How long to use Lidocaine topical gel?

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    Hi ladies. Immediately after my procedure and while practicing with the dilators, I used a mixture of the Lidocaine/surgilube as a lubricant. This worked very well and I used the same mixture on day 2 of my procedure. I think a good question for Dr. Pacik or Ellen to answer is how long should you use the Lidocaine/surgi-lube mixture (i.e. just while dilating at the clinic immediately following the procedure or for a specific length of time post-procedure)?

    Dr. Pacik

    I recommend that patients stop using the lidocaine as soon as possible (3-7 days) for several reasons: Once dilation is in progress I don’t feel the mixture adds anything. It does cause some burning because of the lidocaine. It numbs the penis and causes delayed ejaculation unless a condom is worn.
    Most women are able to use their favorite lubes within a few days of the treatment and the lidocaine mixture is no longer needed. It is very helpful for women to experiment with the different lubes available. There is usually considerable information on the various websites. Excellent question.
    The reader could do a search for “lubes”. We have considerable information on past Forums. We can always add to this information.


    I haven’t used it lately, but when I do, it is only at night, because it makes it easier for me to just fall asleep without feeling something inside me, but lately i’ve been able to just sleep throughout the night by using “slippery stuff”, which I love!!


    I used the surgilube/lidocaine mixture until it ran out (5-6 days post-procedure), but mainly because I didn’t want to waste it. I didn’t feel that it made much difference, but that could be because I was getting used to dilating by day 6. It did sting a little. I bought a tube each of surgilube and lidocaine – the lidocaine is still unopened and I only used the surgilube twice (had a kind of vinegary smell I didn’t like). Still, I think it was worth a few bucks for the peace of mind in case I had wanted to use it longer.

    I’ve been using Sliquid Organics Natural since day 6 with no irritation or infections. Sometimes I add shea butter for overnights. I love the Sliquid for intercourse since it’s a bit thinner and a lot like our natural body lubrication, but I’m thinking of trying Babeland’s “Babelube Natural” for dilating since it sounds a bit less runny.


    Like Heather, I really liked the lidocaine/surgi-lube mixture and used it both in the office as well as for about a week or two when I got home. Since I am post menopausal and super dry, I have really liked the surgi-lube because of its thick consistency and silkiness. I also used the lidocaine and surgi-lube when it came time for me to have my first annual exam after my procedure.


    I think that for patients who may be ‘stuck’ in making the transition from dilators to intercourse, it may be helpful to use a little bit of the Lidocaine/Surgilube mixture. This may work wonders for the first time and will help to retrain your brain into no longer fearing pain with intercourse. I believe it is very similar to waking up with the dilator already in place and then KNOWING that it could be re-inserted again pain-free. You can ease into regular intercourse without this underlying fear once you have first experienced it and KNOW that it is pain-free. Then, once it has happened, you can easily return to regular lubes. Thoughts and comments here???


    Hi all. In an excellent recent post concerning dilating tips, Dr. Pacik wrote:

    “It would be fine to start the lidocaine jelly again either 1% over the counter or 2% with a Rx. This will not hurt you.
    Try putting the dilator in the fridge so it is nice and cold when inserting. This may help. A cold dilator can be combined with the lidocaine can be helpful.”


    Hi, my name is Tiffany and I’m married for 2 years. I’ve been recently diagnosed with vaginismus and I desperately want to be cured. I got my dilators from however I’m seeking advice on using lidocaine. I live in South Africa so Botox is not an option for me, the only way I can overcome my vaginismus is through dilation therapy.I’m ready to do this however the fear and anxiety is overwhelming and I’m struggling to insert the first small one because once I feel the burning I lose the strength I have to go further.. do you suggest I use lidocaine to help me or should I just persist and move slowly maybe inch by inch each day till it gets better? Will it get better? I don’t want to become dependent on lidocaine to insert the dilators but I’m thinking maybe I need something just to help me in the beginning just to get started.. Im known for fussing and moaning even when I get touched down there, my gynaecologist just touched me down there to check if everything is okay structurally and I was moaning because I do feel scared especially because I know the pain I’ve always felt. Is it the fear that I need to control first? And Am I too quick to think about lidocaine? In my desperate attempt to get better please help me. I’m willing to do whatever it takes to be cured, I’m also very stressed and I don’t want to do the wrong thing, please please help, I’m open to all advice and suggestions.. I’d also like to thank everyone at maze for helping women like me all over the world, before I found this forum I was completely lost and alone. Having vaginismus is the worse thing that any woman could go through and you guys make life so much easier simply by giving us hope and encouragement, teaching us on how to overcome and be cured, helping us when we’re stuck. Reading other womens posts and learning of their journey has made me stronger in mine and I just want to say thank you maze because without this I would have never been strong enough to take the first step in curing my vaginismus


