Vaginismus Treatment: Meltdown

Early progress after vaginismus treatment

After the treatment of vaginismus using the Botox program most patients do very well dilating during the first two to three days post procedure despite considerable fear about using dilators. During treatment under anesthesia, the vagina has been numbed with a long-acting local anesthetic. In the recovery area, supervised dilation allows patients to become comfortable removing and reinserting the dilators. Most sleep well with the medium #4 of 6 purple dilator or equivalent glass dilator, some need to take sleeping medication the first night or two. When they return the following day, most are able to progress at least to the pink #5 of 6 dilator. Post-procedure day one is spent with hours of instruction involving dilation techniques and counseling in transitioning to intercourse.

Homeward bound

After two to three days patients return home. It is common to have setbacks, what we call a “bad hair day”. Almost everyone experiences this and it is common for me to get the daily email log that there is concern about regressing. The Botox is just becoming effective, the vagina is rebelling somewhat about the amount of forced stretching. Some discomfort as well as some bleeding can be expected for about a week after treatment.

Vaginismus MD Forum

The strength of the VaginismusMD Forum

After recording their complaints (and fears) to me it is common for women to seek the wisdom of the “veterans”. This is the beauty of participating in the VaginismusMD Forum (see link below). You are not alone, and you can count on the support of others who have experienced the same concerns.

A recent exchange on the Forum

A Pacik level 5 vaginismus patient with a four year duration of vaginismus posted the following eight days post procedure:

Emotional MeltdownSo I officially had (am still having) my first meltdown post-procedure. In my last post, I wrote about how I was having trouble with the blue dilator (#6) and now I’m having more and more problems with pink, #5. Up until a few days ago, I had no problems at all with it. Last night, after dilating with purple, I put pink in, but it was the most uncomfortable it had been until this point. I was only able to keep it in for about 30 min.

I slept with purple overnight with no pain or problems and dilated with it for about an hour this evening (again no pain) before trying pink. It took 30 minutes for me even to get pink in! The longest until today, has been about 5 minutes to insert. Once I got it all the way in, it was so uncomfortable, I had to take it out after a few minutes. The weird part is that it didn’t really hurt at all (just resistance) until I got it in that last bit.

I know there will be bad days, but I really thought it would be getting easier and easier to use pink, not more difficult by the day. I’ve been upset ever since I took it out. Will backing down for more than a day help? I’m not sure what to do. If anyone else has experienced this, please let me know what worked for you.

A previously treated level 5 patient who suffered with vaginismus and inability to consummate her marriage for 34 years was able to achieve intercourse two weeks after treatment. Wanting to be of help to other vaginismus sufferers, Nakitalab volunteered to become one of our moderators and wrote the following:

I’m so sorry you have had a hard time dilating today. Try not to be so hard on yourself though, ok? I know it is easier said than done as I have had challenging dilating days as well and it is so easy to let those negative thoughts in. You are doing so great. Try to remember back to day one when you woke up Positive Thinkingwith blue #6 in and what an amazing feeling it was and that it is possible. It might not work today but it might tomorrow. It is so important to keep dilating no matter what size the dilator is. Our bodies are learning to stretch with the dilators and we are going to have challenging days. I’m 80 something post procedure days and I have challenging days every once in awhile. In fact, I had one earlier this week. They key for me is to try and push those negative thoughts out and continue dilating. It is ok if it takes a long time to insert pink. When I had a hard time with blue I would dial down to pink and if I had a hard time with pink I would dial down to purple. Try not to compare yourself to others as we are all different and have a different story. Please don’t feel bad about yourself or give up hope. I promise it will be easier as time goes on. We just have to teach both our minds and our bodies that we can insert the different size dilators. I also found that I needed to experiment on the most comfortable position to be in when I dilated (i.e. standing, laying on the bed). I found that laying in bed watching TV was the easiest for me. It helps me to be distracted. Also I found that sometimes it is more difficult to dilate if I have had a stressful day. I want you to know that I’m here for you. You are not alone. Sending you a virtual hug!

To view the complete posting on this subject “Day 8 – First Meltdown”, visit our VaginismusMD Forum

Every woman is convinced she will be the one failure

A few days of difficulty with the dilators reinforces this belief. Vaginismus is a nasty condition. Women after treatment are fragile and vulnerable to emotional swings. So much is riding on achieving success that the slightest hint of failure can send someone into a spin. They feel they are not only letting themselves down, but their partners also. Even after achieving intercourse, women may still struggle to find their balance. New emotional issues may surface, which can range from struggles with one’s libido to continued fear and anxiety once they have achieved intercourse. Only with perseverance do women finally overcome the emotional and physical difficulties of vaginismus.

Contact Us 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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