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Dilators for Dyspareunia

Written by Emma McGeorge

dilators for dyspareunia

Dyspareunia, the medical term for painful sex, is described as a repetitive pain in the genitals leading up to, during, or after intercourse. As well as affecting your sex life, dyspareunia can lead to lower self-esteem and impact loving relationships due to a lack of emotional intimacy. However, treatment is available with the help of dilators for dyspareunia

Read on to learn more about the causes of dyspareunia, the different types of dyspareunia, and how you can treat it at home to re-establish pain-free sex. 

What Causes Painful Sex?

Although it can occur in both men and women, painful sex is more common in women, affecting up to 7.5% of sexually active females between the ages of 16 and 74. The cause can vary from woman to woman, depending on both their physical and psychological health. 

Below, we’ve outlined the main causes of dyspareunia.

Physical Causes of Dyspareunia

One of the more common causes of dyspareunia is a lack of natural lubrication. When women are not adequately turned on for sex, the Bartholin glands responsible for vaginal lubrication will not produce enough fluid. This means that the vaginal canal is dry during penetration, resulting in friction and chaffing, and ultimately a painful experience during intercourse.  

Other physical causes of dyspareunia can come down to underlying conditions such as; sexually transmitted diseases, vaginismus, vulvodynia, vaginal atrophy after radiation treatment, or menopause. Symptoms of endometriosis, overactive pelvic floor muscles, ovarian cysts, pelvic surgery, vaginal stenosis, as well as lichen sclerosis can also be the physical cause of painful sex.   

Psychological Causes of Dyspareunia

Psychological concerns like performance anxiety, nervousness surrounding your first sexual encounter, or loss of libido as a result of fluctuating hormones are also common causes of painful sex due to the lack of lubrication secreted when women are mentally under duress. 

While the physical symptoms of vaginismus are usually credited with causing dyspareunia, the automatic tightening of the muscles around the vaginal opening at the mere thought of vaginal penetration is almost always psychologically based. A conscious or sub-conscious fear that exists around sexual intercourse causes the vaginal muscles to spasm involuntarily and intercourse becomes either incredibly painful or intolerable. 

Dyspareunia can also result from psychological issues concerning previous sexual trauma, sexual abuse, and stress, as well as the first time having sex after traumatic childbirth, or after surgery for an imperforate hymen or vaginal septum.

What Does Dyspareunia Feel Like?

There are actually two types of dyspareunia and each feels different because the pain is localized in different parts of the vagina. 

Superficial or entry Dyspareunia is when pain is felt in the vulva or vaginal opening during initial sexual penetration. This pain can be caused by conditions like vaginismus, vulvodynia, or a vaginal infection. However, it can also be caused by a lack of lubrication, an imperforate hymen, or a penis that is too large for your vaginal opening. 

Deep Dyspareunia is when women experience pain during sex in the back region of the vagina. Commonly felt during thrusting, this type of pain resonates as a dull ache or burning feeling around the womb, cervix, or ovaries.  

Once either type of dyspareunia is experienced, the pain can register in the brain and muscle memory, effectively becoming a vicious cycle where fear of painful sex causes the vaginal muscles to tighten and inevitably leads to more painful sex.  

How To Treat Dyspareunia

The first step in treating painful sex is to understand the underlying cause. This is typically understood with the help of a sex therapist, gynecologist, or pelvic floor physiotherapist, who will then recommend the best treatment to remedy your dyspareunia. For some women, this might necessitate counseling to resolve underlying psychological fears surrounding sex, while for others it could mean treating one of the physical conditions mentioned above. 

In addition to understanding the underlying cause, your healthcare practitioner would also typically recommend vaginal dilators to relax and stretch the constricted vaginal muscles. In this case, they will usually show you how to use a dilator in their clinic first and will then recommend that you practice regularly at home for best results. 

What Is A Dilator For Dyspareunia? 

Made from either medical-grade silicone or plastic, vaginal dilators are tube-shaped devices that are used to relieve pelvic pain disorders, relax vaginal tightness, and restore sexual pleasure by training the mind and the body to expect pain-free penetration. 

Available in ascending dimensions that range from the size of a small finger to an erect penis, the variety in dilator sizes allows users to slowly relax and gently stretch the vaginal muscles over time. While your healthcare practitioner will recommend the best size for you to start with, most dyspareunia patients will begin with the smallest dilator, learning to insert the device and relax for 10-15 minutes a few times a week until the size feels comfortable inside the vagina. 

Once confidence is established with the smaller size, women then move to the next size dilator and the next, until they ultimately feel comfortable with a dilator the size of an average penis inside the vagina. 

Treating Dyspareunia At Home

Even though vaginal dilator therapy usually begins during a session with your pelvic floor physiotherapist or gynecologist, once you know the correct size dilator for you to start with, you can also treat dyspareunia at home by practicing for 10-15 minutes up to three times a week. 

The following guide gives clear instructions for treating dyspareunia with vaginal dilators at home. 

  1. Always wash your vaginal dilator with warm water and soap before using it
  2. Designate a private place in your home where you feel safe and will not be interrupted
  3. Drizzle or rub a generous amount of water-based lubricant over the dilator as well as the entrance to your vaginal opening. (It is important to use a water-based lubricant to protect the medical-grade silicone of Intimate Rose Vaginal Dilators.
  4. Select the size recommended to you by your pelvic floor physiotherapist, or start with the smallest size.  
  5. Lie down on your back, on your bed, on a yoga mat, or on some comfortable blankets with your knees bent and feet planted on the floor. Some patients prefer to lie on their side with the knees bent and a cushion or pillow placed between the knees to support the upper leg.
  6. As you inhale, allow your belly to expand and as you exhale, allow your belly to drop. Continue to consciously breathe like this for a few more breaths to relax the vaginal opening with each exhale. 
  7. When you feel ready, bring the tip of the dilator to the vaginal opening, and during the next exhale, gently insert the tip. As you continue to breathe consciously, ease the dilator into the vagina with each exhale until the lip at the end reaches the vaginal entrance.
  8. Breathe deeply and calmly, relax your shoulders, allow your body to sink into the support beneath you, and keep the vaginal dilator inserted in the vagina for 10-15 minutes, or however long your healthcare practitioner recommended
  9. Once you become comfortable inserting each dilator, it's helpful to practice insertion in different positions to mobilize the organs around the vaginal canal and encourage gentle stretching of the tissues. As well as laying on your back or your side, recommended positions include a deep squat and a table-top position with your hands and knees on the floor.
  10. It is also helpful to gently press the dilators against the walls of the vagina by imagining the opening of the vagina as a clock and slowly moving the dilator in a circular position. Pause at each “hour” of the clock, gently compressing the dilator against the vaginal wall in each position. 


Women of all ages, all over the world, are using vaginal dilators for dyspareunia; to relax tight vaginal muscles, restore a pain-free sex life and regain their self-esteem. If you are suffering from dyspareunia, don’t suffer in silence, or abstain from sex because of worry, contact your health practitioner today to discuss if vaginal dilators are an option for you. 

Although painful and debilitating both physically and mentally, dyspareunia is treatable and you can enjoy a pleasurable sex life again. Don’t give up. 


Science Direct – Vaginal Dilators - https://www.sciencedirect.com/topics/nursing-and-health-professions/vaginal-dilator

Oxford University Hospitals  - Vaginal Dilator Exercises - https://www.ouh.nhs.uk/patient-guide/leaflets/files/30804Pexercises.pdf

Mayo Clinic – Dysapeurnia - https://www.mayoclinic.org/diseases-conditions/painful-intercourse/symptoms-causes/syc-20375967