There are two major concerns of patients who have gone through the Botox program for vaginismus:
What happens when the Botox wears of (about 4 months)
What happens after a year.
I advise my patients to dilate for about a year to help prevent regression. There is nothing scientific about this amount of time. I simply feel that by this time the muscles are completely stretched, fear and anxiety have pretty much disappeared, and the patient is having pain free intercourse.
The simple answer to both concerns is that any time there is discomfort it is an indication to dilate somewhat more often. If you are sleeping with the medium dilator every third night , increase to every second night. If you have dropped back to dilating every so often, just increase the amount of dilation. Always reach for the dilators first and be patient, the muscles need to stretch once again. Start with a comfortable dilator size and work back up over time. For those who are willing to re-dilate when discomfort is first noticed, recurrence of vaginismus would be very rare.
For those who are doing well, continue with whatever you are doing. Hope this helps.
