Dilating competition

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    Dr. Pacik

    As has been noted so often on this Forum, each person is convinced they will be the one failure. As also noted on the Forum and in my scientific papers we continue to be successful in more than 90% of the patients.
    Treatment for vaginismus consists of the Botox treatment and progressive dilation under anesthesia on day 1 and counseling combined with dilation on day 2. For most, returning on day 3 is no longer considered important, patients do just fine after they finish day 2.
    With each treatment three patients from different walks of life, with varying severity of their vaginismus, are asked to spend part of day 2 advancing with dilators to the best they can, understanding that the Botox is not yet effective. Each person tends to make her own progress and some definitely feel left behind.
    This past week was on such example. Two of the patients with a less severe form of vaginismus easily dilated to the largest #6 dilator the morning of counseling after sleeping with #4. The third patient went back to the hotel, and did not re-insert it after it fell out. She arrived the following morning with no dilator in place. I knew from speaking to her that she had great fear and anxiety to any form of penetration which is also common in the women who have severe grade 3-5 severe vaginismus.
    On the following day she mentioned that she had considered not coming back for the day two counseling session and flying back home. She was brave enough to return despite high anxiety. I left her alone so she could concentrate on the counseling. During this time she was unable to do any dilation during the counseling as she watched the others continue with their successful advancement.
    After the others left she cried. She once again was sure that she was a failure, continued to be terrified about have anything inserted and left the office once again with no dilator in place. They asked if they could return the following day (day 3).
    The morning they returned I asked if she would allow me to help her with the dilator. With some hesitation she said yes. She was given the choice of having my hand on top of hers or her hand on top of mine. She elected to try dilator #1 with my hand on top of hers, guiding her. #1 just slipped in (!) and the look on her face was profound. Suddenly there was a glimpse of success.
    We allowed the topical anesthesia to take effect and about 30 minutes later she felt ready for us to try #2. Once again, it just slipped in! More amazement, more empowerment!
    Over the next few hours she advanced to the #5. Each larger dilator was easier to insert. She went from feeling like a failure to one of being victorious. I was definitely touched as to how brave she was.
    I mention this story to allow others to understand that there is a natural competitive feeling. In this case it came close to derailing a patient that struggled for the four years of her marriage, where the idea of conceiving seemed impossible though fortunately she had a very understanding husband. She came out victorious and it was worth spending the extra time. I have no doubt that she now understands her body so much better and with the help of her husband will be successful with her goals. Her anxiety levels went from a 10 to about a one. Tears were replaced with a wonderful smile. Her husband’s post can be read in the men’s section
    [url] http://www.vaginismusmd.com/vaginismus-md-forum/?mingleforumaction=viewtopic&t=894%5B/url%5D

    I would love to hear from the others their feelings about this.


    When I saw just the subject line of this post I was deeply concerned until I read the content. At first I was like “dilation competition”? And then I said, “nobody should be in a competition, that’s not what this journey is about”. But then I read the content and I was sad and then thrilled for the young woman. My only two cents for what it is worth is that none of us should compare ourselves to another. Every body is an individual “body” and everyone’s condition is different and may include other factors. Although the method is the same for each person post procedure, our paths, the amount of time we have suffered with this condition, and events that have happened to us are all very very different. I would hope no person feels judged among their peers in vaginismus. It’s bad enough we are judged in the medical community and treated like second class citizens with regard to the validity of our complaints.

    I think though that we all can be a little hard on ourselves as well. It’s too easy to feel we have failed but its much harder to continue to pick ourselves up time and time again and proceed forward.

    I’m very glad she was able to work with you Dr Pacik and that she had success. Our success should be measured not by leaps and bounds but by gradual steps pushing us forward to a better tomorrow~


    I agree with 23 years! Dilation should not be a competition. We all move at our own process and we all have our own achievements. Whether it takes us one month or more to dilate to the next dilator we should be proud of ourselves and celebrate. That story broke my heart and I sat reading it with tears. She progressed so well once it was just her in the room I hope she continues to make great achievements. Dr. Pacik is she on the forum? It would be great if she was and we can all chat with her and read about her achievements. I always get very excited and happy when I read other people’s success stories on the form.


    I feel so sad for that woman who struggled so much, but I am SO pleased that she came back and that she eventually progressed with Dr. Pacik’s help and encouragement! I can completely see where she is coming from in that she felt “left behind” and scared. I was fortunate to be the “easiest” of the 3 patients during my procedure, but even now, a month after my procedure, reading success stories that talk about completely painfree penetration makes me feel like there is still something “wrong” with me (as intercourse still hurts about a 1-2 and I am nervous it always will. I know time will change that, it’s just hard to believe!). I am just so glad that although the person Dr. Pacik posted about had a very rough first and second day, she pulled through on the third day and started making progress! I am also so glad that her husband seems to be so supportive and involved. His post was very profound. Best of luck to her and her husband!

    Dr. Pacik

    More surprise! Follow up:

    She achieved intercourse on day 4 after dilating to to #5 with mild discomfort. She climaxed. I am still in a state of shock that she was successful so quickly.
    It does point out that every patient is different. Though she has more stretching that is needed to be completely pain free, the monumental aspect of this is that she was able to overcome the profound anxiety that is so common place with severe vaginismus. Congratulations to both.


    This is so, so wonderful. Congrats Mayra and Geremia!!!! :):):)


    Wow! That is great news! I had my procedure the same day as they did and it was hard to see her upset and at one point I felt guilty that I was dilating so well but I think what Dr. Pacik wrote above is so true, everyone goes at their own pace and we will all be successful, we just have to take one day at a time. Dr. Pacik had mentioned during counseling that he would like them to.come back on day 3 and I am so happy they did and I am sooo happy for both of them! Way to beat vaginismus! 🙂




    Huge congratulations!! Doesn’t it feel so powerful??

    Every woman should feel powerful at each step no matter what! Every woman!


    Just wanted to update and share that I have been dilating well over the last month. I cannot believe that it will be a month this week since I had the procedure! I have been dilating all the way up to the number five. And the pain/anxiety have gotten progressively lower. I have tried to use the number 3 times. The first time was about 3 weeks ago. I was not successful in inserting it. So I was very discouraged. Yesterday I tried inserting the #6 glass again and was once again unsuccessful. However today after dilating with the number 4 and 5 i decided to try the number 6 silicone. I was thinking that maybe since the silicone was a little softer and I had slept with the number 5 I might be able to make the number six silicone go in. I did!!!

    I am not going to lie… it was very painful (at least an 8 for me) but that was while I was inserting. The pain diminished do to about a four within 10 minutes. I left it in for about an hour until i needed to go to the bathroom. I then took it out and tried the number 6 glass to see if maybe I was able to insert that. To my surprise it went in! Again, it was very painful going in (7 or so) I have now been wearing it for about 20 minutes or so and the pain is at about 3. I am so happy!!! I had started feeling very discouraged that I had not been able to progress all the way to number 6 but now I have renewed hope because I finally go there. And I can see the light at the end of the tunnel. Since I now believe that just as with the 4 and 5 dilators soon the number 6 will be less and less painful 🙂



    Woot woot!!!!

    Yah girl!!!!!!!


    Thanks so much for sharing this story, Dr. Pacik! I remember feeling so frustrated and defeated that first night and second day also. I wasn’t able to sleep in my #4 either and went back to the clinic wearing no dialtor. It is easy to convince yourself you will fail, after dealing with V for so long! So thankful you had the courage to keep pressing on, Mayra! I am so, so happy for you!!

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