The 1, 2, 3 Punch for Future Patients

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    Hi ladies. For those of you who have your procedures coming up in 2014, I wanted to share one of my favorite Blogs from Dr. Pacik: Vaginismus Treatment – The 1, 2, 3 Punch:

    Excerpts include:

    “The first punch is the injection of Botox under anesthesia. This is the knockout punch for the spastic muscle at the entry of the vagina (the “closed fist”). It will be unable to recover for about four months.

    The second punch is the progressive dilation under anesthesia, stretching the tight muscle(s). Once these muscles are weakened and stretched under anesthesia, the continued post treatment dilation keeps these muscles stretched.

    The third punch is reduction of anxiety. It is well known that fear and anxiety play an important role in continued spasm of the entry muscle. The brain says “PAIN“, the vagina responds with a protective reflex “NO ENTRY“. Once fear and anxiety lessen and women are able to tolerate penetration as well as having comfortable pain free intercourse, this protective reflex appears to diminish, and the reflexive spasm of the vaginal muscles appears to disappear.”

    It goes on to describe the importance of post-procedure care:
    “The three punches described must be combined with careful post-procedure monitoring, which includes the review of daily logs to help patients with their post-procedure dilation program. The counseling done after treatment is of utmost importance to help women understand what needs to be done when they return home and the steps needed to succeed in having pain free intercourse.”

    I entirely agree that all of the combined steps of the treatment program along with the post-procedure care are what makes it work so well and be so effective in curing vaginismus. For me personally, once the first and second punch occurred, the third immediately followed. Specifically, once I woke up from my procedure with the largest dilator in place and knew that I could remove and re-insert it without any pain whatsoever, my anxiety was immediately reduced from around a 10+++ to close to nothing. The more that my husband and I practiced with the dilators this day and the more we saw first-hand that I was experiencing no pain, again, the less anxiety I experienced about future penetration. I knew that if worked this time, it would always work and practicing with the dilators truly does re-train your brain. I no longer experienced this pain/fear with insertion that I had experienced for so many years. I wish I could explain it in better terms but it simply disappeared once I experienced pain-free dilation for the first time.

    To the veterans reading this right now, do you believe it was a combination of first punch, second punch, third punch, and post-procedure care that worked for you? What specifically would you like to share with a future patient who may be reading this right now and who may also be considering having this treatment done but is not sure? Any advice that you have would really help.

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