Transitioning to Intercourse and The Importance of Dilating

Many vaginismus sufferers have had years of failed therapy and relationships that did not work out. For the vaginismus sufferer who discovered her condition on her honeymoon, vaginismus has caused a lot of anguish and heartbreak and the marriage is often on the verge of a divorce.

Our Botox Treatment Program for Vaginismus

The Botox treatment program for vaginismus is the same from patient to patient. While the patient is under anesthesia, our patients are injected with Botox in the vaginal muscles and progressively dilated from the smallest dilator to the largest dilator. In the Recovery Room, supervised dilation is performed. When the patient returns on Day 2 and Day 3, post procedure instruction in the use of dilators and transitioning to intercourse is covered. Once the patient has gone home, I follow them by reviewing their dilation logs that are emailed to me. Patient questions and concerns are answered and support is given as long as necessary.

When Can I Expect to Have Intercourse After the Botox Treatment?

Many of our patients are eager about the idea of being able to make love to their partner and often ask me “When can I expect to have intercourse after the Botox Treatment.” The answer to this depends on a number of factors such as how long has the patient had a problem with vaginismus, how strong is their libido and how strong is their partners libido, presence or absence of relationship issues, and how motivated are they to overcome their condition.

A couple with strong libidos in a loving relationship may transition to intercourse faster than a couple with low libidos and a relationship that has suffered because of the vaginismus. It is important to note that Botox will not cure low libido and relationships that have current issues – these are best discussed with a qualified sex therapist in combination with your Botox Treatment.

I have found that the motivation factor and the ability to have open, clear communication with your partner are very important. I also cannot stress enough the importance of dilating every day and especially before any attempts to have intercourse. I always tell my patients, “The dilator is your best friend.” When patients use their dilators religiously, there is a very high rate of success in achieving pain free intercourse.

The Importance of Dilating Before Intercourse

The following is a comment from one of my patients:

“Recently my husband and I had a spontaneous intercourse and I didn’t dilate beforehand even though I had slept with the purple during the night . . . and I had some burning pain with intercourse.”

My response to her was that even if she dilated for 5 minutes beforehand that could have helped her avoid any burning pain during intercourse. Dilating even for a short time is beneficial; however, it is highly recommended that you dilate for at least 30 minutes before having intercourse.

A patient who had severe Level 5 vaginismus of 15 years duration and achieved intercourse in 7 days writes:

“I found that the most important thing for me in the beginning was using the largest (blue) dilator for 2 hours prior to attempting intercourse. Then, he would take it out and slip right in where it once was. And, he is a lot more comfortable than the dilator is.”

Another patient who had severe Level 5 vaginismus of 18 years duration writes:

“Dr. Pacik, My homework/experiment on Saturday evening was a complete success!!! I dilated with pink for 1 hour and then big blue for 1 hour and 15 minutes. When I took big blue out I had my husband slide his erect penis in immediately as you suggested and there was no resistance at all!! I just felt some mild burning but it wasn’t unbearable and certainly nothing like any of our previous attempts! He was able to insert his entire penis within seconds. We held off on any thrusting as you suggested. WOW is all I can think of to say!!!!”

Before the above two patients had their Botox treatment for vaginismus, they did not have any form of penetration whatsoever. Yet, because of their dilation before intercourse, they were both able to achieve pain-free intercourse. These patients are typical success stories that have been repeated often in my practice.

Contact Us for More Information

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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