus.