[evillemure]

As a pelvic floor physical therapist, I am looking forward to hearing responses to this one. I have a few patients with dyspareunia and they are working diligently with their dilators. They have not taken the Botox route, but I have mentioned that to each one as a possible treatment. I recently had a patient come in discouraged b/c she was doing so well with her dilators and was able to insert them without pain. She then thought she would go the next step and try intercourse. Well, she described it as being so frustrating and painful. She hated hearing her boyfriend telling her to “relax”. I suggested perhaps the next step would be to have him use the dilators with her and not think about penile penetration. She found this helpful. She wasn’t ready for him to insert the dilator, so she inserted it and allowed him to work it back and forth and stretch the tight tissue. We discussed the next step could be that he would actually do the dilator insertion. I look forward to other responses on this.

[evillemure]

The major difference I saw with Crisley was her ability to tolerate intravaginal treatment post Botox. Prior to her Botox she was very guarded and couldn’t relax, but post treatment she presented so differently. She was relaxed and more comfortable with her body – it was obvious she had been compliant with her dilators. She was also able to tolerate an intravaginal sensor for EMG, which she impossible pre-Botox. Prior to Botox, I had to use a retal sensor (intravaginally) b/c it was so much smaller in diameter than a vaginal one. As for answering your question, Heather, I agree with Dr. P that water is great for dilation – it causes vasodilation, so more blood flow can occur, making the tissue stretch easier. I know this sounds crazy, but I wonder after dilation how an ice pack to the area would do in order to maintain your gains? Ice after any workout is good and dilation is no different.

[evillemure]

Thank you for the nice welcome! PT may be beneficial b/c it would work on manually stretching the pelvic floor muscles. I always encourage my patients to bring in their partners to their PT sessions and I teach them how they can help their wives/girlfriends on a more regular basis. I also recommend after every shower/bath to just use a finger and manually stretch your vaginal opening. I find that most women are the tightest toward the bottom, so I suggest stretching downward for 10 seconds or so a couple of times can help. The hot water after a shower/bath will improve blood flow to the area, so the tissue will be more pliable rather than trying to randomly stretch throughout the day.

[evillemure]

Dr. Pacik, thanks for suggesting I log onto your website. I have a few patients that may benefit from your treatment and we have talked about what you do during our treatment sessions. I have always been in awe of the patient I sent your way a few years ago and the success she made.

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