The Role of Vibrators and Dilators for Vaginismus
The role of vibrators and dilators for vaginismus patients to relax enough to tolerate penetration is important to understand. Many of my patients do well combining vibrators and dilators for their dilation routine, prior to intercourse and to prepare for a GYN exam. This patient was a severe Pacik level 5 primary vaginismus patient of five years duration, completely unable to tolerate any penetration because of massive anxiety related to any touch in the pelvic area. Her husband wrote all the emails. Even writing about her condition was uncomfortable. The following description shows their experience using the vibrator to help with distraction.
“Exactly 7 weeks after the procedure we were able to achieve full penetration for the first time (yay!). You probably recall that not long before that we were struggling with the fact that progress was limited on the intercourse attempts –
even despite good progress with the dilators. The major hang-up at that time seemed to be continued, intense, anxiety over penetration attempts. This led to difficulties with her physically pushing away and closing off her legs (despite conscious attempts not to), and strong negative reactions that she expressed as pain – but I suspect may have possibly been more emotion and anxiety than literally pain (much like the q-tip vulvodynia test).
I had an interesting idea to try to address some of this – albeit rather indirectly. I thought that she may be able to use a vibrator for clitoral stimulation to distract from the vaginal penetration – hopefully minimizing her adverse reaction. It actually worked! We went from struggling with tip only penetration to all the way in – instantly. It was still painful for her if there was much movement, but this was huge progress. Over the next several days we continued this process – only conducting one actual penetration per night, but we left it in longer each time and gently/gradually increased the amount of movement. From this point, improvement occurred very quickly. We have been continuing the same process since then and she continues to improve each time. After about a week, we were able to have intercourse pretty much normally (after using the vibrator to get initial penetration). She has been able to orgasm with and without the vibrator. Additionally, as soon as her next period came about she was able to use tampons with almost no trouble. She now just uses a little bit of lube on the tampon and gets it in with no problem. I see a marked difference in her level of anxiety surrounding intercourse and tampon use now.”
Nine months after her treatment he writes:
First off, (name withheld) is still doing great! I think I mentioned this briefly in our last update, but if not I’ll say it again – she has been able to wean off of dilating and has not had any issues. It’s been a few months now since she stopped doing it for periodic maintenance, and now only does it sometimes if she’s planning on intercourse or going to the gynecologist for an exam. I should note though, she’s been successful with intercourse and exams without dilating first, it’s just a little easier if she does.
On to the bigger news though – (name withheld) is pregnant! We are really excited, and owe it all to you guys. This wouldn’t have been possible without your procedure. Things seem to be going very smoothly so far. Even conception seemed very blessed – we got lucky the second try (two months of targeting intercourse based on days when she should be ovulating). She has since had her pelvic exam and even an internal ultrasound with no sedation and no dilation. We’re about 8 weeks in now, and starting to tell everybody our exciting news.
Thank you again for the miracle! We were truly scared that we’d never be able to have a baby because of this condition, and I’m convinced that probably would be the case if it were not for your treatment. Thank you so much! (name withheld)
Note from Dr. Pacik:
I have heard the same story from many of my vaginismus patients, and now routinely recommend the combined use of vibrators with dilators for vaginismus treatment. Clitoral vibration makes both dilation and intercourse easier (and more fun). It is also helpful when having a GYN exam using the vibrator and dilator just prior to the exam. If the clitoral stimulation is too strong, the vibrator can be placed on the lower abdomen. When I give Botox injections into the facial muscles, I routinely use a dental vibrating toothbrush (without the brush) to help distract my patients during the injections. Focus on breathing is also very helpful.
This patient is now 1.5 years since her treatment and is about ready to deliver her baby.
Vibrators and dilators for Vaginismus: An excellent discussion on the Forum regarding the use of a vibrator at the same time a dilator is used can be found by linking to VaginismusMD Forum.