Overcoming Refractory Vaginismus with Intra-vaginal Botulinum Toxin: A Case of Restored Marital Harmony

Vaginismus is a rare condition causing involuntary vaginal muscle spasms, which may result in unconsummated marriages and marital distress. Severe cases often remain unresponsive to conventional treatments, necessitating alternative therapeutic approaches. A 32-year-old nulligravid healthcare worker presented with a three-year history of inability to achieve coitus despite multiple counseling sessions and various treatments, including behavioral therapy and pelvic floor exercises. Following persistent symptoms, she was treated successfully with intra-vaginal botulinum toxin injection, which resolved her condition and restored marital harmony. Intra-vaginal botulinum toxin injection offers a safe and effective first-line treatment for severe, refractory vaginismus, providing a valuable option for patients unresponsive to traditional therapies.