This is an important post for a number of reasons: There is great value to the partner to be able to observe the treatment. It allows the partner to better understand the pathology and realize “it is not her fault'”. Vaginismus is undesired and uncontrolled and this becomes clear during the treatment.
It is normal to have some bleeding because of the multiple injections. It may seem like a lot, especially to some of the men, but actually there is a small amount of bleeding which responds well to pressure which is done before the progressive dilation. Some blood does accumulate around the cervix (as was pointed out-secretions move in an upward direction which is true) and sometimes is suddenly evacuated 1-2 weeks later. The patient gets alarmed and thinks she is bleeding, but this is normal.
Lastly the post points out that some women have considerable difficulty with dilation. We skipped the dilation during the counseling to allow the couple to fully absorb the important points of the counseling. They returned to the office the next day, where without the “competition” she was brave to try #1 and slowly progressed to #5 that day, which was monumental for her considering her severe anxiety to any form of penetration. I was thrilled with her progress and feel sure that she will be successful with her goals.