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    April 27th-

    Notes-AM: Medium to Large. Today I had my first Pap Smear.I went with Large in. I didn’t have any pain just discomfort. Its just that I still freaked out; I began to cry and start to remember the pap smear that worsened my Vaginismus and made sex impossible. The Dr. used the smallest speculum. I could tell that she tried to rush through the exam. I don’t know if maybe she thought that be the best thing for a Vaginismus patient, so I wouldn’t have to go through it for long. But that didn’t help. I rather it have taken hours than me having to feel like that again. She told me that the botox is probably all worn out and that I need to stop believing that my Vagina is messed up because I was the one causing this and that I am stopping myself from having a normal sex life. I told her that my sex life is great, and the only problem is my fear for the speculum. Also, I told her that no matter what, under anesthesia, under anything, I would still spasm; that it wasn’t me causing this. I don’t think she fully understands. I then left upset. I started being disappointed in myself too. As soon as I went home I dilated again for 20mins Medium and Large. Just to prove to myself that I was okay and that I could still do it.


    Hi Salvarez. This makes me so, so mad at this gyn doctor for you. For vaginismus patients, the first gyn exam post-procedure is such an important thing. I don’t think anyone truly gets this unless you have gone through horrible exams in the past or just had very bad experiences with physicians who didn’t understand the condition. I’m sorry you had to go through this. Please don’t be disappointed in yourself at all. Be proud of yourself for going through it even with a very uneducated and uninformed doctor. I’m very proud of you for that! I would definitely try to find a new gyn doctor asap and never return to her. I started a thread in another area of the forum about physician/clinician referrals and would love to hear from any of you here as well. I think it’s a great idea to note doctors in our areas who do actually understand the condition of vaginismus and are compassionate and caring individuals. I’m, again, very proud of you Salvarez and sorry that you had to go through this experience.

    Dr. Pacik

    Anyone who can overcome severe grade 5 vaginismus 2 1/2 weeks after treatment, and on top of this go shopping with a glass dilator in place, is a hero and a champion in my book. To be undermined by a doctor that has neither knowledge nor compassion for women who have struggled with vaginismus is indeed a pity and a disservice.

    Our patients need to stand tall and stand proud that they have overcome this disabling condition. Of course fear and anxiety can rear its ugly face at any time, causing a setback. This, as we know is temporary, and as you once again pushed forward by dilating after the exam, shows that you have conquered vaginismus.


    I agree totally Dr. Pacik. Nobody should have to feel like this and to be undermined by a doctor that has neither the knowledge nor compassion for women who have struggled with vaginismus.

    In a recent post, Dr. Pacik discusses his newest publication, which serves as a wonderful source of education to provide to doctors.

    Dr. Pacik writes:

    “I have been sending a copy of this paper to new inquiries so they have a scientific basis for understanding vaginismus. I am also encouraging new patients to send a copy of this paper to their doctors both to get a more meaningful referral for treatment (which helps with insurance reimbursement) and so the doctors themselves can better understand this condition.

    Here is the table that was published. I was somewhat surprised the journal included this Table! Table 2 What your patients do not want to hear (condescending remarks) “Don’t be a baby” “Can’t you just relax” “It’s all in your head” (very common) “Come back when you are more relaxed” “Have a drink” (also common) “You need to take a Valium before you come for an exam. It’s just because you are nervous.” “You need to practice stretching your vagina” “It’s just first time jitters” “It will get better with time” “Let me recommend some lubricants” “You need to stop believing that your vagina is messed up because you are the one causing this and stopping yourself from having a normal sex life.” (This comment after successful treatment of severe vaginismus but crying because of the speculum exam.) “The pain will go away after you have had sex a few times. You will get used to it.” “You know what, I’m going to use the baby speculum” (which never worked) “There’s nothing physically wrong with you” “There must be something wrong with your relationship” “Just tell yourself sex won’t hurt and it will be okay” “I won’t examine you again until you receive sex therapy. Here is the name of a sex therapist that I recommend. After you see her, you can come back to try an exam.” – I’m still shaking my head in disbelief!

    The easiest way to request a reprint is to complete the contact form by linking to Let my staff know that you would like the reprints titled “Clinical Opinion” and the Letter to the Editor.”

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