In order to ensure there is little-to-no pain, we recommend that you start at x-small and go up in size (diameter – not length!) in order to allow you to put in (very, very slightly) larger and larger sizes until you are at a size of a penis. Usually dilator sets include 5-7 sizes.

Inserting dilators should not hurt, although it may be uncomfortable or feel “weird,” as some patients like to tell us. It may just be that you feel some stretching or pulling, but ultimately if you keep it in place for a few minutes and relax around it, the muscles should soften and give in and there should be no significant pain.

There are a number of reasons for recommending vaginal dilators to our vaginismus patients. Here are a few common scenarios:

  • At home when the patient is working towards the use of the larger dilators
  • As a transition to intercourse by dilating prior to intercourse
  • In preparation for a GYN examination
  • To maintain the stretch of the vaginal muscles to avoid regression during the first year
  • For patients undergoing the Vaginismus Treatment Under Anesthesia:
    • A dilator is inserted during anesthesia, after the Botox has been injected
    • In the recovery room, supervised dilation is performed
    • Post procedure, patients return for more instruction in the use of dilators and transition to intercourse


There are several types of dilators and there is truly not a big variation between them. You want a dilator that is sturdy and comfortable to hold. Beyond that, the only variation is how “hard or stiff” the material is. Whichever you choose, make sure you always use a lot of lubricant when you are dilating, as any tension or pain from friction should be avoided.


Plastic Dilators

There are a total of 8 different sizes so you can progressively dilate at your own pace. These medical grade dilators are made of non-latex, white, hard plastic and are longer with no “bottom” to speak of. They have extra length in order to allow you to hold them at the end when they are inside. We find that many of our patients like the hard white plastic dilators since they have no give at all and therefore slide in quite easily, with no bending.

Pure Romance Vaginal Dilator Set

The set includes 6 dilators, each with a flat bottom so when inserted completely, rests up against your vulva. They’re made of 100% silicone which is soft and comfortable, resembling body tissue.

Crystal Delight — Pacik Glass Dilators

These dilators come in 6 different sizes and can be purchased as a set of 3. Made from medical grade tempered glass, they feature the flat bottom that rests against the vulva. Many patients like these dilators because they’re easy to insert, clean and sleep with.

Lilo Liv Vibrating Dilator

The Lelo Liv is an elegant mid-sized vibrator, perfect for vaginismus patients or first-time users of a vibrator that reduces stress and promotes relaxation.  It’s made of silicone and has a gently curved design that will fit comfortably inside the body. The diameter is between the #4 and #5 Pure Romance silicone or Pacik glass dilators. The Liv also features 8 adjustable vibration modes. Find more vibrator recommendations.


Don’t get frustrated if you’re having trouble dilating. Sometimes women just can’t bring themselves to get that first dilator in, and sometimes women are doing fine but can’t seem to get past that medium size dilator. All of a sudden it starts to really hurt or the muscles tighten up and you “just can’t get it in.”

That’s what we’re here for. Contact us for a free phone consult or to make an appointment if that’s the case, as there may be something else that can be done to make the process more comfortable. The bottom line is that intercourse should not hurt. Don't give up on treatment! We're here to support you however we can, as are the many members of our Vaginismus Forum. Join the conversation to share questions, concerns and stories.