Vaginal dilators are tools used intra-vaginally to aid in decreasing pain and stretching tissue. They are used to treat conditions including but not limited to vaginismus (involuntary spasm of the vaginal musculature), vulvodynia (vulvar pain for 3+ months), dyspareunia (painful sex), and vaginal tissue changes following post-cancer radiation, surgery, postpartum or menopause. Vaginal dilators are cylindrical in shape and come in a variety of sizes.

How to use a vaginal dilator:

1. Find an environment you feel comfortable and safe in. Turn on soothing music or light a candle with your preferred scent. One study found that improved patient outcomes were associated with mindfulness and the use of soothing music during use of dilators. Context matters!

2. Choose a size that is comfortable for you. To determine the best size for you, start with the smallest size that is comfortable for your body.

3. Get into a comfortable position. Lying on your back with your knees bent or lying on your side with one knee bent towards your chest and a pillow in between your knees are good positions to start with. 

4. Before you begin to use the dilator, notice how you are feeling in your body. Place a hand on your genitals and take a few breaths down into the belly, relaxing a little more with each breath.

5. Apply a generous amount of lube to the dilator and around the vaginal opening. Make sure it is water-based or oil-based lube if the dilators are silicone.

6. Place the dilator at the vaginal opening and apply gentle pressure. Take a couple of belly breaths here. 

7. Insert dilator to your comfort level. Once the dilator is inserted, continue with your breathing while letting the dilator remain in the same position. When you are ready, you can incorporate extra stretch of the tissue by moving the dilator in a circle. Imagine the vagina is a clock, and pause at each number while gently applying pressure towards that direction. You can also try contracting and relaxing the pelvic floor muscles around the dilator. Squeeze like you are trying to hold back urine and gas, then let go and fully relax the muscles. Lastly, you can explore moving the dilator gently in and out of the vagina at different speeds. Presenting this increase in friction to the area can help build tissue and sensory tolerance. When incorporating any of these techniques, take time to pause and remain curious about the different sensations you are feeling. What feels the same or different from the last time you practiced? What thoughts am I having around this? What does it feel like to move positions?

8. Once finished, remove the dilator slowly and wash with warm water and mild soap. 

9. Try starting with 5 minutes daily based on your comfort level and goals. You can also increase size as you progress through dilator training, with your goal size being the largest size you desire intra-vaginally.  There is no “one size fits all” in regards to a specific goal to reach, which is important to consider when determining how you would like to incorporate dilator training into your routine. Reflect on what you would like to engage in with more ease (intercourse, masturbation, gynecological exams, inserting tampons, etc) and consult with a pelvic floor therapist to determine ways to reach these functional goals using dilators. 

Other things to consider:

You can adjust the temperature of your dilator by running it under warm water or putting it in the refrigerator or freezer before use. This can help increase comfort during dilator training. 

Some dilators, like the Milli, have a vibrating option. Genital vibration can stimulate blood flow to the pelvic floor and (more importantly!) can also provide pleasurable sensations. 

The material of the dilator can make a difference with comfort and flexibility. Silicone dilators are typically more flexible and comfortable. You can find silicone dilators through Intimate Rose or Soul Source. If using silicone dilators, make sure to use water-based lube. 

Have your partner help! Partnered dilator exploration can provide support, connection and comfort. Partners can help by:

• Setting up the environment. Turning soothing music on, lighting your favorite scented candle, setting pillows up in a comfortable position, providing a big hug and/or massage to help relax your body before dilator training.

• Applying lube to the dilator and/or vaginal opening.

• Helping to gently insert the dilator. You can place your hand on top of theirs to slowly guide the process. 

• Coaching you through breathing and/or breathing alongside you during dilator training.

The list could be endless! It is important to maintain clear communication about your needs throughout this experience and decide together the most beneficial ways your partner can help you. When determining your needs, consider what would make you feel increased physical & emotional connection and trust. 

Consult with a pelvic floor therapist to determine if dilator training could be helpful for you and for more individualized treatment options. Schedule your appointment today: https://drsusieg.com/schedule

References

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7678782/

https://pubmed.ncbi.nlm.nih.gov/32014450/

Better Sex Through Mindfulness: Dilator Mindfulness by Dr. Lori Brotto

This information is not intended to substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a healthcare professional with any questions you may have regarding treatment, medications/supplements, or any medical diagnoses. This information is intended for educational purposes only and is in no way to substitute the advice of a licensed healthcare professional.