How to start vaginal dilator therapy


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Written by:
Emma McGowan, writer, editor, and SFSI-certified sex educator
Reviewed by:
Dr. Elena Heber, psychologist
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How to start vaginal dilator therapy

You've been struggling with vaginismus and painful sex for far too long. Your body tenses up and rejects any kind of penetration, and you're not sure how to move forward. 

Sound familiar? It might be time to think about vaginal dilator therapy, an essential part of vaginismus self treatment that employs the consistent use of devices called vaginal dilators or trainers. The aim is not to “stretch” your vagina but to gradually and gently get used to the feeling of having something in your vagina. And while it may seem scary and intimidating, it helped thousands of people overcome vaginismus and take back control of their sex lives. 

The good news is you can get started with dilator therapy in the privacy of your own home. This step-by-step guide will walk you through everything you need to know to begin dilating on your own and start your journey to pain-free sex. While it may not happen overnight, with patience and practice, you can overcome vaginismus. Are you ready to take that first step? Let's get started.

What is vaginal dilator therapy?

Vaginal dilator therapy is a self-treatment method for vaginismus where you gently insert medical dilators of increasing sizes into your vagina to help reduce pain, increase flexibility, and overcome involuntary muscle spasms. The goal is to gradually retrain your pelvic floor muscles to relax, allowing for easier and less painful penetration.

Used in combination with other treatment methods (like cognitive behavioral therapy and relaxation exercises, all of which are included in HelloGina’s holistic program), vaginal dilator therapy is super effective for relieving vaginismus pain. In fact, one 2017 study published in the Journal of Sexual Medicine and titled Vaginismus Treatment: Clinical Trials Follow Up 241 Patients found that 71% of participants were able to have pain-free penetrative sex after five weeks of a combination of vaginal dilator therapy and psychological treatment for vaginismus. So while every person’s results will vary, it’s been shown to be a very effective method for most people with vaginismus.

What you need to get started with vaginal dilator therapy

To get started with vaginal dilator therapy at home, you’ll need a few essential supplies. The good news is it won’t break the bank and you may already have some of these items.

Dilator set

The most important thing is a set of vaginal dilators, which you can for example buy easily and discreetly online. These come in different sizes to allow you to slowly and gently get used to the feeling of vaginal penetration over time. Start with the smallest size and work your way up as your body is ready.

  • Silicone dilators are non-porous, easy to clean, and more comfortable than hard plastic.
  • A set with multiple sizes allows for gradual progress. Don’t rush into larger sizes before you’re ready.


A water-based lubricant is essential for comfortable and effective dilation. It reduces friction and allows the dilators to glide in more easily. Some recommended brands are Slippery Stuff, Sliquid, or Astroglide. Avoid silicone-based lubes, which can damage silicone dilators.

Step by step guide for someone who is using a dilator for the first time

Starting vaginal dilator therapy can be a little scary, but also hopeful. If you're here, we want to say: good job! It's brave to look after your own health like this. Sometimes, the first steps are the hardest. But that's okay, because we're here to help. 

Before starting the therapy, you need to prepare both your mind and your body. Don't worry, we'll guide you! Always remember: this isn't just about getting better, it's also about feeling good in your own body, and living a happier, healthier life.

1. Relax with Progressive Muscle Relaxation (PMR)

Progressive Muscle Relaxation (PMR) is just what it sounds like: A relaxation technique where you tighten and then release a specific muscle group. PMR can help you relax and get focused on the muscles in your vagina, which preps your body and your mind for vaginal dilator therapy. 

2. Do some pelvic floor exercises

While you’ve probably heard of the most famous pelvic floor exercise, Kegels, we actually don’t recommend doing those for vaginismus because oftentimes those muscles are already too tight and don’t need any more of a workout! Instead, try The Butterfly, The Elevator, or The Little Bridge. If you would like to try these exercises as part of a holistic vaginismus treatment plan, consider to sign up for HelloGina.)

3. Start with the smallest dilator size.

Begin with the smallest dilator, typically around the width of a finger. Apply a water-based lubricant and gently insert it into your vagina. Go slowly and stop if you feel pain. Leave it in place for five to 10 minutes to help your muscles relax. Repeat this a few times per week, gradually increasing the time.

4. Practice pelvic floor relaxation techniques.

While the dilator is inserted, practice deep breathing, progressive muscle relaxation, and visualization. These techniques will help your pelvic floor muscles loosen and make insertion more comfortable. Try tensing and releasing different muscle groups one by one. Visualize your vaginal muscles softening and opening.

5. Increase the dilator size gradually.

Once you can comfortably insert and remove the smallest dilator, you're ready to size up. The key is to go slowly. Even moving up one size can take days or weeks of regular practice. Be patient and keep using the relaxation techniques with each new size. Stop if at any point you feel unbearable pain. Your comfort level is the most important factor.

6. Aim for longer insertion times.

As your vaginal muscles start to relax, work your way up to keeping the dilator in place for longer periods, e.g. 15-20 minutes at a time. This will help retrain your muscles to remain relaxed for longer. The more you practice, the quicker and easier insertion and removal will become.

7. Continue regular dilator therapy.

To maintain results, continue using your dilators three times a week for at least several months. Over time, you’ll likely need the dilators less often, but it’s best to keep them on hand in case your symptoms start to return. Ongoing relaxation techniques and pelvic floor exercises can also help support your progress.

