Vaginal Dilators: What They Are, How They Help & How to Use

Discussing sensitive healthcare topics, especially those concerning intimate well-being, can be a source of questions and concerns for many women facing potentially sensitive conditions.

For those dealing with issues such as vaginismus, sexual pain, vaginal stenosis, pelvic floor dysfunction, or vaginal atrophy, using vaginal dilators can offer relief and a pathway to improved comfort and quality of life.

This article provides straightforward information about vaginal dilators—what they are, how they can be beneficial, and the practical steps for their effective use.

We aim to equip you with knowledge that helps you make informed decisions about your intimate health and provides the support and understanding you need throughout your journey toward improved comfort and well-being.

What Is a Vaginal Dilator?

A vaginal dilator is a medical device that gently stretches and expands the vaginal tissues. Dilators typically consist of a cylindrical or tapered shape made from medical-grade materials such as silicone or plastic.

Vaginal dilators are used as a therapeutic approach to address various medical conditions and concerns, including vaginal stenosis, pelvic floor dysfunction, vaginal atrophy, or post-surgical care.

Vaginal dilator therapy works by gradually increasing the diameter of the vagina or the awareness of vaginal expansion, helping to improve elasticity, reduce discomfort during intercourse, manage pelvic pain, or prevent scar tissue formation.

Vaginal dilators come in various sizes to accommodate individual needs and comfort levels. The use of a dilator can be done at home, or guided by a healthcare provider who can provide specific instructions and monitor progress to ensure safe and effective treatment.

Which Conditions Benefit From Vaginal Dilators Use?

Vaginal dilators are therapeutic instruments used to treat and rehabilitate various medical conditions and circumstances. Here is a summary of conditions and scenarios where vaginal dilators may be prescribed or recommended:

      • Vaginismus, or genito-pelvic pain/penetration disorder, manifests as the involuntary contraction of pelvic floor muscles during attempts at vaginal penetration. Vaginismus can render sexual intercourse, gynecological exams, or even the insertion of tampons challenging, often leading to pain and distress.
        Vaginal dilators, such as silicone or rigid plastic vaginal dilators, play a pivotal role in addressing vaginismus. They gradually desensitize the area, alleviate fear and anxiety related to penetration, and assist in training the vagina and the mind to accept penetration without pain.

      • Dyspareunia, synonymous with painful intercourse, can stem from diverse causes, including muscle tightness, spasms, anxiety, menopausal changes, cancer treatment, vaginal dryness, or scar tissue.
        In cases linked to muscle tension or tightness, vaginal dilators can constitute a part of the treatment plan. They allow gentle stretching of the vaginal tissues, thus reducing discomfort during vaginal penetration.

      • Menopause or Genitourinary Syndrome of Menopause (GSM) induces vaginal atrophy, characterized by dryness, diminished elasticity, and susceptibility to micro tears, frequently culminating in painful intercourse. Although vaginal dilators don’t directly address hormonal changes, they can aid in preserving or regaining vaginal flexibility and function, thereby rendering intercourse more comfortable.

      • Treatments for breast cancer, including chemotherapy and hormonal therapies, typically impede sexual health by ushering in vaginal dryness, reduced vaginal elasticity, and painful sexual intercourse.
        Breast cancer often also impact emotional well-being and self-image. Vaginal dilators can prove beneficial by incrementally stretching the vaginal walls, improving elasticity, and reducing discomfort during vaginal penetration, thus enhancing sexual health.

      • Vaginal stenosis, often a consequence of radiation therapy for pelvic cancers, can cause narrowing of the vaginal opening. According to the EMBRACE study presented at the 2023 annual meeting of the American Society for Radiation Oncology, those who engage in vaginal dilation and sexual activity after chemoradiation for cervical cancer are at lower risk for long-term side effects such as vaginal stenosis, minor bleeding, and irritation of vaginal lining.

      • Following surgery, including hysterectomy, prolapse repair, vaginoplasty, or gender confirmation surgery, dilators may be used to uphold vaginal depth and width, easing post-operative recovery.

