Vaginal Dilators

Overview 

Vaginal dilators are tube-like devices made from plastic or medical-grade silicone designed to stretch vaginal tissues. These devices are commonly used as a treatment option for people experiencing pain during vaginal penetration due to medical conditions such as pelvic floor dysfunction. By gradually improving flexibility in the vaginal tissues, dilators help make penetration more comfortable over time. 

The dilators work by gently increasing the size and strength of the vaginal canal and pelvic muscles. They come in different sizes and thicknesses, allowing users to start with a smaller size and gradually work their way up as the tissues adapt. Most people can use vaginal dilators at home, and a session typically lasts less than 20 minutes.

Although vaginal dilators are available for purchase without a prescription from retail pharmacies or online, it is recommended to consult with a healthcare provider before using them. Your healthcare provider can assess your individual symptoms and health history to determine if a vaginal dilator is the right treatment option for you.

Reasons for undergoing the procedure  

Vaginal dilators may be helpful if you experience pain during sexual intercourse or penetration. They function by increasing the flexibility and elasticity of vaginal tissue while also helping to strengthen pelvic floor muscles that may have weakened or loosened.

Some health conditions that can lead to painful intercourse include:  

• Congenital conditions affecting the vagina or hymen: For congenital conditions that result in a small vaginal opening, using a vaginal dilator can be part of the treatment.  
• Vaginal stenosis: This condition causes the vaginal opening to narrow or close due to scarring or hormonal changes.  
• Gender affirmation therapy: Dilators can aid in the recovery and adaptation process following medical or surgical procedures that reconstruct the vagina.  
• Vaginismus: This condition causes involuntary muscle contractions during intercourse or penetration.  
• Dyspareunia: This term refers to persistent pain in the genital area during or after intercourse.  
• Previous radiation therapy or cancer surgery: Radiation and surgical treatments for certain cancers can impact vaginal tissue. Dilators can help restore flexibility and softness to this affected tissue.  
• Menopause: Hormonal changes during menopause can lead to discomfort or pain during sex.  
• Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome: This condition results in the absence of a fully developed vagina, making intercourse challenging. 

Risks

Light bleeding is the most frequent adverse effect, although it shouldn’t get any worse than light pink spotting. If, after using a vaginal dilator, you suffer excessive bleeding or bleeding for more than 24 hours, contact your healthcare physician.  

Mild pain is one of the other negative effects of vaginal dilator therapy. To ensure you’re utilizing the dilator correctly, you should talk to your doctor about how much pain you’re experiencing. If you’re in pain, stop using a dilator immediately.  

During the procedure  

At first, inserting a dilator may cause some minor discomfort. It shouldn’t take longer than 20 minutes to install and operate a dilator. One advantage of this kind of therapy is that it can be conducted in the comfort and privacy of your own house.

The steps of using a vaginal dilator are as follows:  

• Apply a water-based lubricant to the dilator. Avoid oil-based lubricants. Start with a smaller dilator and gradually increase the size over time.  
• Find a comfortable position lying on your back with your knees bent. Let your legs fall outward, similar to the position during a pelvic exam.  
• Insert the dilator into your vagina at a downward angle towards your spine, similar to how you would insert a tampon. You should feel some tension, and the dilator should fit snugly without causing pain. Once you feel this tension, stop and do not force it further.  
• Your provider may suggest doing Kegel exercises with the dilator in place to help relax your pelvic floor muscles. Deep breathing can also aid in muscle relaxation.  
• Spend about five minutes gently moving the dilator inside your vagina. If your dilator has a handle or holder, this can make the process easier. Rotate the dilator in circles towards the front, back, and sides of your vagina, and move it in and out to mimic penetration.  
• Carefully remove the dilator after 15 minutes.  
• Clean the dilator with mild soap and warm water, then allow it to air dry or gently pat it dry with a paper towel.  
• Follow your healthcare provider’s instructions for dilator therapy. Some may recommend daily use, while others might suggest using it every other day.  
• As you progress, aim to use a deeper or thicker dilator over time. You should find that the smaller dilator becomes too easy and that you’re ready to move on to a larger or thicker size.

It’s crucial to use the dilator according to your doctor’s instructions. The manufacturer will also provide specific usage guidelines for their vaginal dilators. If you have any questions or experience pain while using a dilator, be sure to consult your doctor.

Most individuals start with a small vaginal dilator, typically around 3 inches long and roughly the thickness of a pencil, often labeled as “small” or “size one.” As you progress, you can transition to dilators that are longer and wider. However, it’s important to start with a dilator that fits snugly without causing pain during insertion. Your doctor can assist you in determining the appropriate starting size.

Over time, you should be able to advance to larger dilators, which may be labeled as “large,” “extra-large,” or “size seven.” The largest dilators are designed to mimic the size of an erect penis, measuring approximately 7 inches in length and 1.5 inches in diameter.  

Many manufacturers offer dilator kits or packs that include multiple sizes, which can simplify the process by providing all the sizes you might need. Always discuss your use of dilators with your doctor to ensure you’re using them correctly.

Every time you use a vaginal dilator, you should leave it in for ten to fifteen minutes. The advise of your doctor and the underlying issue will determine how frequently you use a dilator each week. While some people use a dilator for several months, others get relief within a few weeks.  

Outcome 

The duration of vaginal dilator therapy depends on your specific symptoms. It’s important to schedule regular follow-up appointments with your doctor and/or a pelvic floor physical therapist during this therapy. They can provide guidance on how long you might need to continue the treatment.  

You may have concerns about whether this type of therapy is effective or feel self-conscious about inserting a device into your vagina. It’s essential to share these feelings with your healthcare provider, as they can influence the effectiveness of the therapy.  

As you discuss various options with your doctor, remember to be kind to yourself. Your provider will work with you to develop a treatment plan that allows for enjoyable and fulfilling sexual experiences.