‘I Got Botox in My Vagina’
We’ve come to know Botox as an anti-ageing treatment – but can the forehead-freezing injection save your sex life?
‘MY HUSBAND AND I HAVE ALWAYS HAD A GOOD SEX LIFE.
We met when I was 19 and have been married for almost 20 years. I never thought I’d lose the ability to have sex with my own husband.
‘My name is Jennifer* and I suffer from vaginismus. It’s a term I’d never heard before being diagnosed. It means the muscles in my vagina contract involuntarily whenever anything comes near my genitals, making sex impossible and causing me to lose my confidence entirely.
‘It all started when I found out I had breast cancer at the end of 2013. I started chemo in April 2014, had a mastectomy shortly afterwards, then began hormonal therapy. The more I continued with the therapy, the drier my vagina became, which eventually made sex excruciating. It was bad enough losing my breasts; to lose my sex life as well was devastating.
‘My oncologist explained that oestrogen levels do drop when undergoing hormonal therapy, which can make the membranes of the vagina thinner and less flexible, and produce less lubricating fluid. I was shattered. Her solution was that I try to use a lubricant during intercourse. Lube? Are you kidding me?? When that didn’t work, she prescribed me with Vagifem, a small tablet that you put into your vagina twice a week. It releases a hormone to restore the levels of oestrogen and enhance moisture. It helped to a certain extent but sex was still incredibly uncomfortable – nowhere near as pleasurable as it had been pre-cancer. It eventually became more of an issue, but there was nothing that I was aware of that could help. My husband was supportive, but it was very frustrating for both of us. I’d pretty much given up hope of ever enjoying sex again … until the day I was waiting for a checkup with my oncologist, and I picked up a magazine that featured an article that would change my life.
Your mind plays a part, too
‘The article spoke about a treatment that could help with vaginal dryness. I showed it to my oncologist; she said she knew nothing about it. I followed up on the article and found Dr Natalia Novikova – the first certified aesthetic gynaecologist in South Africa, based in Cape Town. I made an appointment to see her; after a consultation and a physical exam, she diagnosed me with vaginismus.’
‘Vaginismus is an involuntary contraction of the muscles in the vagina,’ says Novikova. ‘When anything – such as a penis, fingers, dilators or a tampon – is inserted into your vagina, it’s incredibly painful or even impossible because of the spasm of the vaginal muscles. There are all kinds of triggers of vaginismus, from sexual assault to yeast infections, vaginal dryness and bladder infections. Even religious views can have an effect,
‘A DOCTOR RECOMMENDED I TRY A VAGINAL BOTOX TREATMENT. BOTOX? FOR THE VAGINA? I WAS HESITANT. IT SOUNDED ODD, PAINFUL, INTIMIDATING’
or being scared of intercourse because of potential pregnancy. Once women experience such pain, the mind and body can develop a conditioned response to penetration. The body learns to expect pain, which causes the pelvic muscles to contract to protect against that pain. The problem is that the tightening of these muscles actually causes more pain.’
‘I’d never suffered from vaginismus before I’d gone through cancer treatment,’ says Jennifer. ‘It was clear that my body was reacting to what I was going through. Novikova explained that the vaginismus was essentially an emotional reaction – I was anticipating the pain. I would tense up before anything even happened.
‘She told me about a laser treatment called FemiLift – vaginal laser rejuvenation. It’s supposed to reverse changes to a woman’s intimate parts that occur through childbirth, ageing or hormonal changes (as was the case with me). The minimally invasive laser treatment helps to tone the muscles of the vagina and rebuild the collagen of the vaginal walls, making it more moist. I thought to myself, “This is hope!”
‘About a week after having the treatment, my husband and I tried to have sex, but to my dismay it was still very painful. I went back to Novikova. This time, she recommended I try a vaginal Botox treatment along with the FemiLift. “Botox?” I thought. “For the vagina?” I was hesitant. It sounded odd, painful, intimidating.
