Hi Dr. Aniruddha, I have gone through your concern. I will try to guide you, however it may take some time and require on going conversation. As you have a doubt, most of the time the vaginismus is due to tremendous apprehension of anticipated pain during insertion. Therefore at the time of insertion, the woman constricts her perineal muscles, particularly vaginal and anal sphincters. I do not know how many times you succeeded in allowing penile insertion? Usual experience is that once the insertion happens and the woman enjoys the sex, the vaginismus element starts diminishing. Would you let me know about insertional history. After insertion, immediately there may be some discomfort to the woman. Hence, both the partners should just be quiet for some time before starting any movements. This helps woman to entre the erotic feelings again. Usually, for first many intercourses, may be even for a year or more in some cases, complete insertion does not take place. It starts only with the insertion of the glans penis and gradually as the time passes, the length of insertion goes on increasing. I have seen patients who experienced first full insertion only after first delivery. Easier way to come over the apprehension of pain is to relax the vaginal sphincter. If it cannot be done voluntarily, start breathing by mouth at the time of insertion and concentrate on some other erotic thoughts or stories. Deep breathing by mouth always relaxes the vaginal and anal sphincters. In addition to this, it is advisable to use lubricants. The women s genitals should never be touched dry. It causes a lot of discomfort and some times even the pain. Lubricant will make the penile entry smooth. Oil based lubricants should not be used as they are harmful to the woman s reproductory organs and the condom if in use. Use only water based lubricants. Vaginal jellies are available with the chemist. They serve the purpose fantastically. The other reason for vaginismus is any vaginal or vulval infection. You are a doctor and you can rule it out, otherwise you may go for a Gynaecologist s opinion. Cure of infection, in that case will take care of the vaginismus. I would advise you keeping away from the dilators for the time being and try the initial remedies I have suggested you. Before I close this answer, let me tell you that in this answer I have used few medical terminologies taking for granted that you are a Medical doctor. If I am wrong, please correct me and I shall use simple layman s language. I feel this counselling should be on going for few sessions. Hence if you continue it by asking me a direct question, I will try to be of maximum help to you and get rid of your delicate, still very important problem. I hope, you will be satisfied with this explanation.