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Dr Basu
Dr Basu, Experienced Specialist
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Experience:  MD
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I am a victim of vaginismus and cant have sex. I would like

Customer Question

I am a victim of vaginismus and can't have sex. I would like to know which medication I could use to relax my vaginal muscles. I heard of the nytroglycerin ointment, dopamine... ect... Could you recommend something? Thank you.
Submitted: 3 years ago.
Category: Health
Expert:  Dr Basu replied 3 years ago.

mysticdoc :

The views expressed by me are for educational purposes only and do not establish a doctor patient relationship.

mysticdoc :

Hello,

mysticdoc :

Thanks for your question.

mysticdoc :

Pelvic floor exercises and dilator use by gradually increasing the size form the major treatment of vaginismus of unknown reasons.

mysticdoc :

Certain medications can be used to relax the vaginal muscles.

mysticdoc :

Lidocaine 5% topical ointment can be used to relieve the pain commonly.

mysticdoc :

Side effects are less since this is topical.

mysticdoc :

Nitroglycerine ointment also can be used --however this can cause dizziness and low blood pressure as side effect.

mysticdoc :

Another option is the use of oral medications.

mysticdoc :

Gabapentin 100 mg at bedtime and then gradually increasing the dose by 100 mg every 3 to 7 days is another good approach.

mysticdoc :

A muscle relaxant like flexeril also can be used at bedtime 5 to 10 mg.

mysticdoc :

A benzodiazepine like valium is another option.

mysticdoc :

A combination approach --lidocaine ointment and an oral medication like gabapentin may be better in case one agent does not work.

mysticdoc :

Nowadays, botox injection also is being tried to relax the vaginal muscles.

mysticdoc :

Best wishes,

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JACUSTOMER-llvtxtm8- : Hello,
JACUSTOMER-llvtxtm8- : Thank you for this answer.
JACUSTOMER-llvtxtm8- : Do I need prescription for each of these?
JACUSTOMER-llvtxtm8- : and which one would you recommend first?
mysticdoc :

yes all of them requires prescription.

mysticdoc :

Please lidocaine first, then consider nitroglycerin.

mysticdoc :

then oral medications.

JACUSTOMER-llvtxtm8- : as an ointment?
JACUSTOMER-llvtxtm8- : right?
JACUSTOMER-llvtxtm8- : did you ever deal with someone who has vaginismus?
mysticdoc :

yes correct as ointment.

mysticdoc :

Yes I do treat patients with this condition.

mysticdoc :

Above recommendations are based on my experiences.

mysticdoc :

The success rate is high when medication combined with exercises and dilators.

JACUSTOMER-llvtxtm8- : i saw in manhattan, could I eventually get an appointment? or shall I go to a women health center
JACUSTOMER-llvtxtm8- : medication and go straight to intercourse wouldn't work?
mysticdoc :

You should go to a women's health center

JACUSTOMER-llvtxtm8- : ok
mysticdoc :

intercourse should be avoided till you are able to tolerate the dilators without pain.

JACUSTOMER-llvtxtm8- : alright
JACUSTOMER-llvtxtm8- : i am starting with dilators and I don't think my muscles are tight/ pelvic floor also but I just put the tip and I can't forward
mysticdoc :

yes it takes some time.

JACUSTOMER-llvtxtm8- : i can't go* forward
mysticdoc :

Also do the kegel's exercises and also reverse kegel.

JACUSTOMER-llvtxtm8- : well, i've been trying since a little while
JACUSTOMER-llvtxtm8- : reverse kegel??
mysticdoc :

yes

mysticdoc :

please go to this link for further information on reverse kegel:

JACUSTOMER-llvtxtm8- : what do you mean by that?
mysticdoc :

You should see a good physical therapist experienced in pelvic floor exercises.

mysticdoc :

Best wishes,

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JACUSTOMER-llvtxtm8- : well, thank you for the link
mysticdoc :

very welcome

JACUSTOMER-llvtxtm8- : i have an other question: i am sure that a gynecologist won't be able to do an exam (and i never did one), would she recommend medications and dilators before she does the exam?
mysticdoc :

Yes she will

JACUSTOMER-llvtxtm8- : with these medications, I won't feel any pain?
JACUSTOMER-llvtxtm8- : will I get addicted?
mysticdoc :

no you should not

mysticdoc :

addiction is low risk .

mysticdoc :

and most importantly the physical therapy also

JACUSTOMER-llvtxtm8- : are they anti-depressants?
mysticdoc :

no they work on the nerves --anti anxiety and also muscle relaxant

JACUSTOMER-llvtxtm8- : ok great! is it dangerous if yo drink alcohol?
JACUSTOMER-llvtxtm8- : can a sex therapist prescribe these medications?
mysticdoc :

avoid alcohol if possible with these medications.

mysticdoc :

And a MD can only prescribe these medications.

JACUSTOMER-llvtxtm8- : im from Europe, living in New York recently, what is a MD?
mysticdoc :

Medical doctor.

JACUSTOMER-llvtxtm8- : ah ok
JACUSTOMER-llvtxtm8- : is it better to see a gynecologist, knowing that I won't be able to have an exam, or a doctor then I can keep going with dilators until I am ready?
mysticdoc :

You should see a gynecologist still for the prescription of the above medication.

JACUSTOMER-llvtxtm8- : could you recommend someone in New York City by any chance?
mysticdoc :

you can try Columbia Ob Gyn department.

mysticdoc :

This is the link:

mysticdoc :

Best wishes,

JACUSTOMER-llvtxtm8- : thank you, im going to have a look now
mysticdoc :

very welcome

mysticdoc :

Best wishes,

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