If you are a woman and are suffering from painful sexual intercourse, chances are that you have already heard of vaginal dilators at some point. Vaginal dilator is a smooth, cylindrical device that is inserted into the vagina for facilitating gradual increase in its width for easing penetration[1]. They come in different sizes and materials and are used for the treatment of various conditions pertaining to sexual health in women.
Whether you have been prescribed its use by your health care provider or you came across it as a part of your own research, know that you can easily work with a vaginal dilator right at your home and say goodbye to your struggles with sexual activity.
This article will provide you with all the information you need for starting your at-home treatment based on your specific symptoms or condition.
What are vaginal dilators?
Typically, vaginal dilator is a cylindrical device that is used to gradually stretch the vagina for improving sexual function in women who suffer from pain or tightness during penetration. It will gradually expand your vaginal opening making it possible for your partner to penetrate and for you to finally enjoy sexual intercourse.
If your vaginal pain is so severe that it is even disrupting normal activities such as gynecological examination or inserting of tampon, don’t worry, this simple magic wand can help you as well.
How do vaginal dilators work? What are the uses of vaginal dilators?
Vaginal dilators function by gradually stretching the vaginal tissue allowing it to become wider and longer. It applies gradual pressure on the vaginal wall, which enables muscle relaxation in the area allowing the vaginal opening to become wider with time. This is how it helps in reducing pain and tightness during sexual activity.
As dilators come in different sizes, similar mechanism also helps in increasing the length of the vaginal canal. This happens through gradual break down of the collagen fibers and other cells and tissues that are responsible for the narrowing or obstruction of the vagina. This is how it helps in improving sexual function and pleasure in women of all age groups.
Additionally, vaginal dilator increases blood flow to the treatment area thereby improving vaginal health through tissue healing and repair. This helps in avoiding injury or infections, which can occur in women due to painful intercourse.
Overall, the use of a dilator improves overall vaginal health and sexual function while also aiding in natural lubrication thereby making coitus less painful and more pleasurable for women.
Who can use vaginal dilators? How long before the results?
Anyone suffering from pain during sexual intercourse, particularly at the time of penetration, can use a vaginal dilator no matter their medical condition, age or severity of the issue. Treatment with vaginal dilator has proven to be effective in women of all age groups starting from late teens and early 20s to women in their late 50s around the age of menopause. From women with minor pain due to anxiety related to sex causing muscle tightening to women with gynecological cancers and even stenosis, all have benefitted from the use of this tool. Following are the conditions for which the use of a vaginal dilator is recommended along with the duration and particulars of dilator treatment necessary for your specific condition:
Vaginismus
Vaginismus is characterised by tightening, spasm or contraction of vaginal muscles in response to penetration. The use of dilators in these women helps in overcoming anxieties associated with penetration.
It forms the mainstay of treatment for this condition and regular use for about 15-20 minutes can help in reducing the symptoms completely in about a few weeks to a few months depending on the severity of your condition.
Dyspareunia
Dyspareunia refers to recurrent or persistent pain during sexual intercourse. The use of medical dilator helps in increasing the width and length of the vagina thereby making sex less painful in women suffering with this condition. Similar to vaginismus, dilator therapy has proven to be immensely effective in women with dyspareunia and offers promising results when performed regularly for 15-20 minutes over a few months.
Vaginal stenosis
Vaginal stenosis refers to the narrowing and shortening of the vaginal canal making it difficult not only to have sexual intercourse but also undergo a pelvic examination in women. Dilator therapy is of particular help in these women for the restoration of normal vaginal health and gradual improvement in anatomy.
In mild cases of stenosis, regular use of dilators may simply help in reversing the narrowing of the vaginal canal over a few months. In severe cases of stenosis where the vagina is so narrow that even the use of a dilator seems to be extremely painful, it is recommended that you consult your physician for additional treatment.
