Chronic pelvic pain, muscle dysfunction, and nerve sensitivity can contribute to sexual discomfort and impair intimacy. Conditions such as dyspareunia, vaginismus, vulvodynia, vestibulodynia, female orgasmic disorder (FOD), female sexual arousal disorder (FSAD), hypoactive sexual desire disorder (HSDD), and vaginal atrophy can all be linked to pelvic floor dysfunction. Pelvic floor injections, including nerve blocks, trigger point injections, and Botox, offer targeted relief by reducing pain, relaxing overactive muscles, and restoring sexual function.
Treatment Options
- Pelvic Floor Trigger Point Injections: Painful knots, or trigger points, in the pelvic floor muscles can cause tension, discomfort during intercourse, and reduced sexual responsiveness. Injecting a local anesthetic or corticosteroid directly into these tight muscle bands can help alleviate pain and improve muscle relaxation. This approach is particularly beneficial for women with vaginismus, dyspareunia, and vulvodynia, where involuntary muscle contractions or hypersensitivity contribute to discomfort.
- Nerve Blocks: When nerve hypersensitivity plays a role in sexual pain disorders, nerve block injections can provide relief. These injections target overactive nerve pathways to reduce pain signals and improve comfort. Pudendal nerve blocks, in particular, can help women with vestibulodynia, vulvodynia, and dyspareunia by addressing nerve irritation that affects the external genital region.
- Botox Injections: Botox (botulinum toxin) can be used to relax overactive pelvic floor muscles that contribute to pain and penetration difficulties. By temporarily reducing muscle spasticity, Botox helps relieve vaginismus, dyspareunia, and other conditions where excessive muscle tension interferes with sexual function. Over time, this allows for improved comfort and the potential for more pleasurable intimacy.
Chronic pelvic pain and sexual dysfunction can lead to anticipatory anxiety, making symptoms worse. By decreasing physical discomfort, pelvic floor injections can help break the cycle of pain, allowing women to regain confidence in their sexual health. This is particularly relevant for women with FSAD and HSDD, where pain has led to a loss of desire or arousal difficulties.
In cases of postmenopausal vaginal atrophy, pain from thin, dry vaginal tissues can contribute to dyspareunia and reduced sexual pleasure. By addressing associated muscle tension and discomfort, pelvic floor injections can enhance the effectiveness of other treatments, such as hormonal therapy or laser interventions, to improve sexual function.
Next Steps
Women experiencing persistent sexual pain or discomfort that has not responded to other treatments may benefit from pelvic floor injections. By targeting muscle dysfunction and nerve sensitivity, these injections can help restore comfort and improve sexual function.