Vaginismus for 20 years

Geraldine’s Story

Hi all,

I promised to write in more detail once I got over the hurdle of a gynecological appointment last week . . .

Let me start by saying I’m going to give the short version of my story or else we could be here all day!! But I welcome any questions, comments or queries. Like some other women here, I am so grateful for my recovery and I will do whatever I can to help any other women overcome vaginismus in whatever way can work for them.

So short version: I am 36 and have had vaginismus, as far as I’m aware, all my life. From beginning menstruation at age 12, I was never able to insert a tampon and was never comfortable touching myself there. When I started going out with boys around age 16 I knew this would impact on my relationships: I loved dating and had what I would regard as quite a high libido but never got to any kind of insertion and couldn’t tolerate anyone touching me, unless through layers of clothes. I would feel panicky and trembly and would have to stop. As I was young and the fear of pregnancy loomed large for both me and the boys I dated, I could mask this fear quite easily with a ‘we shouldn’t do that’ or ‘we can’t go any further.’

When I met my husband and we were engaged, we did take things further but found we couldn’t even insert his finger. We thought that we would be able to do it when married, with fears of social norms, pregnancy etc. removed, but were devastated on our wedding night to discover, even though we wanted to have sex very badly, it just wouldn’t work and we couldn’t.

Failed Treatments

That was 14 years ago . . . Over the years we alternately desperately tried, and felt frustrated failures each time, or avoided physical contact for long months at a time. We engaged in lengthy, expensive and unfruitful treatment three times: firstly, just pure physical therapy a year after we were married, and two bouts of talk therapy/psycho-sexual therapy, each for almost three years. While I’m glad, looking back, that we never gave up and tried our best, these were the most frustrating times as it became clear that the ‘professionals’ didn’t really understand the problem and were at a loss for how to treat it successfully. It often led to us feeling like failures again and me feeling guilty for not being able to progress.

Botox Treatment Program for Vaginismus

Last year I came across a procedure involving Botox and progressive dilation under anesthesia with Dr Peter Pacik in New Hampshire, USA. I researched all about it through his site and also read the referenced articles and looked at other clinics offering similar procedures. At this point, I had turned 35 and was getting very anxious about children. We had always said, ‘it’ll work for us some day’ but, as time went on and nothing improved, it became clear to me that a new approach was needed, as the traditional ones certainly didn’t work for me – and not for lack of trying. Dr Pacik’s treatment, from the questionnaire and phone consultation at the start to the now daily email updates of my progress seemed to tackle the problem from all angles: physiological, emotional and mental. It really annoyed me and my husband that the traditional approaches seemed to ignore the fact that there is a real physical problem with severe vaginismus and no amount of talking or counseling will unlock a muscle like mine that has been behaving erratically for 24 years! To me it’s like a back spasm or a heart murmur: it is a physical, involuntary movement. The procedure itself involved injecting Botox into the muscle to stop the spasm. The dilation is like physiotherapy and also mentally enables you to see that it is possible to work with the muscle and gain control over it. The emotional support is in the care and openness the whole team has and the holistic manner in which they treat the physical symptoms while always engaging with and connecting with the person.

Dilation Therapy

I cannot speak highly enough about this treatment: it has changed my life in such a short space of time. Two hours after the procedure I was putting big dilators in and out no problem, and am doing it every day now as easily as getting dressed in the morning. And 8 days after the procedure my husband and I were able to have full intercourse!! And continue to do so, and it gets better and more natural each time! And last Friday, only one month after my treatment, I was able to have a speculum examination and smear test no problem at all. That was a very emotional experience as, previously, I could never endure an exam and had extremely stressful experiences (I cried on the street all the way home after one doc’s appointment and, on another occasion, swung a punch at the doctor when the speculum loomed . . . !).

Trying to Conceive

My goal is trying to conceive and this is what really incentivized me to go all the way from Scotland across the Atlantic for this treatment. We had attended adoption information sessions and also talked to my doc about syringe method over the past year. We don’t know what is down the road for us on this front but are hopeful that being able to have intercourse now will be our first step towards conception.


I was in email contact with two former patients of Dr Pacik’s and spoke with one at length on the phone before I went for treatment and it really helped me. I am happy to answer any questions at all about the treatment and pre-/post-procedural issues. Best wishes to all you ladies at whatever stage you are at on your journey and feel free to ask anything about any of my story that you may relate to,

That wasn’t so short after all! Apologies.

Notes from Dr. Pacik

This patient and her husband were a joy to treat. She had the benefit of speaking to another treated patient from Ireland. She received quite a bit of support and encouragement from her and another patient from Boston. My treated patients become wonderful ambassadors for other patients contemplating treatment. By the time this couple arrived, they were well prepared.

I had a mix of feelings treating her. Though I have had excellent success treating patients who have the severe form of vaginismus, and for the many who have struggled with failed treatments for many years, it sometimes worries me that long term, lifelong vaginismus patients may achieve intercourse, but have trouble re-establishing their libido and their relationship. This may take a longer time of treatment with professionals after the Botox program of treatment. This patient recorded a strong libido prior to her treatment and so this part of it was less of a concern for me. Though she had the most severe form of vaginismus (Lamont level 5 primary vaginismus with no ability to tolerate any form of penetration) she was able to achieve pain free intercourse at 1.5 weeks and continues to have intercourse on a regular basis at the time of this writing one month after her treatment. She is very motivated with her dilation program as shown by the daily logs I receive. She is fortunate to have the undying support of her husband and a continued strong healthy relationship. These are all factors in the overall success of the treatment program for vaginismus.

I learn something from every patient I treat. This patients succinctly speaks about the importance of a multi-modal approach to the treatment of vaginismus which as she says ” seemed to tackle the problem from all angles: physiological, emotional and mental.” She understands what so many clinicians fail to understand, that vaginismus is not just mental, nor is it just physical, but rather a combination of many aspects. It is for this reason that just talk therapy may not work and just the injection of Botox does not work, but rather a well structured integrated program of a variety of approaches is of the utmost importance, especially in these severe forms of vaginismus.