Menopause-related vaginal dryness and atrophy
Dryness of the vagina is common in post-menopausal women due to massive hormonal changes such as reduction in estrogen. In these women, especially who suffer from thinning of the vaginal wall, the use of dilator is combined with topical estrogen[2]. Dilator therapy is particularly helpful in these women as it improves blood flow to the area aiding in gradual lubrication while also restoring vaginal health. It also minimises atrophy of the vaginal tissue by enhancing blood flow to the area and retaining the normal anatomy of vaginal walls.
In post-menopausal women, the regular use of dilator has been noted to increase vaginal lubrication as well as in improving the thickness of the vagina. Hence, dilator therapy is recommended starting in the peri-menopausal period 2-3 times a week. Treatment with a dilator has proven to be highly effective in restoring normal sexual activity in about 12 weeks even in cases with narrowing or stenosis of the vagina following menopause[3]. However, it is advisable to stick with your treatment for a few months to ensure the strengthening of the vaginal muscles through regular training.
Sexual dysfunction due to gynecological cancer
Dealing with cancer can be a daunting experience for any person. During chemotherapy and radiotherapy, particularly in cases of gynecological cancers, vaginal dryness, atrophy and lack of libido are commonly faced. Hence, the use of a vaginal dilator is often recommended by healthcare providers for the restoration of normal sexual function following chemotherapy/radiotherapy treatment.
In women with gynecological cancers, the use of vaginal dilators plays a significant role in facilitating sexual rehabilitation allowing the vagina to regain its natural elasticity, lubrication and shape, which is affected due to loss of collagen fibres, reduced blood flow and resultant narrowing or stenosis occurring during radiotherapy treatments.
Women suffering from these cancers are recommended to start using vaginal dilators 3 months after the completion of their radiotherapy and continue using it for 15-20 minutes about two to three times a week for upto 12 months for improving their sexual function.
Vaginoplasty
Dilators are essentially prescribed to transgender women after male-to-female gender re-affirming surgeries procedures including vaginoplasty for the procurement of neovagina. Regular use of a dilator is an essential therapy for these women in order to maintain normal sexual anatomy.
Treatment with vaginal dilators is encouraged from about a week following gender-reassignment surgery following which a lifetime use is recommended to ensure healthy anatomy, structure, physiology and function of the neovagina. The use of dilator also helps in avoiding any risk of infections or stenosis that are common after surgeries in transgender women; hence, regular and consistent treatment is emphasised. 15-minute sessions two to three times a week are recommended[4].
Other conditions
Vaginal dilators can also help with a plethora of other sexual conditions in women including:
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- Vaginal septum- In this condition, there is a wall or a septum that runs vertically or horizontally in the vaginal opening causing extremely painful sexual intercourse. Dilators help by loosening the wall.
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- Imperforate hymen- In this condition, the opening of the hymen is affected and a dilator may help alongside other treatments.
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- MRKH syndrome- In MRKH syndrome, the vagina is not fully developed. Along with medical and surgical treatments, a dilator can help in enhancing blood flow to the region and restoring normal function when prescribed by a physician.
If you have any of these conditions, it is advisable to talk to your physician/gynecologist before making the use of a dilator to ensure that it is compatible with other medical/surgical interventions that you must be having. While the use of dilator will help in making sex less painful in these conditions, you must use it only as an adjunct if recommended by your physician keeping your safety in mind.
How do I use a vaginal dilator?
It is quite simple and comfortable to use a vaginal dilator at home in privacy or with the help of your sexual partner. Just make sure you are calm during the process so that your vaginal muscles are relaxed. This can take some time, so, be patient while following these steps:
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- Wash your hands with soap and water and start with the smallest dilator from your set. You can also wash your dilator with soap and water before using.
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- Sit comfortably on your couch or lie down on your bed with your hips and knees bent a little for proper accessibility of the area.
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- Gradually breathe in and out allowing yourself to relax while being mindful of the process.
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- Then, use your breathing pattern to gradually relax your pelvic floor muscles.
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- Then, gradually place the tip of the dilator on the entrance of your vaginal opening. Make sure that your dilator is covered with a water-based lubricant at this point to facilitate smooth entry inside the vaginal opening when you insert it.
