Achieving Intercourse after Treatment

Achieving Intercourse after
Botox Treatment for Vaginismus

During my counseling sessions after Botox treatment for vaginismus, I tell every patient that intercourse is more comfortable than the large dilators. An erect penis is softer and more comfortable than the stiff dilators. Yet almost every patient has significant fears transitioning from dilators to intercourse. The original fears and anxiety of not being able to consummate, and all those original feelings of feeling like “freaks” routinely surface once again. Psychologically, transitioning to intercourse, despite success with dilation, can become very uncomfortable for some, while others just “do it.”

Painful intercourse and painful sex are hurdles that vaginismus patients can overcome. Our comprehensive vaginismus treatment program can open the doors and help women achieve intercourse after years of being physically shut off to the experience.

Patient to Patient

Often I ask other successful patients to support those who are at the brink and are ready to step over the line. In the story below, two patients responded to a patient recently treated.

The first successful patient was a severe Lamont level 5 vaginismus of 6 months duration who was able to achieve intercourse in two weeks.

“I was a little nervous about trying to have sex because we had so many bad experiences with trying and failing before the procedure. Surprisingly, it was EASY! We were just going to start with tip-only, but before we knew it, we had achieved full penetration in a matter of minutes! I had no pain; it was actually way more comfortable than the dilators! It was such a contrast to when we had tried before. Before, we couldn’t even find my vaginal opening because my muscles were closed so tight! And now, it’s totally possible.

I would recommend dilating before you try, as I’m sure you were planning to. And just relax, and think of it like dilating (but more comfortable and nice). Wishing you the best of luck and feel free to email me if you have any questions or just want to talk. I’m really happy to help!”

She received an email from a second patient who also had a severe Lamont level 5 vaginismus of 15 years duration and achieved intercourse in 7 days. (Independence Day 2011!!)

“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.”

My patient (Lamont level 5, 18 years duration) took their advice and wrote:

“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 all of his penis within seconds. We held off on any thrusting as you suggested. Wow is all I can think of to say!!!!”


Of interest is that all three patients had the most severe form of vaginismus, Lamont/Pacik level 5, and none of them had ever had any form of penetration possible prior to being treated with the Botox program for vaginismus. Yet all three were able to achieve intercourse comfortably and without pain. These patients are typical success stories that have been repeated often in my practice. When patients support other patients in this fashion, anything is possible.


Support and Advocacy to Achieve Intercourse

I have often said that Botox by itself will not cure vaginismus. One needs to incorporate a comprehensive program of treatment that includes dilation under anesthesia and extensive post-procedure counseling and support. One of the powerful moments in this program is on day two when we spend time explaining how to transition from dilators to intercourse. Our discussion centers not only on the physical, but also the spiritual, which is the glue that binds relationships together in the first place. We discuss various aids, lubes, “toys,” professional films and books, all of which educate our patients in an area that has been underdeveloped for years. When we add the support and advocacy of our patients who have gone through the Botox treatment program, we have a nearly foolproof system of allowing our patients to be successful with their goals.