      • Some women are born with congenital conditions like vaginal agenesis or Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome, an underdeveloped vagina. Vaginal dilators can be an integral part of the treatment plan, supporting the creation or expansion of the existing or reconstructed vaginal canal.

    Vaginal Dilator Therapy

    Vaginal dilator therapy is a therapeutic approach used to address various medical conditions and concerns related to the vagina. The therapy involves the use of vaginal dilators, which are medical devices designed to gently stretch and expand the vaginal tissues over time.

    The goal of this therapy is to improve vaginal elasticity, reduce muscle tension during intercourse, manage pelvic pain, or prevent scar tissue formation, among other potential benefits.

    The therapy typically begins either as self-treatment, or under the guidance of professionals such as pelvic floor physical therapists who assess the individual’s medical condition and develop a treatment plan tailored to their specific needs. The plan may include recommendations for the frequency, duration, and size of dilators to use.

    Vaginal dilator therapy depends on your commitment and patience. Individuals start with the smallest dilator size and progressively work their way up to larger sizes as their comfort level increases. Regular and consistent use is essential to achieve the desired outcomes.

    This therapy aims to improve the overall quality of life by addressing specific vaginal health issues and enhancing comfort and sexual well-being. 

    How do I Choose a Vaginal Dilator?

    When choosing a vaginal dilator, it is recommended to consider the combination of cost, style, availability, and personal choice regarding shape and size to ensure comfort and effectiveness.

    Many women buy their own by trial and error before even reaching out to a healthcare professional for guidance, which is fine as long as you listen to your body. Here are steps to help you choose the right vaginal dilator for your needs:

        • Optional: consult a medical professional: Speak with a gynecologist, pelvic floor physical therapist, or another professional familiar with your medical situation and specific needs.

        • Starting Size: Dilators often come in sets with varying sizes. You typically start with the smallest size and gradually increase as your comfort level increases. You always have the option to consult with a medical professional who can guide you on the right starting size and pace of moving along the dilation program.

        • Material: Most dilators are made of silicone, plastic, or rubber. Silicone is often preferred because it’s non-porous, easy to clean, and feels softer and more body-like. Ensure that the material is medical grade and free of harmful chemicals.

        • Shape: Most dilators are straight, but some have a slight curve. Your preferred shape depends on your vaginal physique, comfort, and specific conditions.

        • Texture: Smooth dilators are preferred as the ribbed ones that often lead to pain or discomfort.  

        • Handle Design: Some dilators come with a handle, making them easier to use. Handles are beneficial for those who have difficulty reaching during insertion.

        • Vibrating Option: Some dilators have a vibrating feature, which is thought to relax the pelvic floor muscles and make the dilation process more comfortable. However, this is not typically recommended as ‘natural’ and ‘normal’ vaginal penetrations do not have a vibrating aspect to them.

        • Lubrication: Always use a water-based lubricant with your dilator to make insertion more comfortable and to prevent vaginal chafing. Avoid silicone-based lubricants with silicone dilators, as they can degrade the material.

        • Cost and Brand: Prices vary widely depending on the brand, material, and features. Research brands read reviews, and ensure you’re purchasing from a reputable source.

        • Cleaning and Storage: Ensure the dilator you choose is easy to clean, and follow the enclosed instructions. Some can be boiled or washed with mild soap and water. Store your dilator in a clean, dry place.

        • Listen to your body: It is essential to pay attention to how your body responds. If a dilator feels too large, uncomfortable, difficult to use, or irritating, revert to a smaller size and consult your healthcare provider.

      Remember, the goal of using a vaginal dilator is to make you more comfortable, whether it’s during intercourse, medical examinations, using menstrual insertable aids, or simply day-to-day living. 

      How do I Use a Vaginal Dilator?