    Hi Tiffany,

    You have taken the first step toward curing your vaginismus and that is huge.

    I think using lidocaine when initiating dilation is totally acceptable. Getting over the hurdle of inserting the first dilator is very scary, and if the lidociane gives you some comfort, and strength to push that dilator through, then I think it is fine to use it.

    After you are able to insert the first dilator, and use it for some time, you will probably find that you don’t need the lidocaine anymore.

    When inserting the dilator, just remember to maintain steady pressure on the dilator, pushing the dilator through the vaginal entrance might take more pressure than you actually think. As you keep the pressure on the dilator at the vaginal opening, the muscles should slowly give, and you should be able to pass the dilator through.



    Tiffany, I just want to say you should feel really proud of yourself for beginning to work with the dilators – building up this courage takes many women years and years, and you’ve taken the first step towards your own treatment.

    I would second what Melissa says – so much of dealing with vaginismus is just getting over that fear and initial discomfort of insertion, so whatever helps make that possible is just helping you on the way toward an independent sex life (the botox treatment at Maze, in fact, is this idea taken to the extreme; the botox doesn’t stay in your system forever, nor does the anesthesia they use when inserting the initial dilators, but they help you to understand that insertion is possible). Once you start getting used to inserting something and your muscles begin their stretching, you likely won’t need the lidocaine. I got a tube of it when I went for botox and didn’t end up ever using all of it – I was able to do it myself before long! Breaking that psychological association between penetration and pain takes something different for every woman and lidocaine could be a big help for you!


    I really appreciate the advice, thank you so much


    I did a $5,000 Botox for Vaginismus treatment in Beverly Hills, and it didn’t do much at all. Months have passed, it wore off, and my husband and I still couldn’t have sex. Needless to say, it’s discouraging that I’ve tried just about everything I can with no luck. My husband is suggesting trying lidocaine, but I admit I don’t think it will work since nothing else has. I’m willing to try it, but just want to be clear that it’s safe to use internally, right? I see a lot of info on using it on the vulva, so want to clarify it’s safety for inside the vagina.


    Hi. I just need to clarify, that Botox injections alone is not very helpful. In fact, if that is all that is done, you may end up more hopeless than you started.

    The way we do the Botox procedure is to manually relax the spasm, complete an exam, inject Botox and a short term numbing agent, and then INSERT A LARGE DILATOR, in order to keep the muscles from having another spasm until the Botox kicks in. All of this is done under conscious sedation so your anxiety is not a factor. We then teach you how to work through the next few months. We have not had to re-inject any patients. It kills me when I hear about practices that merely inject Botox and send you home. That would be like doing knee surgery and not giving you follow-up PT instructions and after-care procedures.

    Topical lydocaine should not be harmful at all if prescribed by your physician, but in our experience it is not effective either.

    Good luck to you.


    I second what Bat Sheva said – I had the botox procedure at Maze and the fact that I woke up with a dilator inside me and was aided in dilating from that point was ABSOLUTELY what made the difference in my recovery. I don’t even have any idea when exactly the botox wore off because I never noticed a difference myself. I know it played a part, but the psychological part is so much more potent and needs to be part of a treatment plan whether or not botox is involved!

    After my procedure I dilated for awhile with lube mixed with a numbing gel and it never harmed me. I don’t think I noticed a HUGE difference in sensation, but so much was new and different at the time so it’s hard to say!


    Is there anyplace on here where instructions for using Lidocaine are provided? I’d like to see if it will help me to avoid the pain at the start of intercourse. Pain is just at the very entrance area.

    Thanks so much!!

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