How to choose the right size dilator for vaginismus?


Vaginismus is estimated to effect 1 in 10 women in Australia, yet is often under diagnosed and left untreated. Vaginismus can be described as recurrent or persistent involuntary spasm of the pelvic floor that interferes with sexual intercourse or other types of penetration. It may limit your ability to insert things into your vagina like tampons, fingers, vibrators/dildos, or a penis. It may also cause painful gynaecological examinations. 

It can often feel like your vagina is closed; like there is no opening and that the idea of putting something inside the vagina seems impossible. Some people may never have been able to insert anything into the vagina (primary vaginismus) and for others they might have previously had no issues with penetration and then due to trauma, surgery or with an insidious onset they can develop vaginismus (secondary vaginismus). 

An explanation for this feeling is because the muscle that surrounds the entrance of the vagina (bulbospongiosus) goes into involuntary spasm causing a restriction to the opening of the vagina. This then means that if something is trying to enter the vagina, the vaginal opening is unable to relax and allow for penetration to occur. Trying to push past this muscle spasm can be incredibly painful and, in some cases, may feel impossible. This muscular response can be due to a fear or threat response (e.g. in response to a previous trauma) or due to psychological reasons (such as shame around sex, sexuality and/or masturbation) or in the case of someone who is concerned about the appearance of their genitals or how they present sexually. The reason for the pelvic floor muscle spasm is often a combination of psychological and physical reasons and so your treatment team often includes both a physiologist, physiotherapist and gynaecologist.  

Symptoms of vaginismus may include: 

  • Pain or inability to use tampons or other menstrual products
  • Painful intercourse often with tightness, burning or stinging 
  • Pain or inability to use a vibrator/dildo internally 
  • Penetration being difficult or impossible 
  • Pain during gynaecological exams 


As noted above, treatment for vaginismus often involves several factors: 

  • Exploring your beliefs and experiences. Seeing a sexologist or psychologist can be pivotal in the treatment of vaginismus. These professionals can help explore your beliefs around sex, shame and body image or can help you work through trauma or fear responses to past experiences. 
  • Getting an accurate diagnosis. Seeing a pelvic floor physiotherapist and/or gynaecologist who specialises in pelvic pain is so important
  • Dilator Therapy. Dilators can be a fabulous tool to help gradually stretch the vaginal walls and pelvic floor muscles to allow for pain free penetration. Not only do they provide a physical stretch to the muscles, but they also allow the brain to gradually experience penetration at different sizes in a pain free, controlled way. Starting with our BIEN size small dilator set would be the best place to start if you have vaginismus. 
  • Pelvic Floor Physio. As well as Dilator Therapy, seeing a Pelvic Floor Physio will allow your treatment to be tailored to you. A Pelvic Floor Physio will use several different techniques and tools to assist you to achieve pain free penetration. This might include things like bio-feedback, manual muscle release work (like a massage for your pelvic floor), stretches,  breath work and so so much more! 

Vaginismus is a treatable and curable condition – you do not have to suffer in silence.