Lifelong Vaginismus 38 years
Mary at the age of 58 has had life-long vaginismus for 38 years. During this time she was never able to achieve intercourse and never married. She threw herself into her work, learned to fly her own plane, and became a successful and well-known professional. Her last unresolved issue was her vaginismus. Her story follows.
I had a life-long struggle with vaginismus, which was worsened by sudden-onset menopause from the chemotherapy I was undergoing because of treatment for breast cancer. I had tried some progressive dilation on my own, with only moderate success. At the age of 58, 10 years after my breast cancer diagnosis, I came across information on Dr. Pacik’s treatment of vaginismus. After he and I discussed my situation, I decided to proceed with treatment, which began on March 7, 2012.
During the procedure, Dr. Pacik was able to insert the pink dilator (which is next to the largest size), which was in place following the procedure. This was very important because it gave me a benchmark of the 
“minimum” of what was possible. Progressive dilation from the purple (next size smaller) back to the pink was done that same day. Re-insertion of the pink was very painful and difficult for me, but I was able to insert it a small amount. I was able to comfortably insert the purple and leave it in place overnight.
I returned to Dr. Pacik’s office the next day for additional progressive dilation work and was unable to insert the pink dilator. So, I continued using the purple dilator.
Early struggles
The first seven days of dilation were a struggle for me. I had no trouble inserting the purple dilator and leaving it in place throughout the night. However, the pink dilator was a challenge. With much effort, I was able to insert the pink dilator ½” to 1”. I experienced significant pain, burning, and some bleeding of vaginal tissues. When I realized that the purple dilator was the same size as what I had been able to insert prior to my learning of Dr. Pacik, I was disappointed. Dr. Pacik and I talked by phone about the need to give the tissues time to heal, as this was quite a bit of new activity over the past week. We agreed that I would stop using the pink dilator for the time being, continue to sleep with the purple dilator, and he would check on the availability of dilators of different sizes or tapered dilators.
After one day of using only the purple dilator, the vaginal tissues were not as irritated. I also did not want to lose the progress I had made with the larger dilator. I remembered during one of the counseling sessions that clitoral stimulators can be useful in easing the muscle constriction during insertion of the dilators. So, I decided to give that a try the next day (Day 9). With that help, I was able to insert the pink dilator a little farther than before. The pain, burning, and some bleeding continued, but were better each day, and I was able to insert the pink dilator farther each day. I am now in Day 18 of dilation. The bleeding stopped several days ago; there is some burning, but that is also rapidly diminishing; and, yesterday, I was able to fully insert the pink dilator. This progress has given me confidence that I will eventually be able to insert the largest dilator (blue).
The emotional and the physical
Getting to this point has been a challenge. On the emotional side, the challenge was getting to the point to actually contact Dr. Pacik’s office and go through the procedure and then, after the procedure, dealing with the disappointment of whether or not it would work for me. On the physical side, the challenge was working through the pain and discomfort associated with the progressive dilation. I am a few days away from three weeks after the initial procedure, and that “ton of emotional bricks” that has been that adult life-long albatross has been lifted.
Dr. Pacik commentary: Normally I am able to progressively dilate the vagina under anesthesia to the largest dilator. Because of atrophy and tightness of the surrounding vulvo-vaginal structures (due to menopause) and the long duration of her vaginismus, I was only able to dilate her to the Pure Romance pink #5 of 6 dilator. This was at least a good start, but it will take further work on her part to achieve the #6 large blue dilator which is about the size of an erect penis. With continued effort I have little doubt that Mary will be able to achieve this.
On a separate note I normally prefer to have menopausal patients use an estrogen cream before treatment with Botox and dilation. With the loss of estrogen, the vulvo-vaginal tissues become thin and tear easily. Once the cream is used there is a significant change in the appearance of the tissues which now appear more robust and able to withstand the trauma of repeated dilation. In Mary’s case where she had breast cancer, this is left up to the patient and her doctor.
If you have any questions about our Botox treatment for vaginismus and progressive dilation under anesthesia, please contact us via our contact us form.