Hi LOL. Welcome to the Forum and thank you so much for your post. Huge CONGRATS on your upcoming treatment on Friday. I had the Botox treatment program back in 2011 with Dr. Pacik in NH. He is currently retired but referring patients to Maze Women’s Sexual Health outside of New York City. What country are you from? I think it is beyond wonderful that we have this Forum to be able to talk back in forth when I am in the states and you are in another country. I, too, had vaginismus all during my 20s and into my early 30s. I could never undergo the Gyn exams, use tampons, or have intercourse without the extreme pain/fear/wall of resistance. It was so, so frustrating at the time and I am so, so thankful that I had the treatment and am now able to have the exams, wear tampons, and have pain-free intercourse – all just a dream while having vaginismus. I wanted to address your questions. I do not know exactly what it will be like where you are but I can tell you what I experienced when I had the Botox treatment program for vaginismus with Dr. Pacik in NH:

1. Are you conscious during the procedure? Do you feel pain or anxiety meanwhile?

I do not know what it will be like in your country and if you will be conscious or not. When I had my procedure, I was extremely nervous prior (i.e. throwing up on the drive up, dizziness, wanting to leave, etc.) so I received IV Versed in advance and, after this, next remember waking up with the dilator in place and the procedure over with. Dr. Pacik has written an excellent Blog regarding vaginismus treatment anesthesia:


Excerpts from the Blog include:

What type of anesthetic is used?
Patients are given conscious sedation which allows them to breathe on their own yet be able to sleep and be unaware of treatment. General anesthesia is not used, this is reserved for major surgical cases. Conscious sedation allows me to do the injections and progressively dilate the vagina with no pain. Generally the patient is asleep for only about 15 to 20 minutes and wakes up rapidly when the treatment has been completed. The sedation is similar to what is used for colonoscopy.
How long does it take to recover from the conscious sedation?
Generally one to a few minutes. Patients wake up quickly. A long acting local anesthesia (bupivacaine) will have been injected making the entire vagina numb so that you can wake up with no pain. This also allows you to work with the dilators during your recovery without pain.
Risks and safety of anesthesia for vaginismus
This type of sedation is used worldwide for procedures that require minimal anesthesia. Conscious sedation has a high level of safety.”

I personally was terrified of being under anesthesia pre-procedure. To help with this, I talked and listened to Dr. Pacik and Ellen explain the incredible safety of this and I trusted them completely. I also had my hubby right there with me and he assured me it would be fine. But, like anything, the number one thing that helped was actually doing it and then waking up completely fine and vaginismus free. This was my best evidence that the anesthesia was safe. Without being under anesthesia, I don’t believe the procedure would’ve worked at all. At my one past attempt at a gynecological exam, I had such high anxiety that I almost passed out and could not even let the doctor near me (felt like jumping off the table, legs tightly involuntary closed, extreme dizziness). By being under anesthesia for this procedure and waking up with a dilator in place, for the first time I mentally knew I was not broken and something could be inside of me pain-free. Thereafter, I got used to this and it entirely changed my way of thinking and very soon after, my husband and I were able to make love. Again, I don’t believe this would’ve been possible based on my extreme level of anxiety without being under anesthesia for this procedure.

2. Once you have finished the procedure, may I go home and do my usual life?

On the day of and day after my procedure, I commuted from NH to Boston where we live. While I felt sore, I was still able to ride in a car. I also felt like I was on such an emotional high post-procedure because it was finally over and I was able to have something inside of me for the first time and it did not cause intense pain. At the most, it felt strange and uncomfortable at times because it was something I had to get used to. Several of the other girls on the Forum have posted that they were able to visit the beautiful coast following their procedures as well as explore Boston.

3. After the months we are dilating, do the effects of the treatment last? Or is it possible that we need some more botox to be put?

As for noticing any difference after the botox wore-off, I am so glad to report that I noticed absolutely no difference at all. I had my procedure in 2011 and, 5 years later, have had zero regression and am able to have pain-free intercourse, exams, and wear tampons. Dr. Pacik has also written “Most of the time women notice very little change. Perhaps some improvement in natural lubrication, and possibly more intense orgasms as a result of being able to feel the vaginal contractions during orgasm.”

4. Does it hurt?

I did not feel pain at all with the Botox treatment program. I did feel some soreness while dilating and for a couple of weeks post-procedure as there was just so much activity in the area where before there was none. In the past, a Forum member on here wrote a great post with a suggestion for Hydrocortisone cream and this was followed up by Dr. P: “Dr. Pacik’s suggestion to use Hydrocortisone Cream has been a HUGE help for me. My lady bits are just so dang sensitive!!! I bought Hydrocortizone10 in the Cooling Gel formula for during the day and I’ve felt SO much better – then I’ve been using the Hydrocoritzone10 in the ointment for adding to my lube mix with dilating at night. I honestly can’t believe how much that’s helped me feel better the last couple days.” Dr. P has written: “It is common for women to have some skin irritation as a result of post procedure dilation. There is suddenly a great deal of penetrative activity that did not exist in previous years. 1% hydrocortisone is an over the counter topical that is anti-inflammatory and can be purchased either as a cream (faster acting) or as an ointment (longer lasting). It is generally used as a pea sized amount rubbed into the irritated area twice a day and can be used for 1-2 weeks.

I am so, so excited for you to have your procedure tomorrow LOL. Please, please post back to us and let us know the details and how it goes. To help with pre-procedure, anxiety, I wanted to share one final excellent post with you and hope it helps so much! Sending you big hugs today!!!!

DEALING WITH NERVES: I was excited up to about two weeks before the procedure, when I experienced a whole other additional dimension of fear than I ever knew existed within me. Fortunately I have a therapist, and she was able to talk me through it. She adivsed that whenever I start getting panicked to re-focus back on the goal and to leave the emotions to the side. Just concentrate on the facts: you have a medical condition that can be treated by an expert in the field and will then need to use medical devices as part of physical therapy over the course of a year (the dilators).”