Vaginismus Treatment Protocol
First Step: Proper Diagnosis
The first and most important step we take with any couple facing difficulties in their intimate relationship is to conduct a precise and thorough diagnosis.
It’s important to understand that not every woman who experiences pain or tightness during intercourse is necessarily suffering from vaginismus. Pain can result from many other causes—such as infections, psychological stress, or even improper technique. That’s why it’s essential for the doctor to listen carefully to the full story, take a detailed medical history, and conduct a clinical exam to identify the true cause.
Do All Cases Require Vaginal Dilators?
Many people assume that vaginal dilators are a magical solution for vaginismus, but that’s far from the truth. Dr. Reham El-Shall explains:
Some women have tried all types of dilators with no improvement.
Not every case is suitable for dilators—this decision must be made by a qualified medical professional.
In certain cases, physical therapy and guided exercises during the medical session are sufficient without the use of any tools.
In summary, while dilators can be helpful in some situations, they are not a one-size-fits-all solution. Their use must be carefully planned, supervised, and introduced gradually.
Is Botox Necessary for Every Case?
Botox injections can be a valid treatment option for certain cases, but they are not needed for everyone.
If Botox is used, it must be done with precision, by a trained specialist, and at the right time.
ncorrect timing or technique can result in no improvement at all, even if the patient had Botox before.
Some women had Botox injections years ago with no results, but when it was administered correctly and followed by proper guidance, they experienced significant improvement.
How Do We Decide Between Dilators or Botox?
The decision depends on careful, step-by-step assessment:
1. We begin with a detailed evaluation of the case.
2. Start with conservative treatment: physical therapy, exercises, and follow-up sessions.
3. If no progress is made, then we consider dilators or Botox, based on what’s most appropriate.
4. Whether using dilators or Botox, the process takes time. It’s not something that shows results in just 2–3 days, as commonly misunderstood.
Can Vaginismus Be Treated Online?
Absolutely! We’ve seen many cases make significant progress through online consultations and remote follow-ups.
We were able to guide them step-by-step without the need for frequent clinic visits. In some cases, only one in-person session was needed.
How Many Sessions Are Needed When Using Dilators?
There is no fixed number of sessions that applies to all cases:
Some couples improved after the first session.
Others needed several months or even years of gradual work.
Each case is unique, and the treatment plan is tailored accordingly.
Myths and Misconceptions About Vaginismus
Unfortunately, many women have heard hurtful and incorrect comments, even from doctors, such as:
• “You’re weak.”
• “You’ll never get better.”
• “It’s all in your head.”
These statements are completely false and emotionally damaging. The truth is: vaginismus is a real medical condition, and it’s treatable—with the right support and guidance.
What to Expect from the Treatment Protocol
1. Accurate diagnosis through a one-on-one consultation.
2. A customized treatment plan that may include physical therapy and stretching exercises.
3. Follow-up sessions, either online or in-person, depending on the case.
4. Use of dilators or Botox only if truly necessary.
5. Compassionate psychological support throughout the journey.
6. Education and involvement of the partner, to foster a supportive relationship.
In Conclusion
The journey to healing is not complicated or impossible—it just requires patience and commitment.
We start with a proper diagnosis, followed by a clear treatment plan.
Emotional support from your partner and loved ones plays a vital role.
Some cases improve in as little as three sessions.
Others may take longer—but every step is purposeful and manageable.
What truly matters is the cooperation between both partners.
And remember:
You are not alone.
We’re here for you—online, in the clinic, through videos or sessions—to support you, listen to you, and walk with you every step of the way.
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