I remember your treatment well. You had a great deal of anxiety to penetration when I treated you about three years ago. It took about 14 months of dilating before you felt comfortable attempting intercourse. If a woman has only sporadic intercourse and is no longer using the dilators on a regular basis there is a good chance for regression or discomfort with thrusting. The treatment for this is to start over again using the dilators, starting with the small ones and advancing as the tissues are being stretched to the larger dilators and dilating to the large dilator for one hour prior to intercourse. Repeat Botox treatment is rarely necessary. Your Female Sexual Function Score, which measures libido, improved dramatically after treatment. Counseling with Anita can be very helpful in combination with getting back to a good dilating schedule. You are welcome to email me.