Self Assessing Vaginismus
Getting started with dilators for vaginismus is actually fairly simple if one self assesses the severity of their vaginismus. If a woman is able to tolerate some penetration, there is a good chance she can advance with dilators and achieve intercourse. If the vaginismus is so severe that no form of penetration is possible, and/or there is intense fear, anxiety and pain relating to penetration, it is likely that therapy with dilators will fail. Self assessment can be as simple as noting minimal, moderate or severe anxiety and pain to penetration, or can be more sophisticated using the
Lamont system of classifying vaginismus.
There are a number of companies that sell dilators. I prefer the Pure Romance line of dilators which are available through my office or by contacting us via email or ordering through PureRomance.com. The pure romance dilators are color coded for size. They are made of silicone and therefore non porous. They clean easily with normal soap and water.
Slow Stretch of Tight Vaginal Muscles
For those who can tolerate penetration one needs to start with the smallest dilator. This is left in place for 10-15 minutes. As the dilator becomes more comfortable, as a result of the vaginal muscles stretching, advance to longer times ending with two hours a day. I prefer one hour in the morning and one hour in the evening. If the morning is too hectic, two hours in the evening works well also. In my own program of using Botox injections for the more severe vaginismus patients, I like my patients to sleep with a dilator every second night. My patients wake up with the largest dilator that has been placed during the anesthetic, however for those advancing on their own, the time and size of the dilator is progressively increased until the larger dilators are comfortable.
If you have any questions about our Botox treatment for vaginismus and progressive dilation under anesthesia, please contact us via our contact us form.