How long would I have to use dilators?

[LBS1515]

I’m 26 and never been sexually active. Ive only been able to insert a tampon once and it was extremly painful and I almost wasn’t able to get it out. I’ve avoided Pap smears but had my first pelvic exam in the emergency room when I was having abdominal pain. It was so painful and traumatizing. My doctor sent me to pelvic floor PT and she had me buy dilators. My PT is really nice but I get really anxious when she has to insert her finger. Ive been stuck on the 2nd intimate rose dilator and it hurts to put in. Ive been in PT almost three months and I’m still so anxious about going to the OBGYN to have a Pap smear. I was just wondering how long I would have to use the dilators for before things don’t hurt anymore?

[mazemelissa]

Hi LBS1515,

This is a complicated answer, because everyone is so different.

The dilation process helps in two ways: 1. it helps to lengthen and stretch the tense and tight muscles in the vagina, and 2. helps to reduce your fear surrounding penetration, by the repeated act of continuing to dilate every day.

However, for some the anxiety and fear is so overwhelming, that moving up in the dilation process is really challenging.

For many women addressing the anxiety, either through talk therapy or medication, can be the added key to moving up in dilation.

Anxiety can make pain perception more intense, and the more anxious you are, the more your body will tense your vaginal muscles.

This is why our Botox procedure is also very helpful. The botox injected in the muscles will prevent them from tensing and tightening, so you are not working against yourself.

Vaginal valium suppositories might also be helpful to relax the pelvic floor. Those are prescription and you would need to get them from your gynecologist.

There is no set time for successful dilation…you do you…just don’t stop trying and seeking help. Treating vaginismus is more of a long distance run, than a sprint…it takes time and effort, but you can get there, you are already on your way.

Melissa

[LBS1515]

Hi Melissa!

Thanks for answering! My OBGYN wanted me to try taking Ativan before my first Pap smear to help me relax but I was worried I wouldn’t feel like I was in control. I have to go back in a few months so I was hoping I would be less nervous after going to PT but thinking about it still makes me cry. Do you have any tips for getting through OBGYN exams? Should I try the Ativan?

[annelies]

Internal exams are a nightmare to most vaginismus patients. I think in some cases they might even make the vaginismus worse, but unfortunately those exams are necessary for your own health. Don’t skip them since PAP smears are absolutely needed!

Prior to each exam, I always tell the gyn I have vaginismus. The best gyns are helpful and try to be gentle, others (in my experience: mostly women) think I’m overreacting, exaggerating and have no compassion at all. It’s sometimes incredible to see that something so many women suffer from, is met with so little understanding.

I always take my husband with me, and I make sure he is standing stand next to me during the exam. Him being around makes things a little less uncomfortable. Also, I take a pain killer one hour before my appointment, although I’m not really sure that helps. The “try to relax” thing is b***shit. In all honesty: most of the time I’m “praying it will be over soon”. Luckily a PAP smear doesn’t take long.

Sorry I haven’t got a more positive story to tell.

[mazemelissa]

I do think taking the ativan can help.

You can also ask to insert the speculm yourself if you feel more comfortable with that.

I’d encourage you to possibly wait until you are further along in your PT and dilation before going back for the pap.

If you can insert a middle sized dilator, a speculum would be easily inserted.