Vaginismus Dilating

Large Dilators for Large Partners

Concerning vaginismus dilating, women who have large partners need to be dilating to large dilators – large dilators or large partners. Treatment using the Pacik Botox multimodal program for vaginismus includes Botox injections and progressive dilation. During treatment under anesthesia the patient’s partner is routinely sitting at my side. He is asked to comment on the size of his erection when compared to the dilators on my treatment table. Most often, he notes that he is between a #5 and #6 dilator or more like the #6 dilator. For these couples, dilating to the #6 is enough to achieve pain free intercourse. Recently two of the men mentioned that they are larger than the #6 confirmed by the female partner the next day during counseling.

A frequently asked question is “How much dilation is needed to achieve pain free intercourse?”.

This is determined by the partner’s size. It is simply a matter of adequate stretching of the vaginal muscles to comfortably achieve penetration with a large partner.

vaginismus treatment with Botox and vaginal dilators

Dr. Pacik has customized these glass dilators so that they are shorter in length and therefore, more comfortable. The #4, #5 and #6 glass dilator is shown.

Pacik Glass Dilators

Pacik glass dilators in sizes #7 and #8 are available for women who have large partners. Once the number 6 dilator is comfortable women are able to advance to the larger dilators. Though this may seem impossible early after vaginismus treatment this progression can be achieved by those patients who require larger dilation. To better understand how to use dilators A general overview of articles describing dilation.

Pacik Glass Dilators

Since Dr. Pacik retired on September 1st, 2015, we are not selling the Pacik Glass dilators through our office anymore but we do have a web page with the manufacturer Crystal Delight where you can still order them. You can order the dilators as a set or individually with or without a pouch.

Forum Commentary

On the Forum, members have commented on their own personal use and benefit of using the larger dilators as they have larger partners. 

Patient 1 writes:

“Hi there…  Once I got really comfortable with the six, I progressed to seven, and this helped me feel less anxious about attempting intercourse. However, once we were able to have sex, I realized I didn’t actually need to use the seven any longer, and in fact I now only rarely use the six, as the five is sufficient! So I would say it’s not essential, but helped me to physically and mentally prepare.”

Patient 2 writes:

“I’m not sure I would have had the confidence to attempt intercourse if I hadn’t dilated with the glass seven for the weeks prior to our first attempt at intercourse. It really seemed to help relieve some anxiety going into that first attempt knowing that I had successfully dilated with the glass seven. When I first transitioned to the seven, I dilated a little longer with the glass #6 beforehand and made sure to use the lidocaine/lube mix.”

Dr. Pacik’s reply:

“For partners who are larger than the #6 dilator, dilating to #7 is like an insurance policy. Once you get comfortable with intercourse it is unlikely #7 needs to be used. We have a glass #8 also and here too it is possible to dilate to this size. A baby’s head is larger than #8 so the vagina is certainly capable of this stretch.”

Summary
Vaginismus dilating requires dilating to a size similar to the partner’s erection. For men who are larger, dilating to the Pacik glass #7 or #8 is very helpful in achieving pain free intercourse.

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About Dr. Pacik

Peter Pacik, MD, FACS is a recognized pioneer in treating patients with Botox for vaginismus and the author of When Sex Seems Impossible: Stories of Vaginismus and How You Can Achieve Intimacy. He has been in practice for over thirty years and belongs to a small group of prestigious surgeons who are double board certified by both the American Board of Surgery and the American Board of Plastic Surgery. In 2010, Dr. Pacik received FDA approval to continue his study to treat vaginismus using intravaginal injections of Botox together with progressive dilation under anesthesia.
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