Tips for progressing to the next dilator size

Go slowly and listen to your body

As you start using larger dilator sizes, go slowly and be gentle with yourself. Your body will tell you if you need to slow down or take a break. It can take weeks or months to progress between sizes, so don’t rush it. The key is to stay patient through the process and remember to give yourself grace. 

Use plenty of lubricant

Lubricant is your best friend during dilator therapy. Apply it liberally to your dilator and vaginal opening before insertion. Water-based lubricants are a great option as they are non-irritating and rinse off easily. As the dilator sizes increase, you’ll want to use more lubricant. Don’t be shy–use as much as you need to make insertion comfortable.

Start with the tip

Begin by just inserting the tip of the new dilator size. Hold it in place as your muscles relax, then slowly slide it in a bit further. Remove and reapply lubricant as needed. Gradually work your way to inserting the full length of the dilator. This gradual process will help you get accustomed to the new size at your own pace.

Take breaks when needed

Don’t feel like you need to rush through the process. Take breaks in between inserting the dilator to rest and relax. You can also try practicing your deep breathing techniques during the breaks. Insert the dilator for as long as is comfortable for you, even if it’s just 30 seconds. Over multiple sessions, aim to increase the time. But go at the pace that feels right for your body.

Try different positions

Experiment with different positions to find what is most comfortable for you. Lying on your back with knees bent is a good starting position, but you can also try kneeling, standing, or lying on your side. Different positions may help the dilator slide in more easily. See what works best for your body.

Progressing to larger dilator sizes is a big accomplishment, so celebrate your wins along the way. Stay positive and keep practicing–you've got this! 

Try HelloGina

If you’re having trouble getting started with vaginal dilator therapy–or with sticking to your routine–it might be a good idea to call in some extra help. That's where HelloGina comes in. Our holistic mind-body program will not only guide you through dilator therapy, but will also teach you the necessary pelvic floor exercises and self-management skills (which are gleaned from evidence-based cognitive behavioral therapy) to help you feel better. Do you wonder if this might be for you? Take the quiz to find out.

It will take patience and practice, but by going slowly and listening to your body, you can overcome vaginismus. Stay consistent with your dilator therapy sessions, keep a journal to track your progress, and don't get discouraged if it takes time. Stay focused on your end goal, start with the smallest dilator size that works for you, and gradually progress at your own pace. 

With time and practice, vaginal dilators can help you overcome vaginismus and allow you to experience pain-free intimacy. You deserve to feel empowered and in control of your own body. Keep up the good work!

Frequently Asked Questions (FAQs) about vaginal dilator therapy

Is vaginal dilator therapy painful?

Vaginal dilator therapy should not be painful if done properly and gradually. You may experience some discomfort initially, especially when inserting larger dilator sizes, but you should never feel sharp or intense pain. Go slowly, use a lubricant, and stop if you feel pain. The key is to relax and breathe steadily as you gently insert and remove the dilators. Any pain usually subsides once the muscles relax. If pain persists, talk to your doctor.

How long will it take to complete the dilator therapy process?

The time it takes to complete dilator therapy can vary from person to person depending on several factors, including the severity of your vaginismus, how diligent you are with the exercises, and your body’s response. Most people find noticeable improvement within four to six weeks of regular therapy. But the experience for every person is different: Complete therapy where you can have pain-free intercourse may take longer or shorter, depending on your circumstances. The key is to be patient and consistent. Don’t get discouraged if progress seems slow. Every small success and millimeter of progress matters.

Do I need to use the dilators every day?

Using the vaginal dilators three times per week is typically recommended for the best results. However, you can adjust the frequency based on what works with your schedule and how your body responds. The most important thing is to stick to a regular routine. Some people find it helpful to schedule dilator therapy sessions in their calendar to help make it a habit. You can start with just two times a week if needed and build up from there. The more consistent and frequent you are, the quicker your progress will be.

What if I miss some days or weeks of therapy?

It’s okay if you miss some days or even weeks of dilator therapy at times. Life happens, and you may fall out of your routine for various reasons. Don’t be too hard on yourself. When you’re able to start again, go slowly to allow your muscles to readjust. You may need to drop down a dilator size or two initially until you work your way back up. Staying committed to your therapy in the long run is most important. A few missed days here and there will not undermine your progress if you get back on track.

Can I stop dilator therapy once I’ve achieved my goals?

Once you’ve completed your dilator therapy goals and are able to have pain-free sex, it’s a good idea to continue using the dilators occasionally for maintenance. About 1-2 times a month is typically sufficient for most women. This helps ensure your vaginal muscles do not tighten up again and prevents vaginismus from recurring. Dilator therapy is an ongoing process, and occasional practice and consistency is key.

Sources cited: 

  1. Vaginismus Treatment: Clinical Trials Follow Up 241 Patients

Emma McGowan

Emma McGowan is a writer, editor, and SFSI-certified sex educator with over a decade of content marketing experience. She is currently the managing editor of consumer-facing blogs at the global cybersecurity and privacy company, Gen. Emma was formerly a sex/relationships/dating writer at Bustle, including their sex advice advice column SEX IDK, and the senior writer at Her work has appeared on Buzzfeed, Broadly, Bedsider, Mashable, The Daily Dot, Mic, and The Bold Italic, and Sexual + Being, among others. When she's not writing and editing, Emma can be found sewing, reading, and playing with her two cats, Dwight and Poe.
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