Botox Treatment for Vaginismus: Pre-Procedure Nerves

Profound Fear and Anxiety for the Vaginismus Sufferer

AnxietyNerves, tension, and extreme anxiety are pre-procedure symptoms that often accompany anticipated treatment of vaginismus. These feelings are often overwhelming when the moment of treatment arrives. Some patients want to get back on the plane and go home, others may suddenly have their menses when not expected. Often, no amount of re-assurance seems to be helpful. It is for this reason I keep the first meeting short. The patient is there to be treated, anything of importance has been discussed. Most of my patients simply want to get “it over” as fast as possible.

Relieving the anxiety for our patients before the Botox Treatment for Vaginismus

After we take care of a few preliminaries she and her partner change into scrubs, they are made comfortable in their bed, and an intravenous is started. At this moment we start having some control, and an anti-anxiety-sedative medication (Versed, which is the IV analog of Valium) can be administered. This does wonders in relieving anxiety and allows the patient to get back in control. My staff is well trained in anxiety control and from the first moment to the recovery, the patient is made to feel comfortable.

I asked one of my patients to write about this time, it is so important, and will help give definition to the feelings of women awaiting treatment. Here is what Katie wrote:

Anticipatory Anxiety. Pre-Procedure

Anxiety and VaginismusPrior to my procedure, I posted the following on the Forum:

“I am actually in a state of terror right now. I have been cranky and crying for the last two days. We drive to NH tomorrow morning and my procedure is on Monday. I am absolutely terrified and do not want to go! I fear the dilation process will be painful, and unsuccessful. My stomach hurts so bad and I am unable to get any sleep. I started fighting with my husband and I just feel like I am unable to go.”

The Day of My Procedure

On the day of my procedure, I posted the following on the Forum:

“I had my procedure this morning and I have to express my appreciation and admiration for Dr. Pacik and his staff. They were amazing and they helped me through each step of the procedure. When I arrived at the office this morning, I wanted to throw up and pass out. Once inside, I started to panic and freak out. The staff was amazing, they didn’t judge me and understood how I was feeling. I honestly didn’t think I was going to make it through the procedure and be a failure. When I woke up, I had the largest dilator in and didn’t realize it. It was a profound moment for me. I am now sitting at the hotel with a size 4 glass dilator and haven’t taken it out. I am in shock still and my anxiety has gone from 100 to a 6. I want all the future patients to know they are not alone and that it is ok to be nervous. Please have faith in this procedure. The Botox hasn’t even started working yet and I am dilating all by myself! This problem was one of the worst things, I have ever gone through. My fear of it was absolutely the worst. It was indescribable, how scared I was. I had ACDF surgery in September, which removed two bones from my neck/spine and replaced them. My fear had me believing that this pain would be worse. In fact, my pain level is only around a 3 right now. My post neck surgery was a 1000 on a scale of 1 to 10. You have nothing to fear from this procedure! I will pray for all women suffering from this condition. Yo
u will defeat this!”

My observations

As I have seen so many times in now treating over 300 patients with vaginismus, Katie’s pre-procedure anxiety and nerves was replaced by post-procedure elation.

Tips for Overcoming Pre-Procedure Nerves:

There are many helpful tips that I have learned from my patients that have helped them overcome pre-procedure nerves including the following:

  1. Participating in the VaginismusMD Forum. Reaching out and posting about your fears and talking openly to others who either have gone through or who are also going to go through the same procedure can be extremely helpful. The community is there to support you and so many of the veteran patients have felt these similar feelings and fears pre-procedure. For the patients who are too shy or anxious to post, even reading through posts on the VaginismusMD Forum can help greatly to reduce your anxiety.
  2. Speaking to one of my previously treated patients. I often contact one of my previously treated patients and ask them to communicate with new patients via e-mail, text, phone calls. By speaking 1:1 with another patient who, again, has gone through the procedure and experienced similar feelings is extremely helpful in reducing pre-procedure nerves.
  3. Leaning on your significant other. Many of my patients have shared that their partner during the process was their rock and was extremely helpful and supportive through every aspect of the treatment, including being there pre-procedure. Even if it is a gentle hug, holding your hand, or just letting you vent and even cry, they are there for you and will help you through.
  4. Speaking to me or a member of my staff about your fears. We are all here to support you. I have posted this in the past and want to share these words again: “There are a thousand worries that the average patient has as the day of treatment approaches. “What ifs” tend to be all consuming. There comes a point that it helps to simply allow the flow to take you along its course. I often tell (my worried surgical patients) that they should think of their surgery or treatment as a ride in the car. They put their seat belts on (these are the many safety monitors we have throughout the operating and recovery room) and I’ll take them for a safe ride. I know the route and I am a safe driver. For my vaginismus patients where the treatment has a high level of safety, but anxiety rears its ugly head, the same can be true to help stem the normal anxiety that takes place. There is not much more anyone can say. The day comes and goes, much like any other day. Now you are on one side, then you have stepped across and you are on the other side.”

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If you have any questions about our Botox treatment for vaginismus and progressive dilation under anesthesia, please contact us via our contact us form.

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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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