‘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?

Cosmopolitan (South Africa) - - CONTENTS - AS TOLD TO JAIME WADDING­TON

‘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’

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