Vaginismus Treatment with Muscle Relaxing Injections

Vaginismus is a painful medical condition where the muscles around the vagina tighten involuntarily during attempted penetration.

This muscle tension is often an automatic reaction, which means it can happen even when a woman wants to have penetrative sex, use a tampon, undergo a gynaecological examination or use vaginal dilators.

Common symptoms of vaginismus may include:

• Painful intercourse or a burning, stinging or tearing sensation during penetration
• Difficulty or inability to have penetrative sex
• Tightness, closing or spasms around the vaginal entrance
• Anxiety, fear or physical guarding before attempted penetration
• Discomfort during pap smears, pelvic examinations or tampon use
• Vaginal dryness or increased sensitivity linked to stress, hormonal changes or discomfort
• Ongoing avoidance of intimacy due to previous pain or fear of pain

Vaginismus occurs for different reasons, and contributing factors may include previous painful intercourse, pelvic floor dysfunction, anxiety, trauma, hormonal changes, vaginal dryness, infections or other underlying medical concerns.

A specialist consultation can help identify what may be contributing to your symptoms and guide you towards the most appropriate treatment plan.

Book a consultation to discuss your symptoms in a safe, discreet and supportive environment.

At Dr Nerina Wilkinson + Associates, vaginismus treatment is approached with sensitivity, discretion and medical expertise.

Because vaginismus can be influenced by physical, emotional and psychological factors, every treatment journey begins with a detailed consultation. During this appointment, your specialist will assess your symptoms, medical history and concerns, while explaining the treatment process, expected outcomes and any relevant risks.

Our aim is to create a safe, supportive environment where you feel understood, informed and comfortable before moving forward with treatment.

Book a consultation to discuss a personalised treatment plan.

Vaginismus treatment works by using botulinum toxin to relax the overactive pelvic floor muscles that contract involuntarily during attempted penetration.

By temporarily interrupting the nerve signals that trigger this muscle response, the treatment helps reduce spasms and allows the vaginal muscles to relax. This can make penetration feel more comfortable and less physically guarded.

The effects usually last for several months, giving the body time to build new, more positive responses to intimacy, examinations or dilator use. In many cases, this window of relief helps support long-term improvement.

Book a consultation to find out whether this treatment is suitable for you.

Vaginismus treatment may be suitable for women who experience persistent vaginal pain, tightness or involuntary muscle contraction during penetration, especially when other methods have not provided enough relief.

This treatment may be considered if you experience:

• Painful sexual intercourse or difficulty with penetrative sex
• Pelvic floor spasms that make sex, examinations or dilator use uncomfortable
• Anxiety or fear linked to attempted penetration
• Discomfort during gynaecological examinations, including pap smears
• Difficulty using vaginal dilators or intimate products
• Vaginismus symptoms that affect your confidence, intimacy or quality of life

Suitable candidates are generally in good health, understand what the treatment can and cannot achieve, and are looking for a non-surgical treatment option.

A consultation is essential to confirm whether vaginismus treatment is appropriate for your symptoms, medical history and personal goals.

Vaginismus treatment is carried out in a private clinical setting by an experienced medical team.

The procedure begins with a consultation to assess your symptoms and confirm that the treatment is suitable for you. A local anaesthetic is then applied to improve comfort before the muscle-relaxing injection is administered into three areas around the vaginal circumference, targeting the muscles involved in involuntary spasm.

The treatment takes approximately 30 minutes and involves minimal discomfort. There is no formal downtime, and most women can return to normal daily activities shortly after the appointment.

The muscle-relaxing effect develops gradually over the following days, with many women noticing improved comfort during penetration within one to two weeks. Mild tenderness or slight bleeding at the injection site may occur, but this is usually temporary.

Book a consultation to discuss the procedure in more detail.

Vaginismus treatment offers a non-surgical option for women struggling with painful or difficult penetration caused by involuntary vaginal muscle spasms.

Key benefits may include:

• Reduced pain during intercourse by relaxing the muscles responsible for spasm
• Improved comfort during penetration, examinations or dilator use
• A discreet in-room procedure performed under local anaesthetic
• Minimal discomfort and no required downtime
• Support for restored intimacy, confidence and sexual wellbeing
• Results that may last beyond the active treatment period as the body develops a less defensive response

Many women experience meaningful improvement after one treatment, although individual results may vary.

Book your consultation to find out how vaginismus treatment can support more comfortable intimacy.

Some women begin to notice an improvement within a few days, although results typically continue to develop over one to two weeks as the treated muscles relax.

Your specialist may recommend a follow-up appointment to assess your response and advise whether additional support, such as pelvic floor therapy, counselling or vaginal dilators, could help enhance your outcome.

Many women achieve noticeable improvement after a single vaginismus treatment session.

In some cases, a second treatment may be recommended if symptoms continue, if the muscle spasm is more persistent, or if additional relaxation is needed to support progress.

Your specialist will guide you on the most appropriate treatment plan based on your consultation, symptoms and response to the initial procedure.

Vaginismus treatment is a quick, in-room procedure that usually takes around 30 minutes, including the application of a local anaesthetic.

There is no required downtime, and most women are able to continue with their usual daily routine after the appointment.

Your specialist will explain the full treatment process and timing during your consultation.

Vaginismus treatment does not usually require a recovery period.

