What if vaginal dilator therapy does not relieve pain during sex?

Dilators gradually introduce pressure and may help some types of tightness or fear of penetration, but they do not address every cause of pain. Dryness, skin irritation, infection, scar tissue, pelvic-floor overactivity, endometriosis, or pain originating deeper in the pelvis can require a different approach. Pain can also increase when exercises are rushed or performed against resistance.

Tell your pelvic-floor physiotherapist or clinician exactly where the pain starts, whether it is burning or deep, and how long it lasts afterwards. Ask them to check the size, lubrication, pace, and pressure used. Avoid forcing a dilator through sharp pain; comfort and relaxed breathing are useful guides. A clinician may suggest pelvic-floor treatment, management of dryness or irritation, or evaluation for another condition. More information is available under [Pain During Sex](/symptoms/pain-during-sex/) and [Vaginal Dilator Therapy](/treatments/pelvic-floor-and-rehabilitation/vaginal-dilator-therapy/).

Arrange prompt medical assessment for new bleeding, sores, unusual discharge, fever, severe pain, or pain that persists after stopping the exercise. Seek urgent help for sudden severe pelvic pain, fainting, or heavy bleeding. Do not continue an exercise that causes marked pain while waiting for advice.

Ask what type of pain your symptoms suggest, whether the pelvic floor needs examination, how to modify the programme, and which symptoms should make you stop and seek help.