Vaginismus 101

As a result of inadequate information as well as poor training among doctors, vaginismus is generally poorly understood even though it was described as early as the 1500’s and given its name in 1861.

Women with vaginismus note difficulty with vaginal penetration and this includes attempts at using a tampon, having a pelvic exam, insertion of fingers and attempted intercourse. As such, vaginismus is defined as a genital pelvic pain/penetration disorder. Vaginismus can affect women of any age from early teens to menopause.  A woman with vaginismus is unable to have comfortable vaginal penetration despite a desire to do so. Vaginismus causes difficulty during teenage years when a tampon cannot be inserted. Later, vaginismus is disruptive to relationships when the woman is not able to tolerate finger or penile penetration. This results in shame and embarrassment and has destroyed many honeymoons.

Understanding and Treating Vaginismus

Determining the severity of her vaginismus is one of the most important things a woman with vaginismus can do, and it will help her decide what treatment plan is appropriate for her. In my one-hour video titled “Understanding and Treating Vaginismus,” I elaborate on the concept of self-evaluation, self-treatment with vaginal dilators and other treatment options. This one-hour video also covers vaginismus background information, vaginismus symptoms, vaginismus treatments and how to use vaginal dilators. This film is based on my many years of experience evaluating women with sexual pain and treating vaginismus.

To understand more about vaginismus, it is suggested that women and their partners read the book “When Sex Seems Impossible. Stories of Vaginismus & How You Can achieve Intimacy by Peter T. Pacik, MD, FACS available on Amazon in paper back or Kindle.

This book highlights stories from women who suffered with vaginismus and the different types of vaginismus treatments attempted. It profiles the difficulties women and their partners have in attempting to understand why the woman is unable to function sexually and why treatments may be ineffective. The book includes success stories and vaginismus treatments that are effective. This vaginismus book is both interesting because of the real-life stories as well as educational because it brings vaginismus information and vaginismus treatment options up to date.

– Peter T. Pacik, MD, FACS


We’re Attending the AASECT Conference!

For the first time, we are attending the AASECT (American Association of Sexuality Educators, Counselors, and Therapists) Conference at the Green Valley Ranch Resort, Spa, and Casino in Las Vegas, Nevada. The conference will be held June 15th-18th, and draws a diverse group of over 600 people from all over the world, many of them professionals and experts in their respective fields which include sex education, psychology, sociology, nursing, counseling, and many others.

This will be the 49th Annual AASECT Conference, and they will be celebrating their 50th anniversary with this year’s theme “Honoring Our Past, Celebrating the Present and Envisioning Our Future.” The fields of human sexuality and sexual health have a long history of being considered taboo, and because of that, being under-researched. This year the conference will be recognizing our past and celebrating all of the progress we’ve made, and continue to make, in this area. There will also be an emphasis on the progress the field of human sexuality has come in making its community and research intersectional and how important it is to remember how each individual’s personal experiences, sexual identity, language, culture, and a number of other factors play a role in seeing the complete picture of human sexuality.

The AASECT Conference is one of the largest gatherings dedicated to deepening our understanding of human sexuality and behavior. There are numerous workshops, presentations, and panels that will offer unique perspectives and expert knowledge on a wide range of topics pertaining to sex and sexuality. It is a one-of-a-kind opportunity for knowledgeable professionals to share the latest research, clinical techniques, statistics, and technology in this field, as well as engage in dialogues that broaden our understanding of the complexities of human sexuality.

Our contribution to the convention will be our Pacik Dilators. As exhibitors, we will be displaying our dilators and sharing information with attendees about their design, how they work, and how they’ve helped so many people. We’re so excited for this opportunity to share our own knowledge and learn from all of the health professionals that will attend. This will be a great way to introduce these devices to the sexual health community, and we hope we can make more people aware of them and what they can do. We are eager to learn from, and be inspired by, all of the information and ideas that will be exchanged there, which will surely expand our minds and make us even better at what we do!

