I posted this elsewhere, but I thought it be helpful to reach those on this thread as well. To summarize though, I am a firm believer in the dilators and in physical therapy with someone that specializes in pelvic floor pain. Good luck everyone!
I'd like to briefly share my story and my ongoing recovery so that it hopefully helps other women on this site.
When I first got married, sex was fairly painful, but it got better. The pain never entirely went away though, but it was tolerable and I figured everyone experienced pain sometime so it's normal.
A couple months in, I got what I thought was a UTI. Then, I increasingly got what I thought were UTIs. I was diagnosed with about 12 UTIs in 1 1/2 years. Eventually, I started having a burning UTI-feeling quite often and as time went by, almost all the time. Sex also got more painful--which I thought was because my vaginal area hurt all the time. That's when I figured something was wrong and I needed to get a better doctor. I got a pelvic ultrasound and found out I was also not emptying my bladder completely when urinating. I saw a number of non-helpful doctors. Finally I saw a gyno-urologist who looked over my medical records and said she couldn't tell if I had EVER had a UTI because no one had cultured my urine. She also mentioned the possibility of having interstitial cystitis which is a permanent inflammation of the bladder without an bacterial infection. (So, if I doctor tells you that you are getting frequent UTIs, make sure they are culturing it!--preferably by catherizing the urine so you get a really clean sample--and don't assume it's cultured just because they tell you that they are seeing lots of bacteria, like my doctors did.)
I kept researching things online all the time regarding this since doctors weren't overly helpful and came across the book Heal Pelvic Pain by Amy Stein. If you are having painful sex--GET THIS BOOK! You can read parts of it for free on google books. The book is actually about pelvic floor disorder and claims that a lot of things (interstitial cystitis, painful sex, premature ejaculation, irritable bowel syndrome, erectile dysfunction, vaginismus) are all caused by weakened and/or tightened pelvic floor muscles. The disorder can be started from something as benign as sitting on bleachers too long or from how you were potty trained as a child. Basically what happens, is your muscles start tightening up and then they literally shorten and weaken, which causes a lot of different problems that eventually involve your nerves, creating a lot of pain. My physical therapist guessed that I've had the problem for a long time, as I was unable to use tampons in high school--so it's not a problem that begins overnight.
So, since last April, I have been going to see a physical therapist that specializes in pelvic floor dysfunction (you can find a similar specialist here: http://www.pelvicpain.org/providers/find_provider.aspx
). They were the ones that diagnosed me with PFD. In fact, my vagina was so tight she couldn't finish the internal exam (and I have had gynecologists tell me that I am completely normal or that I'm simply small--they solution was to drink a glass of wine and use numbing cream for sex!!! But I actually had a physical problem!) Which, by the way, don't let anyone every tell you that you are simply small. A vagina should be able to fit a penis without pain--if it can't, it's because your muscles are tight, not because you are too small. A vagina with healthy muscles should be able to stretch.
Apparently my PFD had three main side effects: painful sex, UTI-like pain all the time, and keeping me from emptying my bladder completely. But, it was all due to PFD.
I have been doing a series of stretches to lengthen my pelvic floor muscles since they have shortened so much. When they are lengthened, I will start doing strengthening exercises. I am also doing ab-work because my abs were trying to pick up the slack from my pelvic floor muscles and thus weakened as well. I am also using a vaginal dilator and manual internal vaginal work in order to stretch out those internal muscles that are so tight. I am also working on regularly re-aligning my hips because apparently since the muscles are so shortened, they easily get out of alignment if I try to take too big of a step or something, thus causing a lot of pain.
Here's the weird thing: even thought the pain felt like it was coming from my urethra and that it was bladder pain (thus, thinking it was UTIs all the time), when my physical therapist finally pressed on a specific vaginal muscle I could feel that that was EXACTLY where the pain was radiating from. I am fully convinced that what I really have is pelvic floor disorder.
A couple weeks ago I started having sex for the first time since starting therapy (the PT wanted me to wait until I had progressed to the largest size dilator) and sex was completely pain free!! No numbing cream needed--not even really prolonged foreplay or anything (although lots of lube was needed). I still do get frequent burning pain, like a UTI, but my PT is confident that in time that will go away, and in the meantime, I know how to deal with it by doing stretches or re-alignment exercises.
The main thing I want to say is that pain during sex is never normal. Other pain is never normal either. I'm not sure I would've gone through so much trouble to get diagnosed (and it is troublesome for women to get diagnosed with problems like these!) if I had just had pain during sex and the not the constant burning all the time. But, I am so glad that I finally found the answer to my problems. I would very much recommend the book Heal Pelvic Pain and also finding a physical therapist who specializes in pelvic floor dysfunction, because they really should be able to help you.
Anyway, I hope this helps those that need it! I wish I had come across this information earlier--it's been a long couple years to get to the point that I finally feel as if I'm recovering.