How to insert the first dilator: a step-by-step guide

For many women with vaginismus, the very first step — inserting the smallest dilator — feels like standing at the base of a mountain. It’s not just about a piece of medical-grade silicone or plastic; it’s about facing fear, letting go of tension, and allowing yourself to trust your own body again. I know from decades of experience with women worldwide that this first insertion can feel overwhelming. But once you’ve done it, it becomes the turning point: the moment you know progress is possible.

Why the First Dilator Matters

Dilators are not about “forcing” anything open. They are tools to retrain your nervous system and gently teach your body that penetration can be safe. With vaginismus, the pelvic floor muscles tighten in a protective reflex — an amygdala hijack, driven by fear. The smallest dilator (often no wider than a tampon) is designed to bypass that cycle by giving your body a chance to learn: This is safe. Nothing bad is happening.

That first dilator is the bridge between avoiding all penetration and beginning the easing journey.

Step 1: Preparing Before Touching a Dilator

Looking with kindness

Many women have never really looked at their vulva — or only looked with fear. Some describe it as “red,” “damaged,” or “wrong.” But this is simply anxiety coloring perception. Vaginal tissue naturally looks pink-red, like the inside of your mouth. Every vulva is unique.

Try this gentle approach:

• Find a quiet, safe space and use a mirror in soft lighting.
• Place your hand on your lower belly and breathe deeply.
• Look without judgment — you are saying hello to your own body.
• If you want to see the vaginal entrance more clearly, wrap your arms around your thighs, pull gently back on your buttocks, and cough. You may notice a small indentation — that’s normal.

This is not about inserting anything. It’s about reconnecting with your body and beginning to replace fear with familiarity.

Step 2: Early Touch Exercises

Exercise 1: Conscious dabbing after urination

• After you finish urinating and wipe as usual, take a fresh piece of toilet paper.
• Dab again slowly and consciously, noticing the sensation.
• Over time, try the same motion with your fingertips.
• There’s no right or wrong, only curiosity and connection.

Exercise 2: Gentle tapping towards comfort

• Begin by lightly tapping your thighs with your fingertips.
• Gradually move closer toward your vulva.
• When ready, try tapping gently on the labia.
• You should hear a soft tapping sound. This is about desensitizing and reassuring your nervous system.

A Gentle Reminder

Many women tell me: “The technique isn’t the hardest part. Starting is.”

If your body feels tense before you even begin, read → Why Overcoming Vaginismus Feels Like Jumping Into a Lion’s Den

If you prefer a structured daily progression instead of guessing, explore → The Vaginismus Zone Programme

Getting used to the dilator itself

• Don’t start by staring at it — just hold it in your hand, close your eyes, and feel its weight and texture.
• Tap yourself gently with the tip of the dilator, increasing pressure very gradually.
• Rest the tip against the fold between the inner and outer labia, more toward the lowest point (near the perineum).
• The goal isn’t insertion yet — but if it slips in slightly, don’t panic. That’s simply your body showing readiness.

Step 3: How to Find the Vaginal Entrance

One of the most common fears I hear is: “I can’t even find the hole.” Please know: . The vagina isn’t an open tunnel — its walls rest against each other and only part slightly when something gently enters.

Here are some simple techniques:

• Feel, don’t hunt: Use your fingertip or the tip of the dilator to trace slowly downwards between the inner labia, toward the perineum (the skin between the vagina and anus). The entrance is located just above this point.
• Try the cough technique: Place your hand around your thighs, pull gently outward, and cough lightly. This can make the opening more visible as a small indentation.
• Use a mirror with soft lighting: Harsh lighting can make tissue look “wrong” or scary. Warm, natural light helps you see clearly.
• Think “backwards,” not “upwards”: The entrance isn’t straight up into your body — it angles slightly backwards, toward the base of your spine. Pointing the dilator in this direction helps enormously.

Remember: it’s normal not to see a big “hole.” You’re looking for a soft, flexible indentation.

Step 4: Practical Technique for First Insertion

Here’s where most women struggle: they think they’re trying, but the dilator isn’t even touching the skin. The brain believes effort is being made, but nothing is actually happening.

1. Use the palm trick

• Hold the end of the dilator in your palm, not with your fingertips.
• When your palm presses against your body, the dilator must be in contact with the skin.
• This avoids “hovering” and ensures genuine progress.

2. Gentle knocking movements

• Instead of pushing steadily, use short, gentle knocks.
• Press forward slightly, then release pressure — but don’t pull the dilator away.
• Repeat in a rhythmic, wave-like motion, adding a little more pressure each time.

3. The cough trick

• Just before pressing, cough gently.
• Coughing contracts the pelvic muscles briefly, and then they release.
• Use that moment of release to apply pressure and move the dilator forward.
• Stop coughing when you start pressing.

4. Getting past the first barrier

• At about 1–2 cm, you’ll feel some resistance from the pelvic floor - that´s completely normal.
• Once you pass this “gateway,” the level of the pelvic muscle - the dilator often slides in more easily.
• When you’ve reached about 2 cm, you can continue smoothly through.

Step 5: Celebrate Small Successes

Even inserting just a few millimetres is a victory. The goal is not depth — it’s showing your body and mind that safe penetration is possible. Each success weakens the fear cycle and strengthens your confidence. Write it down, celebrate it, and remind yourself: I did it.

Step 6: If It Feels Impossible

Not being able to insert the dilator yet does not mean failure. It simply means your nervous system needs more preparation. Keep working on external touch, mirror exercises, and the tapping method. Many women also benefit from professional support to guide them through these first milestones.

The Bigger Picture

That first dilator is not just a physical act. It’s a declaration: I am stronger than my fear. Each small step builds momentum, and with gentle practice, what once felt impossible can become part of your daily easing routine. 

Slow is not failing — slow is how the body learns to trust again.
Warmly,
Dr Julia Reeve

Gynaecologist · Psychotherapist · Sexologist · Author of The Vaginismus Book

Dr Julia Reeve

Gynaecologist, psychotherapist and sexologist based in Amsterdam, with over thirty years working with women experiencing vaginismus. Author of The Vaginismus Book and creator of the TVZ dilator companion app.

This article is for general information and education. It is not a substitute for individual medical advice. If you have persistent pain or distress, please see a qualified healthcare professional.