Dilation in Vaginismus Treatment

How long does one need to dilate after Botox treatment?

A frequently asked question is “How long do I need to dilate after vaginismus treatment?”


Pure Romance Dilators are used in Dr. Pacik’s vaginismus treatment program when the patient is progressively dilated under anesthesia.

Dilation has always been an important part of vaginismus treatment and was first described by Dr. Sims 150 years ago. Most clinicians who treat vaginismus rely on dilators to help stretch the vagina. Graded dilation advancing to the use of larger dilators allows the vagina to stretch enough to have pain free intercourse.

An important part of Dr. Pacik’s Botox vaginismus treatment program is progressive dilation under anesthesia a time that the vagina is completely relaxed. One can progressively dilate the vagina until one of the larger dilators can be inserted. The patient wakes up with a large dilator in place and does not feel it because of the long acting local anesthesia injected.


Dr. Pacik’s customized glass dilators are often used post vaginismus treatment because they are shorter in length when compared to the Pure Romance dilators; therefore, more comfortable.

Following treatment for vaginismus, the patient returns home to continue dilation two hours a day and sleeping with a medium dilator every second night for about four to six weeks. As a patient progresses and becomes more comfortable with dilation the amount of time for dilation can be reduced first to about one and a half hours, then to one hour a day. It is difficult to suggest a formula because each patient progresses at a different speed. This is the value of keeping a daily dilation log and corresponding with Dr. Pacik after Botox vaginismus treatment.

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.

More can be read by linking to a discussion about the length of time dilation is needed by visiting our VaginismusMD Forum and also the VaginismusMD.com website.

Contact Us About our Vaginismus Treatment Program

If you have any questions about our Botox vaginismus treatment program 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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