Virtual Vaginismus Coaching

In our clinical experience, the average patient completes treatment within 7 to 9 sessions. Outcomes depend on symptom severity, consistency, and contributing factors, which are assessed during the Initial Clinical Evaluation (Discovery).

Treatment is individualized and adjusted as progress unfolds. As we work together, contributing factors become clearer and specific techniques are introduced or refined as clinically indicated.

Our goal is to achieve steady and durable progress within the fewest number of sessions necessary. Session frequency can be adjusted based on clinical need and patient preference.

If at any point it becomes clinically appropriate, patients may elect to transition to in-person treatment at our New York office. Likewise, if virtual treatment reaches its clinical limit, we will discuss alternative recommendations.

It is not uncommon for patients to seek treatment after attempting self-directed dilation, pelvic floor therapy, or other approaches without achieving lasting progress.

Vaginismus is an anxiety-based, reflexive condition. Effective treatment must address both the physical component and the anxiety response simultaneously. Focusing on dilation alone, without directly managing anticipatory muscle guarding and fear, often leads to plateau or frustration.

In our clinical model, vaginal function is approached as it is intended to operate, not in a compromised or avoidance-based manner. Dilation and graded exposure are guided in real time under direct clinical supervision, allowing for precise pacing, technique adjustment, and anxiety regulation. Patients are not sent home to navigate the most anxiety-provoking steps on their own.

When anxiety is guiding the process rather than structured clinical oversight, progress can stall. Guided treatment helps interrupt that cycle.

If prior attempts have not produced the results you hoped for, that does not mean the condition is untreatable. It often means that a more integrated, structured, and simultaneously managed approach is required.

Virtual treatment provides structured, clinician-guided care for patients who do not require a prior pelvic examination as a condition for beginning the treatment program. It is particularly appropriate for women who have experienced at least some form of vaginal penetration, such as a finger, tampon, small dilator, pelvic examination, or intercourse, even if painful or difficult.

Virtual treatment may not be appropriate in cases where there has never been any form of vaginal penetration, where significant structural or medical conditions are suspected, or where an in-office physical examination is clinically indicated. In such situations, a prior gynecologic evaluation by your local clinician, additional medical intervention, or in-office treatment may be recommended.

If at any point it becomes clear that virtual treatment has reached its clinical limit, which is uncommon, we will advise you and discuss appropriate alternative recommendations. Our priority is to ensure that you receive the most appropriate and effective care for your individual circumstances.

Virtual treatment does not include a physical examination by our clinicians. Therefore, we rely on clinical history and prior medical evaluation to determine whether virtual care is appropriate.

In most cases, if a patient has previously tolerated some form of vaginal penetration, such as tampon use, dilator insertion, pelvic examination, or intercourse, even if painful or difficult, a formal in-office examination is not typically required before beginning virtual treatment.

However, if a patient has never experienced any form of vaginal penetration, we generally recommend a gynecologic examination to rule out structural or anatomical considerations before proceeding. If a standard pelvic exam cannot be tolerated due to severe anxiety or muscle guarding, an examination under sedation by your gynecologist will be required, with a report of findings provided to us.

We strongly recommend that patients maintain access to a local gynecologist for evaluation of any medical concerns that may arise before, during, or after treatment.

When appropriate medical factors have been reviewed and no contraindications are present, virtual treatment can proceed safely and effectively.

Each virtual treatment session is conducted one-on-one via secure video conferencing.

Initial Clinical Evaluation (Discovery):
The first session focuses on a detailed assessment of your symptoms, treatment history, and goals. Based on this evaluation, a structured treatment plan is developed, including defined targets, identification of contributing factors, and specific strategies tailored to your situation.

Follow-up sessions:
Subsequent sessions focus on implementing the treatment plan, monitoring progress, adjusting techniques as needed, and providing clinical guidance and feedback. Treatment progresses step by step according to your individual response.

Patients are encouraged to communicate openly about their symptoms, concerns, and experiences throughout the process. Clear communication allows for more precise adjustments and individualized care.

To maximize the benefit of each session, it is helpful to prepare questions in advance.

If a time-sensitive question arises between sessions, you may contact us by email. When clinically appropriate, we may recommend additional supportive measures between sessions.

In the event of an emergency or urgent medical concern, please contact your local physician or emergency services immediately.

Treatment length varies based on symptom severity, treatment history, and individual progress. That said, many patients complete the core treatment process in an average of 7 to 9 sessions.

Typical structure:

• Initial Clinical Evaluation (Discovery): We assess your history and current symptoms, answer questions, and outline your individualized treatment plan.

• Follow-up sessions: We typically recommend scheduling sessions every 7 to 10 days, since continuity is an important factor in steady progress. However, session frequency can be adjusted based on individual circumstances.

• Session length: Most follow-up sessions are 50 minutes. A shorter 30-minute session may be appropriate in select situations, at our discretion.

There is no requirement to book a set number of sessions. Patients schedule sessions as needed and pay per session.

Virtual treatment sessions are available Monday through Wednesday, 10:00 AM to 5:00 PM (New York time). We make reasonable efforts to accommodate special scheduling requests when possible.

Next step: Contact us with any questions and to schedule your Initial Clinical Evaluation (Discovery).

We will review this in detail during your Initial Clinical Evaluation (Discovery) after assessing your specific symptoms and treatment needs. At that time, we will outline a clear treatment plan and provide guidance on any supplies that may be appropriate.

In general, most patients will need:

• Your set of vaginal dilators (if appropriate for your situation)

• Lubrication (we will advise you on the type to use)

• A towel or protective covering placed under you

• A comfortable bed or private space where you can lie down during the session

If you do not already have dilators, please do not purchase any in advance. We will advise you on the appropriate type and sizing based on your individual needs.

Additional items may be recommended depending on your treatment plan.

Virtual vaginismus treatment is provided by Dr. Ditza Katz or Dr. Ross Lynn Tabisel through Women’s Therapy Center.

Women’s Therapy Center has specialized in the treatment of vaginismus and painful sex since 1996. Both clinicians have extensive experience treating vaginismus and related sexual pain conditions, and have treated thousands of patients using a structured, specialized treatment methodology developed through decades of clinical work.

You may read more about their qualifications and professional background [here]

Virtual vaginismus treatment follows the same professional standards of privacy and confidentiality as our in-person clinical care. All services adhere to applicable privacy and confidentiality laws and professional requirements.

Your personal information is kept strictly confidential and is never shared, sold, or used for purposes unrelated to your treatment.

Patient records are securely maintained in accordance with applicable record retention regulations. Records are typically retained for six years, which allows patients to resume treatment or schedule additional appointments during that period if desired.

Virtual vaginismus treatment is provided through Women’s Therapy Center using a structured, step-by-step clinical methodology. There is no package requirement. Appointments are scheduled individually and you only pay per session.

Fees:

• Preliminary clinical review of your history via initial email exchange: no charge

• Initial Clinical Evaluation (new patients): $350 USD.  The session will last approximately 50 minutes.

• Follow-up treatment session: $275 USD.  The session will last up to 50 minutes.

• Brief follow-up session (30 minutes): $145 USD, available in select cases, at our discretion.

Payment is processed at the time of booking via major credit card or PayPal.

The average treatment process takes 7-9 sessions.

Please join your appointment a few minutes early and wait to be admitted into the session. If you join late, your session will still end at the scheduled time and you will receive the remaining time available.

If you are unsure whether virtual treatment is appropriate for your situation, please contact us. Most patients benefit from a structured series of follow-up sessions based on individual progress and clinical need.