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- Now, slowly guide the lubricated dilator towards your vagina and take your time to gently slip it inside. Focusing on your breathing pattern at this time can help in relaxation.
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- This may require some patience and training because if you have vaginismus, the natural reflex of your body would be to tense up the vaginal muscles fearing penetration. So, it is important that you take the process slow and perform it in a location where feel absolutely comfortable such as your bedroom. Soothing music and meditation can also help in this process.
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- Start with a minute of insertion initially and gradually build up to 10 to 15 minutes. It is okay if your dilator is not fully inside the vagina on the first day. It will be gradually trained to do so as your vagina expands with repeated sessions. On the other hand, if you notice that the dilator is completely inside and you cannot see it at all, relax, this is what the goal is. Hold on for as long as you can and repeat as and when possible.
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- When you feel totally comfortable with the smallest dilator, you can switch up to the next size in the set. It will be helpful to train your vagina with the smaller size of dilator for a minute or two before preparing to switch to a larger size in order to avoid any unexpected discomfort.
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- You must only switch to the next size of the dilator when you are completely comfortable with the previous size and can hold it inside your vagina for at least 10 minutes.
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- Use your breathing to relax your pelvic muscles. You can also seek the help of your partner if you feel anxious about using the tool alone.
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- For some women with mild cases of vaginismus, a bigger size of dilator can be used in the first session itself if the smallest size feels unchallenging.
You must note if there is extreme pain or any sort of bleeding, it is recommended to talk to your physician. If there are any negative psychological thoughts associated with the treatment, don’t worry, the use of a dilator is completely normal. It will help reduce your pain and you can also use this private time to self-reflect for overcoming any patterns of guilt or shame associated with the fear of penetration and sexual activity. This will essentially add on to your treatment results with a dilator.
Key takeaway
Vaginal dilators are used for the management of sexual pain disorders in women, making intercourse less painful and more pleasurable. They come in various sizes and materials and can be easily used at home in conjunction with water-based lubricants. Usually, about 15 minutes of therapy is recommended about 2-3 times a week in most women; however, even a more frequent use is safe and rather favourable provided there is no discomfort. It is important to be patient while using a dilator and trying to relax so that the device is able to enter and help in stretching of the vaginal walls over repeated sessions.
The treatment may take a few weeks to months to even a year in some women depending on their individual responses. Soon enough, the vagina would become longer and wider easing penetration and improving sexual function in women of all age groups. It is important to keep your specific condition in mind to assess personal needs and goals related to the therapy. If your symptoms are mild and have just started, a dilator will give results sooner than expected; however, if there are additional underlying medical causes, it could take a while and you must be patient as the magic wand does its wonders.
[1]Amies Oelschlager AM, Debiec K. Vaginal Dilator Therapy: A Guide for Providers for Assessing Readiness and Supporting Patients Through the Process Successfully. J Pediatr Adolesc Gynecol. 2019 Aug;32(4):354-358. doi: 10.1016/j.jpag.2019.05.002. Epub 2019 May 12. PMID: 31091469
[2] Charatsi D, Vanakara P, Evaggelopoulou E, Simopoulou F, Korfias D, Daponte A, Kyrgias G, Tolia M. Vaginal dilator use to promote sexual wellbeing after radiotherapy in gynecological cancer survivors. Medicine (Baltimore). 2022 Jan 28;101(4):e28705. doi: 10.1097/MD.0000000000028705. PMID: 35089231; PMCID: PMC8797530.
[3] Naumova I, Castelo-Branco C. Current treatment options for postmenopausal vaginal atrophy. Int J Womens Health. 2018 Jul 31;10:387-395. doi: 10.2147/IJWH.S158913. PMID: 30104904; PMCID: PMC6074805
[4] Pariser JJ, Kim N. Transgender vaginoplasty: techniques and outcomes. Transl Androl Urol. 2019 Jun;8(3):241-247. doi: 10.21037/tau.2019.06.03. PMID: 31380230; PMCID: PMC6626315