How to Use Dilators in the Treatment of Vaginismus and Menopausal Sexual Pain

Vaginal dilators play an important role in vaginismus treatment and menopausal sexual pain. Regardless of the type of treatment for these conditions, dilators are almost always needed to overcome penetration difficulties in both younger women and also for women who have menopausal sexual pain.

Both of these conditions are marked by considerable pain with penetration attempts. For younger women with vaginismus this includes the inability to use tampons, pain with finger penetration, and difficulties with penetration pain during pelvic speculum examination and intercourse. The pain is related to muscular spasm in younger women and dryness and vaginal atrophy in menopausal women. When severe, this is known as secondary menopausal vaginismus. A milder case of penetration pain in menopause is known as dyspareunia.

Vaginal dilators are manufactured in a variety of styles and materials graded in size from #3 to #8 with the common sizes being numbers 4-6. Size relates to the widths of the dilators (the smaller the number, the narrower the dilator). Wide dilators such as #7 and #8 are needed for partners with larger than normal erections. During my experience using dilators for vaginismus patients, I found that many of the dilators were too long as the size increased. Since the normal vagina is about 3 ½ inches long, a dilator that is 5-6 inches long will protrude from the vagina and impair mobility during dilation. It is for this reason that borosilicate dilators were developed all of which are 3 ½ inches long, regardless of the width.

Too often dilation recommendations by professionals in the field underestimate the length of time needed for effective dilation and the correct progression of the dilators. To understand how to use dilators in the treatment of both vaginismus and menopausal sexual pain, I recommend the following resources:

  1. A blog written by Dr. Peter T. Pacik titled How to use Vaginal Dilators” (link
  2. A one-hour film available as a download by Dr. Peter T. Pacik titled Understanding and Treating Vaginismus (link:

-Dr. Peter Pacik MD, FACS

Who Benefits from using Vaginal Dilators?

Who Benefits from using Vaginal Dilators?

There are many benefits from using vaginal dilators. As a woman ages, there are problems with dryness and sometimes tearing when intercourse is attempted.  This can result in painful intercourse (dyspareunia).  If intercourse becomes impossible because of severe pain, this is known as secondary vaginismus. Though there are treatments for these two conditions, most of these women also benefit from a dilation program using the #4, #5 or #6 dilator (depending on the size of her partner) for 15-30 minutes prior to intercourse to help stretch the vagina slowly without tearing. It is always helpful to start with a smaller dilator such as the number 4 or a finger and then progress to the larger dilators. With experience this becomes easier. The use of lubricants is combined with the dilation.

Women who have never been able to tolerate intercourse due to spasm of the vaginal entry muscle suffer from a condition known as primary vaginismus. Women with more severe forms of vaginismus are also unable to insert tampons. Treatments such as sex counseling, physical therapy and/or Botox for more severe forms of vaginismus rely on the use of vaginal dilators. These conditions are discussed more fully on the Pacik Vaginismus website.

A prior blog on the Crystal Delights website titled “Vaginal Dilators for Vaginismus: The Role of Self Evaluation by Peter T. Pacik, MD” explains the value of self-evaluation for women struggling with vaginismus. Milder cases can self-treat with a good dilation program, which is discussed in Dr. Pacik’s one-hour video  “Understanding and Treating Vaginismus” and is available as a digital download for $25.00.

In summary, there are many indications and benefits for the use of dilators, which include both primary and secondary vaginismus as well as menopausal atrophy with dryness and tearing. The Pacik Glass Dilators are easier to use than other commercial dilators (which are made too long in the larger sizes) because all sizes of the Pacik glass dilators are the length of an average vagina (3 ½ inches) and have a comfortable ergonomic fit at the vulva. These dilators allow a woman to be normally active while dilating.

The dilators are made of medical grade borosilicate glass and resist breakage. Care must be taken when washing the dilators to avoid having them fall against a ceramic sink which can cause breakage. A wash cloth placed in the sink helps prevent breakage during washing. They are dishwasher safe.