Dilators for Vaginismus. Discomfort of Dilation

Early in the process dilation may be uncomfortable and create soreness. Sometimes it starts off being comfortable and then it is hard to find a position that allows for pain free insertion. This may cause distress (because the dilation was going so well) but needn’t be because most women do experience discomfort with dilation at some time.

Sometimes the lube dries up and extraction of the dilator is uncomfortable. By simply twisting the dilator first this loosens it so that it can be removed more comfortably. Most dilators are too long and it is important to avoid inserting the dilator so far that it hits the cervix which can create discomfort. This discomfort of hitting the cervix is also true for intercourse when the penis is too long. When using the Pure Romance dilators the pink #5 dilator needs to stick out about one inch and the blue #6 about two inches. For painful extraction, experiment with the different lubes including silicone lubes. The water based lube gets absorbed overnight and dries out.

One may be sore from the dilation process because the vagina is not used to this new frequency and duration of using dilators. This gets better with time. It is OK to use ibuprofen or Tylenol at this time. The correct dose of ibuprofen is three 200mg tabs (over the counter) three times a day. This can be used for about a week if needed.

If you find a position of comfort, this may be your position for transitioning to intercourse. One should therefore experiment with different positions including squatting for dilation and then intercourse.

Most women with vaginismus have spasm involving the entry muscle. The higher muscles may be tight but usually not in spasm. Therefore once one gets past the entry muscle, about one inch (2.5cm), the dilator practically “falls in” and the rest of the dilation process becomes easy. It is also helpful to do a series of Kegels, with complete relaxation of the pelvis on the 5th Kegel, and then insert. Also the use of a vibrator has been shown to help relaxation when dilating. Always use lots of lube.

If you have any questions about our Botox treatment for vaginismus and progressive dilation under anesthesia, please contact us via our contact us form.

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About Dr. Pacik

Peter Pacik, MD, FACS is a recognized pioneer in treating patients with Botox for vaginismus and the author of When Sex Seems Impossible: Stories of Vaginismus and How You Can Achieve Intimacy. He has been in practice for over thirty years and belongs to a small group of prestigious surgeons who are double board certified by both the American Board of Surgery and the American Board of Plastic Surgery. In 2010, Dr. Pacik received FDA approval to continue his study to treat vaginismus using intravaginal injections of Botox together with progressive dilation under anesthesia.
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