Struggling to dilate while sitting? Here’s what’s really happening

If you’ve ever thought, “Why is this so much harder when I sit down?” — you are absolutely not alone.

One of the most common questions I receive inside my vaginismus programs and clinical practice is about positioning during dilation. Many women find that standing in the shower suddenly “unlocks” progress — only to feel stuck again when they try to sit or semi-recline.

Let’s unpack what’s really happening — and what you can do to make sitting positions work for you instead of against you.

Why Dilating in the Shower Suddenly Works

When you stand in the shower:

• Your pelvic floor is often more relaxed.
• Warm water increases blood flow.
• Gravity is working with you — not against you.
• Your hips are slightly open.
• Your body feels safe and private.

It’s no coincidence that you moved up an entire dilator size in just four days. That’s a sign your body can relax — which is the key factor in vaginismus progress.

But here’s the important part:

Standing is not “better.” It’s just easier for your nervous system right now.

And that’s okay.

Why Sitting Feels So Much Harder

There are three main reasons sitting becomes difficult:

1. Many Women Push Downwards When Sitting

When you sit upright or lean forward, your natural tendency is to bear down. That downward pushing increases pelvic floor tension. Instead of softening, your muscles brace. For vaginismus, that’s the opposite of what we want.

2. Sitting on Your Bottom Isn’t the Right Sitting

This is subtle but crucial: Many women sit directly on their sit bones (their bottom) and try to dilate. That compresses the pelvic floor. Instead, you want to sit slightly tilted back onto your lower back, allowing the pelvis to open gently.

Think:

• Not upright and braced.
• Not slouched forward.
• Slightly reclined with support.

3. “My Arms Feel Too Short!”

When you lean back (which is correct), suddenly your arms feel too short to comfortably hold the dilator. This isn’t a failure — it’s a positioning issue.

Often the fix is simple:

• Scoot your hips closer to the edge of the bed or sofa.
• Bring your knees up and let them fall outward.
• Use firm cushions behind your lower back.
• Support your elbows on pillows.

Your body needs support — not strain.

The Most Important Principle: Your Nervous System First

With vaginismus, we’re not stretching tissue. We’re retraining protection. Your pelvic floor tightens because your nervous system believes penetration is unsafe. The more physically awkward or unstable you feel, the more it will brace.

Standing in the shower may feel:

• More private
• More instinctive
• Less exposed

So your muscles soften.

Sitting might feel:

• Vulnerable
• Awkward
• Like “practice mode”

So your muscles tense. This is nervous system regulation — not failure.

Should You Just Keep Standing Since It’s Working?

Short answer: Yes — for now.

Long-term answer: You will eventually want to practice other positions too.

Why?

Because real-life intimacy doesn’t always happen standing in the shower.

Your body needs to learn:

• Lying down
• Semi-reclined
• Side-lying
• On top
• Sitting

But you don’t introduce challenge until your system feels safe.

Progression looks like this:

• Master the easiest position.
• Build confidence.
• Gradually introduce harder ones.

Not the other way around.

How to Make Sitting Easier (Practical Adjustments)

Here’s what I recommend clinically:

1. Lean Back — But Support Your Lower Back

Use firm supportive but comfy cushions, not soft collapsing ones. Support at the lumbar spine lets your pelvis tilt correctly.

2. Don’t Sit Directly on Your Bottom

You want your weight slightly shifted back. Imagine your tailbone lengthening, not pressing down.

3. Elevate Your Hips Slightly

Place a folded towel or yoga block or supporting cushion under your sacrum. A small lift changes the pelvic angle significantly.

4. Support Your Arms

Rest elbows on pillows. Short arms aren’t the issue — unsupported shoulders are.

And if you have the feeling your arms are too short to actually dilate, then your sitting position is not correct - you might be leaning back too far.

5. Slow the Transition

Instead of jumping from standing → fully reclined, try:

Standing → Leaning against a wall → Seated at edge of bed leaning back → Semi-reclined → Fully lying down

Gradual exposure reduces guarding.

A Very Important Reality Check

Often asked:

Should I just keep standing while dilating because it’s working and eventually everything will be settled?

I want to gently reframe one word:

“change.”

With vaginismus, it`s more:

• Desensitization
• Muscle retraining
• Nervous system safety
• Gradual integration
• so you don`t have to "change" yourself - although it feels like it.

Your body learned protection.

And now it’s unlearning it.

That takes progression — not pressure.

When You’re “Stuck for Weeks”

Plateaus are common.

Often they mean:

• Your body needs variation.
• Your nervous system needs reassurance.
• Or you’ve been pushing instead of softening.

The fact that you progressed quickly in the shower tells me something important:

Your body is capable.

We just need to expand that safety into new positions.

The Big Takeaway

If standing works — use it.

Then gently expand.

But don’t force sitting just because you think you “should” be able to.

easing vaginismus is not about endurance.

It’s about safety and making progress.

Progress shows us that your nervous system is beginning to trust again.

—

Sometimes it’s not you — it’s the angle. Be willing to experiment kindly.
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.