Most women can return to normal daily activities immediately after the procedure. It is common to wait a few days to one week before attempting penetration, depending on comfort levels and whether any minor tenderness has settled.

Temporary swelling, slight bleeding or sensitivity at the injection site may occur, but these effects are usually mild and short-lived.

Your specialist will provide tailored aftercare instructions during your consultation, including guidance on when to resume intercourse, use dilators or continue with any complementary therapy.

The cost of vaginismus treatment in South Africa can vary depending on the clinic, practitioner expertise, treatment method and products used. At medical aesthetic clinics, pricing may range from approximately R2,500 to R12,000 per session.

At Dr Nerina Wilkinson + Associates, vaginismus treatment is priced between R3,500 and R7,500 per session.

A consultation is recommended to confirm your suitability, discuss your symptoms and provide a clearer cost estimate based on your personalised treatment plan.

Book your consultation to learn more about pricing and what to expect from your treatment journey.

Vaginismus treatment is considered safe when performed by qualified medical professionals in an appropriate clinical setting.

Botulinum toxin has been used in medical treatments for many years and has a well-established safety profile when administered correctly. As with any injectable treatment, minor side effects may occur, including temporary tenderness, swelling, bruising or slight bleeding at the injection site.

A detailed consultation is important to assess your medical history, discuss any contraindications and ensure the treatment is suitable for your individual needs.

Vaginismus treatment is generally well tolerated, but all medical procedures carry some level of risk.

Possible side effects or complications may include:

• Mild swelling, tenderness or slight bleeding at the injection site
• Temporary bruising or discomfort in the treated area
• Infection, although this is rare when treatment is performed in a sterile clinical environment
• Temporary weakness in nearby muscles, which is uncommon when the injection is placed correctly
• Allergic reaction to botulinum toxin, although this is extremely rare

During your consultation, your specialist will discuss your medical history, symptoms and any potential contraindications before treatment.

Following the recommended pre- and post-treatment guidance can help reduce risk and support the best possible outcome.

At Dr Nerina Wilkinson + Associates, vaginismus treatment is handled with sensitivity, privacy and specialist medical care. Every treatment plan is tailored to your symptoms, comfort levels and personal goals, helping you feel informed and supported at each stage of the process.

Your journey begins with a detailed consultation where your specialist will assess your medical history, discuss your experience of vaginismus and explain whether this treatment is appropriate for you.

What to do before vaginismus treatment

To prepare for your vaginismus treatment, please follow these guidelines:

• Share your medical history: Inform your specialist about any existing medical conditions, previous pelvic treatments, allergies, medications, or other relevant health concerns.
• Discuss your symptoms openly: Be prepared to talk through your experience with painful penetration, pelvic floor tightness, anxiety around intercourse, difficulty with examinations or challenges using dilators.
• Avoid blood-thinning medication where advised: Your specialist may recommend avoiding aspirin, anti-inflammatory medication or certain supplements before treatment to reduce the risk of bruising or slight bleeding.
• Ask questions during your consultation: Use your appointment to discuss the procedure, expected results, possible risks, aftercare, and whether additional support, such as pelvic floor therapy, may be beneficial.
• Plan for comfort: Although there is no downtime, you may prefer to keep the rest of your day light and comfortable after your appointment.

Day of vaginismus treatment

On the day of your treatment, our team will guide you through the process with care and discretion.

• Medical assessment: Your specialist will review your symptoms, confirm suitability and answer any final questions before treatment begins.
• Preparation: You will be given privacy to prepare for the procedure, and the treatment area will be carefully cleaned in a clinical setting.
• Local anaesthetic: A local anaesthetic is applied to help minimise discomfort during the procedure.
• Treatment: The muscle-relaxing injection is administered into targeted areas around the vaginal circumference to relax the muscles involved in involuntary spasm.
• Procedure time: The treatment usually takes approximately 30 minutes from start to finish, including preparation and anaesthetic time.

After vaginismus treatment

After your vaginismus treatment, you can usually return to normal daily activities immediately. Mild tenderness, slight swelling, bruising, or minor bleeding at the injection site may occur, but these typically settle within a few days.

Please follow these aftercare guidelines:

• Avoid penetration initially: Your specialist will advise when it is suitable to attempt intercourse, use dilators or resume other forms of vaginal penetration. This is often within a few days to one week, depending on comfort.
• Monitor your response: The relaxing effect develops gradually, with many women noticing improved comfort within one to two weeks.
• Follow personalised guidance: Your specialist may recommend gentle dilator use, pelvic floor therapy or other supportive steps to help reinforce your results.
• Contact your specialist if needed: If you experience unusual pain, ongoing bleeding, signs of infection or any concerning symptoms, contact the clinic for medical advice.

The goal of treatment is to reduce involuntary muscle tightening and create a more comfortable experience with penetration over time. Your specialist will guide you on what to expect and whether a follow-up appointment is recommended.

Vaginismus treatments are performed at Dr Nerina Wilkinson + Associates, an intimate wellness and medical aesthetics clinic located at the V&A Waterfront in Cape Town.

The clinic forms part of the House of Aesthetic Couture and Skin Science, providing a discreet, calm and professional environment for sensitive treatments.

Each appointment is handled with clinical care, privacy and compassion, ensuring you feel supported from consultation through to treatment and aftercare.