Inclusion Criteria:  Patients 18 years or older English or Spanish speaking  Patients currently or previously treated for:  Gynecologic cancer (surgery, chemotherapy, adjuvant vaginal brachytherapy) Breast cancer (chemotherapy, aromatase inhibitors, or selective estrogen receptor modulators; surgical menopause) Current desire for penetrative sexual activity  Endorsement of at least one of the following in the last 6 months:  Dyspareunia during penetrative sexual activity Reported sensation of penetrative object (partner's penis, sex toy) not fitting in the vagina Avoidance of penetrative sexual activity due to fear of pain Physically able to insert a vaginal dilator by themselves Ability to understand and the willingness to sign a written informed consent document  Exclusion Criteria:  Patients with prior primary or upfront pelvic radiation Patients with whole pelvic radiation at any time Patients with a history of chronic pelvic pain Patients with vulvodynia as noted on baseline pelvic exam with > 5/10 pain score during an external exam with a cotton swab Patients with prior vaginal dilator use for any indication