But the truth was I couldn’t bear how uncomfortable sex was – I had nothing to lose.’
It’s a game changer
‘Botox is not just for wrinkles,’ says Zak Schabort, founder of the Cosmetic and Dental Emporium in Cape Town who offers accredited Botox training to doctors. ‘Botox or botulinum toxin A is derived from a form of bacteria, and is used medically for conditions such as excessive sweating, migraines or, in this case, muscle spasms. When it’s injected into the targeted muscle, it temporarily blocks nerve impulses that tell it to contract. Botox causes a weakening or paralysis of the targeted muscles, which lasts up to four months.’
‘The night before the Botox treatment, I put on a numbing cream,’ says Jennifer. ‘Just before the procedure, I also took a painkiller. General anaesthesia can be used for more serious cases. My doctor used a tiny needle to inject Botox into the muscles of my vagina. I didn’t feel any pain and had no discomfort after the treatment.
‘Two weeks later, my husband and I had sex. We actually managed to have sex. Good sex! I couldn’t believe it. After one treatment, the difference was remarkable. I can’t explain the emotional and physical relief. After losing my breasts and experiencing vaginal dryness from the hormonal therapy, my confidence was shot. When I couldn’t have sex, I didn’t feel sexy. But Botox helped me reclaim my confidence – I finally felt like myself again.’
‘This is an important move for women’s health in South Africa,’ says Novikova. ‘In the past, all we could offer for the treatment of vaginismus was psychological therapy and the use of vaginal dilators. It’s incredibly exciting that a new, effective treatment is now available. Even better: it’s typically a once-off treatment. Injecting Botox into the vaginal muscle stops the vagina from contracting – it breaks the vicious cycle. The effects of Botox wear off completely after a while, but the effect of a normal sex life during this period can heal vaginismus completely.’
You need to know
‘Three sessions of FemiLift cost me R15000; the Botox was R6000,’ says Jennifer. ‘Medical aid didn’t cover it. But it’s important for women to know there is an option.’
‘A gynaecologist trained for the vaginal Botox treatment can advise you on how many units you’ll need, so you can get an idea of the cost before committing,’ says Schabort. Novikova says, ‘On occasion, I have to repeat the injection after the Botox has left the system. But I expect patients to have easy, pain-free vaginal penetration four to six weeks after the procedure.’
Although Botox has been approved by the US Food and Drug Administration and CE-approved by the European regulatory body, there are many unregulated and counterfeit versions out there. Not only that – there are also many unqualified practitioners administering Botox. Yikes! So how do you make sure that you’re in good hands?
‘It’s critical to have the procedure done by a qualified medical doctor experienced in injecting Botox,’ says Schabort. ‘A gynaecologist with special training in aesthetic medicine is ideal. Ask the doctor whether they’ve had official training in cosmetic injections, and are a certified injector. You may also ask to see the bottle to make sure it’s the real deal – Botox Botulinum Toxin Type A or Dysport Botulinum Toxin Type A.’ Never be afraid to ask!
Breaking the silence
‘What disturbed me most throughout this process was not the pain but the fact that there is great silence around this issue,’ says Jennifer. ‘Women rarely talk about the problem, and many doctors don’t know how to treat it. When I raised the concern with my oncologist, there was very little knowledge, empathy or concern. It was as though nobody even acknowledged the impact this has on physical and mental wellbeing. I know there are women who have vaginismus from a young age and never speak about it. Had this Botox treatment been more widely known and more readily available, I would have escaped a lot of pain.
‘I highly recommend this to anyone struggling with this issue. It will help you reclaim your sexuality and confidence – and by seeking treatment, we can encourage continued research and awareness, so that women don’t have to endure this pain for the rest of their life. Everybody deserves to have a good sex life.’ ■
*NAME HAS BEEN CHANGED
‘WHAT DISTURBED ME THROUGHOUT THIS PROCESS WAS NOT THE PAIN BUT THE FACT THAT THERE IS GREAT SILENCE AROUND THIS ISSUE’