While dilators are relatively simple to use, there are several key factors that will enhance the utility of your dilator. People’s experience using vaginal dilators vary greatly. In this blog we’ll review the common uses, when dilators are appropriate, how to care for your dilator, as well as some troubleshooting tips when they seem to not be working or you are not seeing benefit.
Common Uses For Dilators
Some of the common diagnoses or conditions associated with dilator use are vaginismus, pelvic floor dysfunction, vulvodynia, vaginal stenosis, and dyspareunia (painful sex). Dilators may be appropriate in all of these instances but when to use them in your treatment plan may be a critical factor for them to be effective. Listed below are some of the common reasons why someone may benefit from using a dilator. To find out if dilators are right for you check out our article here.
- Preventing or improving narrowing of the vaginal opening or canal after surgery or medical treatments such as gender affirming surgery or post radiation or cancer treatments
- Pain with penetration with sex, pelvic exams, or tampon insertion
- Tight pelvic floor muscles
- Desensitization and exposure therapy to reduce fear around penetration in the vagina
Whether you’ve been recommended to try vaginal dilators from a medical professional or you are considering purchasing them because you’ve done your own research, consulting with a pelvic floor physical therapist or other sexual health provider is recommended. While we hope to provide you with a comprehensive guide for self-treatment, these conditions can be complex and there may be other treatments that are necessary before incorporating dilators into your treatment plan.
How To Use Vaginal Dilators
Prepping For a Successful Session
- Clean your dilator. It is very important to clean your dilator thoroughly before and after each use with soap and warm water.
- Use Lube. Choose a water based lubricant if you are using silicone dilators. Oil or silicone based lubricants break down the material of the dilators. You’ll want a decent amount of lube to minimize discomfort and it can get a bit messy so you may want to grab a towel before you lay down.
- Find your zen. Find a comfortable place to lay down and where you will not be distracted. Lie down with your knees opened outwards. You can use pillows or cushions to support your knees, this will help you ease any tension in your legs and hips when using the dilator. An empty bathtub can be a good place because it provides support to your back and you can rest your legs on the sides of the tub.
- Breathe. Begin to calmly breathe, making sure that your rib cage and belly are expanding all around with each breath, and limit the amount that your chest is involved. You may want to put on calming music or do a meditation beforehand, especially if the thought of dilating makes you nervous, tense, or fearful.
- Size matters. Start with a size that you know you will be successful with, or that is recommended by your healthcare provider. This is important because you want to have a positive experience and we want you to be successful! After selecting the size of the dilator, place the lube on the tip of the dilator and use your finger to spread the lube over the rest of the dilator. This will help reduce friction as you insert your dilator.
Using your dilator: A step-by-step guide
- Starting the session. Place the dilator at the opening of the vagina, you can use a mirror to help guide you if needed. This is a good time to check in and make sure your body is still relaxed and your breathing is steady and slow.
- Insertion. Slowly, insert the dilator gradually, some discomfort is expected, but this should be minimal. If you start to feel discomfort, check in with your body and breath and let the dilator just rest in that spot, the discomfort or pain should begin to subside quickly. Continue this process until the dilator is fully inserted.
- Stretch and hold. After the dilator is fully inserted, there are several things you can try. Think of the vaginal opening as a clock. 12 o’clock is the urethra. Move the dilator gently to the right (3 o’clock), then to the left (9 o’clock), and downward (6 o’clock). Hold the stretch for 5-10s (times may vary).
- Moving around the clock. Once you have stretched each of the areas, you can apply gentle but steady pressure and move your dilator around from 1 o’clock to 11 o’clock and reverse. Avoid the 12 o’clock to prevent discomfort on your urethra.
- Check in. If at any point you feel discomfort or pain, check in with your body, soften any tense muscles and return to your calm, steady breathing. The pain should reduce relatively quickly (30 seconds or so) by holding the dilator and steady breathing. If it does not, this may not be a muscular pain, or you may need more individualized training with a pelvic floor physical therapist.
- Sizing up. Once you feel confident with the first dilator you selected, you can progress to the next size, repeating the process.
While the amount of time will vary for each person, 10-15 min is usually sufficient. You may have some soreness immediately following but this should not limit you from any activity and should subside by the following day for most people.
This is a very general guide of how dilators are used and the instructions above may not work for everyone. A pelvic floor PT can help you find what works best for you, and create an individualized plan as to how you should be using your dilators. Below are additional considerations and troubleshooting tips for using your dilator.
Troubleshooting: Common vs. Normal
Muscular/Myofascial pain: Pain of myofascial origin often feels dull or achey, but can be intense. Occasionally it may feel burny or sharp, and can vary in intensity. However, if you are breathing calmly, your body is relaxed, and your muscles are softened (not clenching), the pain/discomfort should reduce within 30-60s. If your pain is not subsiding, is very intense (>7/10), or getting worse while using the dilators, you need to see a pelvic floor PT to make sure dilators are right for you.
- Non-muscular pain: Non-muscular pain tends to be described as hot, burning, fire-like pain. In severe cases, muscular pain can also be described this way. The key difference is that muscular pain will subside rather quickly, usually in 30-60s, with continuous pressure, relaxation, and breathing. The pain will quickly start to change into a duller sensation. If you are unsure, it is best to consult with a pelvic floor PT or other provider who specializes in sexual health to determine the underlying cause and appropriate treatment(s), before starting to use your dilators. You can also read about causes of painful sex in our blog here.
Dilators should not cause bleeding. If your tissue is weakened or fragile which is common in those with hormonal deficiencies such as those on oral contraceptive pills (birth control), perimenopause, menopause, or undergoing cancer treatments such as radiation therapy or hormonal suppression therapies, dilators may need to be on hold until you can work with your provider in improving the health of your tissue.
**For those that are using vaginal dilators after gender affirming surgery or post-radiation therapy, some bleeding may be expected, but you will want to discuss this with your provider.
We can help!
Vaginal dilators can be an incredible tool that can help empower one to connect more with their body and improve their pelvic health. NewFlora Dilators are designed for comfort and ease of use and are appropriate for most people looking to improve their pelvic health. Click below to check out what makes us unique!