A touching thread on the VaginismusMD Forum discussed the dreaded GYN exam. It is well known that most vaginismus patients are terrified of not 
only having a GYN exam but also about thinking of one. A patient with an eight-year history of severe vaginismus wrote, “When I know I will have a GYN exam, I have nightmares the night before.”
It is for this reason that part of post procedure counseling involving the Botox Treatment program deals with the mental and physical preparation for the GYN exam. This includes instructions in dilating beforehand and actually holding a child’s speculum; understanding that though it is made of stainless steel there are no sharp edges. One then has an opportunity to learn how to self insert it. Since this speculum is about half the size of the pink #5 dilator, it becomes somewhat less daunting, but not entirely so.
The following is the thread that appeared as follows: Forum – VaginismusMD Forum – Vaginismus Dilating – Dilating and Gynecological Exams/Tests
From Heather (our VaginismusMD Forum moderator):
Hi ladies. I think the subject of dilating and gynecological exams/tests deserves a topic all by itself. So many of us have had very bad experiences with gynecological exams in which a physician did not understand the condition of vaginismus. This can be very frustrating and humiliating. When I met Dr. Pacik, it was one of the best feelings in the world to finally find a doctor who did actually get it and understand. Following my procedure, when I had my first successful gynecological exam, this was such a surreal and great feeling. I felt “normal” as I could now have this with ease and pain-free. The key to my success with the exam was DILATING. I dilated the entire evening prior. I then inserted the largest blue dilator for a while before my actual exam. This helped tremendously both physically (stretched out the muscles) and mentally (I knew if the dilator could fit pain-free than a speculum, which is much smaller, would cause no pain). For “to-be-treated patients” reading this, gynecological exams and tests really are possible following the procedure. For treated patients, what have been your experiences with these exams/tests post-procedure? Do you have any tips that may help a patient who visits the gynecologist for the first time post-procedure?
From Walker: (11:12 AM)
So here I sit at work in my office and I am only 1 hour from my first gynecologist appt post procedure! As I write, I have Ms Pink (which is the largest dilator I use) inside while I work. It is so crazy because I have never dilated outside of my home! I have a lot of emotions going on inside as I keep telling myself that if I can dilate to the larger dilator and have intercourse successfully with my husband, I can overcome this fear of the gyno doctor. I am conquering two fears today face on as I dilate while at work and have a successful gyno appt during my lunch break! I will keep you ladies posted!
From Walker (5:08 PM)
It went great! Another milestone accomplished as I had my first successful gyn exam without any pain!!! I was so nervous as I started last night dilating with purple overnight and then around 11am while I was at work I dilated with Ms. Pink for two hours before my exam at 1pm. I have not been able to comfortably dilate with Big Blue but Ms Pink is all I need to have successful intercourse and pap smear completed. I told my doctor about my condition and how I was treated in June with Botox to stop the spasms and dilation schedule to stretch the vaginal muscles. He was very impressed with the procedure but he was more impressed with how I went from not being able to have any type of penetration without excruciating pain to being able to have pain free sex with my husband and to successfully complete a gyn exam with absolutely no pain! Oh course I am completely overjoyed to get a great bill of health and at the same time talk to my doctor about getting pregnant!!! Let me tell you I could have done cartwheels done the office corridor. Just want to encourage all the ladies with the condition that there is light at the end of the tunnel. Don’t get discouraged but continue to dilate regularly and keep posting. You not only change your life with your testimony but you also change the lives of others who read your story.
From Heather:
Hi Walker. HUGE CONGRATS on your first successful GYN exam. This is so wonderful to read and such an amazing accomplishment. I, too, remember the feeling of jumping for joy after finally being able to have my first pain-free and successful exam post-procedure. CONGRATS TO YOU!!!!!
Post-Procedure Counseling Important for Success!
As I mentioned above, during the post-procedure counseling, we have the time to work with our patients, allow them to feel the bluntness of the speculum, and teach them the needs of dilating prior to a GYN exam and how they can insert their own small speculum. It may seem impossible but patients who have been treated with the Botox program are able to have success with a GYN Exam. Heather’s story, titled “Success with GYN Exam” was posted to our website and is really a worthwhile read.
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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.
only having a GYN exam but also about thinking of one. A patient with an eight-year history of severe vaginismus wrote, “When I know I will have a GYN exam, I have nightmares the night before.”
