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Dr Farzana Khan

Dr Farzana Khan

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Dr Farzana Khan qualified as an MD from the University of Copenhagen in 2003. She has worked in dermatology and obstetrics & gynaecology across the North of England and completed her MRCGP (CCT, 2013) and the Diploma of the Faculty of Sexual & Reproductive Health (2013). Her clinical focus is vaginal health—including dryness/GSM, sexual function concerns, lichen sclerosus, and comfort or volume changes. She offers careful assessment, discusses medical and conservative options first, and considers selected regenerative or aesthetic treatments where appropriate. Dr Farzana also trains clinicians as a KOL/Trainer with Neauvia, Asclepion Laser, and RegenLab (since 2023). Ongoing CPD includes IMCAS, CCR, ACE and expert training in women’s intimate fillers, PRP, and polynucleotide injectables. Her approach is simple: clear explanations, realistic expectations, and shared decision-making.

MD MRCGP DFFP
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Authored and medically reviewed by Dr Farzana Khan on 24 July 2026
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How Clinicians Safely Palpate the Pubococcygeus Muscle to Identify Entry Pain Trigger Points

How Clinicians Safely Palpate the Pubococcygeus Muscle to Identify Entry Pain Trigger Points

How Clinicians Safely Palpate the Pubococcygeus Muscle to Identify Entry Pain Trigger Points

How Clinicians Safely Palpate the Pubococcygeus Muscle to Identify Entry Pain Trigger Points

Does the O-Shot hurt and is anesthetic used?

Does the O-Shot hurt and is anesthetic used?

Does the G-Shot hurt and is numbing/anaesthetic used?

Does the G-Shot hurt and is numbing/anaesthetic used?




Specialist-led


Injection option


Screen first

Women’s Health Clinic FAQ

Can a targeted trigger point injection using lidocaine into the bulbocavernosus muscle provide short-term diagnostic relief or longer-term benefit in selected cases for entryway penetration pain?

Nerve blocks, trigger point injections and pelvic-floor botulinum toxin are specialist interventions, so public advice should explain principles without teaching technique.

Direct answer

A targeted lidocaine trigger-point injection may provide diagnostic or short-term relief in selected muscle pain, but durable benefit is not certain and requires a wider plan. The safe clinical route is to confirm the pain pattern and diagnosis, check contraindications or red flags, explain realistic benefits and limits, and keep medicines, injections, surgery, devices and rehabilitation clinician-led. This gives patients useful understanding without turning specialist care into public protocol instructions.

The safest answer explains what the injection is trying to change, who may be considered, why screening matters and why relief can be diagnostic, temporary or incomplete.


Educational only. Suitability and next steps should be confirmed after consultation. Results vary. Not a cure.

Women's Health Clinic consultation about can a targeted trigger point injection using lidocaine into the bulbocavernosus muscle provide short-term diagnostic relief or longer-term benefit in selected cases for entryway penetration pain?

Injection assessment

At a glance

These are the main points to understand before considering medicines, injections, surgery, laser, dilators, biofeedback or multidisciplinary review for painful sex.

At a glance

Clinical summary

Main area

Nerve or muscle target

Pattern

Focal or spasm pain

Watch for

Infection signs

Next step

Specialist assessment

Important safety note

Injection should be postponed or reviewed if there is active infection, fever, unexplained bleeding, pregnancy concern, allergy risk, numbness, urinary retention or rapidly worsening pain.

Suitability
Consent
Monitoring
Pelvic floor
Review




Detailed answer

Detailed answer

The deeper answer starts by separating mechanism from protocol. Patients need to know why an option may be considered, not the private clinical settings, formula, dose or procedural steps.

Direct answer

The key is to explain the target and purpose of an injection while keeping screening, consent, procedural planning and aftercare specialist-led.

Mechanism
Criteria
Limits
Safety

Direct answer

target planning, imaging and medicine choices are clinical procedures, not public instructions.

Injection mechanism

Blocks and trigger injections may reduce pain input or muscle spasm in selected cases.

Selection and screening

Active infection, bleeding risk, allergy and pregnancy context need checking before intervention.

Consent and monitoring

Relief may be temporary, partial or diagnostic rather than curative.

How the research shapes the answer

The clinical reality is that refractory dyspareunia can involve tissue sensitivity, nerve amplification, pelvic-floor guarding, medication tolerance, infection screening and consent boundaries.

The benchmark shaped search intent and section order, while final wording avoids formulas, doses, procedural details, technical settings and unsupervised progression plans.





Patient safety

Why this matters

Treatment-heavy dyspareunia pages can easily become too promotional or too technical. The safer route is to explain clinical reasoning and keep supervision visible.

It keeps technique private

target planning, imaging and medicine choices are clinical procedures, not public instructions.

It explains mechanism

Blocks and trigger injections may reduce pain input or muscle spasm in selected cases.

It screens for harm

Active infection, bleeding risk, allergy and pregnancy context need checking before intervention.

It sets expectations

Relief may be temporary, partial or diagnostic rather than curative.

Escalation should be structured

Persistent painful sex is rarely solved by adding one more treatment without checking the diagnosis, tissue state, pelvic floor and pain pathway.

A better plan connects the mechanism to suitability, consent, monitoring and realistic follow-up.





