To assess the effectiveness of the Milli device in achieving vaginal intercourse

The Milli Vaginal Dilator is a patient-controlled vaginal dilator that provides therapy through distention of the vaginal tissue under electromechanical expansion.

This study is intended to provide data in support of the Milli Vaginal Dilator as a commercially available, over-the-counter medical device.

The Milli has been granted marketing authorization by the FDA under premarket notification K220035 for the following Indications for Use statement:

The Milli Vaginal Dilator is a tool indicated for controlled dilation of the vagina. It can be used for dilation for an examination (by your doctor), in preparation for a surgical procedure, or to help relieve the symptoms of vaginismus (condition that involves tightening of the vaginal muscles) and related painful sex.

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Inclusion Criteria:

• Subject is a female at birth aged ≥18 years of age
• Subject is able to read and understand the approved, informed consent form (ICF)
• Subject meets vaginismus and related painful sex/GPPPD criteria as defined in the DSM-5, as confirmed by having one or more of the following for greater than 6 months:
• Pelvic pain
• Vaginal pain
• Pain with vaginal intercourse
• Pain with vaginal penetration
• Fear or anxiety about vaginal or pelvic pain with vaginal penetration
• The inability to achieve vaginal penetration
• Subject currently has a sexual partner with a functional penis
• Subject is currently seeking vaginal penetration to achieve sexual intercourse
• Subject is currently unable to tolerate vaginal penetration to achieve sexual intercourse (Score of ≤1 on PEQ Question #1)
• Subject purchased Milli vaginal dilator
• Subject is not contraindicated for Milli vaginal dilator use
• Subject is able and willing to comply with study protocol

Exclusion Criteria:

• Subject has previously participated in any studies by the company in the past 12 months or has used Milli prior to enrollment
• Subject is pregnant
• Subject has an active pelvic infection (vagina or vulva)
• Subject has open wounds in the tissue inside or surrounding the vagina
• Subject has an untreated major mental health disorder (e.g., affective disorder, psychosis, PTSD)
• Subject has prior history of gender-confirming surgery, vaginal reconstruction surgery, pelvic radiation, and/or vaginal procedures that result in extensive scarring (with the exception of hysterectomy procedures)
• Subject or subject's partner experiences other conditions preventing intercourse (e.g., erectile dysfunction, lack of libido)

Subjects eligible if female at birth, aged ≥18 years

The study population shall include subjects seeking relief for the symptoms of vaginismus and/or associated dyspareunia (painful sex).

The Milli Vaginal Dilator is cleared for use as an Over-The-Counter device (K220035). As such, the study population shall be comprised of all adult subjects who provide (≥18 years of age) Informed Consent.