      Assuming a comfortable position lying on your back with your legs bent at the knees and relaxed outward, similar to the position for a pelvic exam, hold the dilator parallel to the bed and insert it into the vagina to ‘the end’ or as deep as you without distress.  Once done, take it out as there is no need to keep it inside for any reason.  Repeat about 20-25 times, with the goal of (gradually) mastering this in & out maneuver before moving to the next size dilator.  Once done, clean per enclosed instructions. 

      For a more comprehensive dilation program, follow your healthcare provider’s guidelines for frequency and progression of the program.

      The goal of using a vaginal dilator is not to cause pain but to gradually increase comfort with penetration. It’s essential to listen to your body and progress at a pace that’s comfortable for you.

      However, if you feel that the process is taking too long, that you cannot proceed in a reasonable, timely fashion, that you struggle or get frustrated, cannot transition to the next size, or to using the vagina pain-free, it may be time for professional intervention.

      Contact us for our in-person or online dilation coaching program – we are here to take you through the process under direct supervision and guidance.

      Can I use a vaginal dilator when I’m menstruating?

       Yes, and here are considerations:

          • Comfort: Menstruation can sometimes lead to heightened sensitivity, discomfort, or cramping. Using a dilator during this time might cause additional discomfort for some women. 

          • Excessive Bleeding: when the inserted dilator taps on the cervix/uterus, you may experience more bleeding but, at the same time, may shorten the duration of your period. This tapping on the cervix/uterus is a natural occurrence. It is perfectly safe as long as you don’t jam the dilator into it. If ever in doubt, consult with your healthcare provider.

          • Hygiene: The menstrual flow might make the dilator more slippery and a bit messier to use. After use, clean the dilator thoroughly according to the manufacturer’s instructions or as advised by your healthcare provider.

          • Menstrual Insertable Products: If you’re wearing a tampon, a disk, or a cup, remove them before using a dilator.

          • Cultural Implications: In some cultures, menstruating women are encouraged to refrain from vaginal penetration for various reasons. While no scientific evidence supports these ideas, cultural attitudes are often deeply ingrained and can influence a woman’s ability to recover.

          • Mental and Emotional Considerations: Some women might feel more sensitive or emotional during their periods. It’s essential to approach the use of a dilator with patience and compassion for yourself, regardless of the time of the month. But if you find it mentally or emotionally challenging during menstruation, you might choose to wait.

        Ultimately, deciding to use a vaginal dilator during menstruation is personal, and what’s most important is ensuring your comfort and safety. 

        Can I leave a vaginal dilator overnight?

        You can but what for?  Vaginal activities, with the exception of menstrual insertables – tampons, disk, cup – are about in & out movement, which is what you want to treat and train for.

        Exceptional circumstances could occur when you are given specific medical instructions to leave the dilator in the vagina overnight, such as after particular surgeries when the risk of adhesion is imminent.

        Are vaginal dilators for me?

        The decision of whether vaginal dilators are suitable for you should be based on a careful evaluation of your medical condition, treatment goals, and personal comfort level.

        Vaginal dilators are typically recommended for a variety of conditions that affect vaginal function. Dilation program calls for a commitment on a steady basis.  Although it may only take 10-15 minutes to partake, some women may find this “too much’ for their coping ability or for fitting into their busy schedule, at which case dilation may not an appealing choice.

        Sometime, the decision can be facilitated in collaboration with your healthcare provider so do not hesitate to reach out so you can regain positive use of your vagina.  After all, in most cases dilation therapy is a short- term program, not a forever one.

        About The Author

        Dr. Ditza Katz

        Ditza Katz, PT, Ph.D., is the founder of Women’s Therapy Center, a practice specializing in urogynecologic rehabilitation, treatment of female sexual dysfunction, breast & female cancer rehabilitation, and management of somatic disorders. Dr. Katz holds an undergraduate degree in Physical Therapy, a Master’s degree in Pastoral Psychology & Counseling, a doctorate in Clinical Sexology, and clinical training in manual therapy and urogynecology. Dr. Katz is a Diplomate with the American Board of Sexology, Professor at the American Academy of Clinical Sexology located in Orlando, Florida, and the only physical therapist in the USA who is a clinical sexologist.

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