Considerations

What to consider

A consultation should clarify pain location, diagnosis, previous care, medicine history, contraindications, infection risk, pelvic-floor findings, consent questions and follow-up needs.

Consultation priorities

Useful details include pain location, onset, previous diagnoses, current medicines, allergies, infection history, bleeding, discharge, pelvic-floor symptoms, previous treatment response and what matters most to the patient.

Diagnosis
Risks
Alternatives
Follow-up

Target question

Pudendal, vestibular and muscle-trigger pain are different targets.

Infection screen

Hidden infection or inflamed tissue can change whether injection is appropriate.

Consent

Benefits, limits, alternatives and aftercare should be understood before treatment.

Combined care

Physiotherapy, tissue care or pain medicine may still be needed.

What not to assume

Do not assume more intensive treatment is better, or that refractory pain means the patient has failed conservative care.

Timelines vary because tissue healing, nerve sensitivity, medication review, pelvic-floor retraining and postoperative recovery each move at a different pace.





Common concerns and myths

Common misconceptions

Treatment content can sound confident in ways that are not clinically fair. These corrections keep the answer useful and responsible.

Myth: An injection proves the diagnosis

Reality: treatment decisions need diagnosis, suitability, consent, monitoring and realistic expectations considered together.

Myth: Pain relief is always immediate and long-lasting

Reality: treatment may reduce symptoms in selected patients, but response varies and monitoring matters.

Myth: Technique details are suitable for public self-guidance

Reality: procedural details should stay with trained clinicians, with public content focused on consent, safety and expectations.

Mechanism is not instruction

It is appropriate to explain what a treatment is trying to change while keeping formulas, settings, doses and technique private.

Review protects progress

If pain worsens or response is poor, the next step is reassessment rather than force, escalation or self-adjustment.





Safety checklist

Safety checklist

Use these checks to decide whether treatment discussion can continue routinely or needs review before any next step.

Is the diagnosis secure?

Pain map, tissue findings, infection screen and pelvic-floor pattern should fit the proposed treatment.

Are there red flags?

Fever, bleeding, severe pelvic pain, pregnancy concern, infection signs or urinary retention should be reviewed first.

Are risks understood?

Medicines, injections, surgery, laser and rehabilitation each need consent, alternatives and monitoring.

Is progress being tracked?

Pain intensity, function, tolerance, flare-ups and side effects should guide follow-up.

More reassuring signs

A treatment pathway is more reassuring when diagnosis is clear, symptoms are stable, red flags are absent, consent is informed and follow-up is planned.

Clear diagnosis
No red flags
Follow-up

Reasons to seek advice

Injection should be postponed or reviewed if there is active infection, fever, unexplained bleeding, pregnancy concern, allergy risk, numbness, urinary retention or rapidly worsening pain.

Bleeding
Infection
Severe pain




When to escalate

When to seek medical help

Some symptoms should not be managed by continuing, intensifying or self-adjusting treatment.

Use NHS 111 online

Fever, infection signs or feeling unwell

Fever, offensive discharge, pelvic pain, worsening redness, swelling or feeling systemically unwell needs urgent advice.

Bleeding, pregnancy concern or severe pain

Bleeding with sex, possible pregnancy, severe pelvic pain or rapidly worsening vulval pain should be assessed promptly.

Neurological or urinary symptoms

New numbness, leg weakness, severe shooting pain or urinary retention needs medical advice.

Emergency symptoms

Call 999 for life-threatening symptoms such as collapse, chest pain, breathing difficulty or stroke-like symptoms.

Use NHS 111 for urgent advice or call 999 in a life-threatening emergency. This page is educational and does not replace individual medical assessment.

Additional clinical context

How to use this answer

This page is designed to separate treatment mechanism, suitability, consent, monitoring and escalation. It deliberately does not provide formulas, doses, procedural details, technical settings or unsupervised rehabilitation steps.

What to discuss at appointment

Useful details include pain mapping, current medicines, allergies, infection history, bleeding, discharge, previous treatment response, pelvic-floor symptoms, mental health context, treatment goals and what level of risk feels acceptable.

Next step

Book a clinical consultation

A consultation can review pain location, pelvic-floor tone, infection risk, previous treatments, consent, allergy history and whether injection, physiotherapy or another route is safer.

View Research Sources (12 Sources)
• NHS - Pain during or after sex
• NICE - Medicines optimisation
• POGP - Pelvic health physiotherapy
• PubMed - pudendal nerve block pelvic pain dyspareunia
• PubMed - botulinum toxin pelvic floor spasm dyspareunia
• PubMed - trigger point injection pelvic floor dyspareunia
• NICE - Neuropathic pain in adults
• NICE - Pelvic floor dysfunction
• NICE - Menopause identification and management
• RCOG - Skin conditions of the vulva
• British Society for the Study of Vulval Disease
• PubMed - pelvic floor biofeedback dyspareunia

These 12 source names are selected from 246 curated sources. Additional reviewed material included UK clinical guidance, professional society guidance, peer-reviewed clinical papers, evidence reviews; duplicate and low-relevance records were removed before display.

Educational only. This information is for education only and is not a substitute for professional medical advice, diagnosis or treatment. Results vary. Not a cure.

  • Clinical Assessment: Individual suitability is determined by a clinician; results may vary.
  • Non-NHS: Private healthcare provider only. Pricing varies by treatment and site. Availability varies by clinical location.