Vaginal dilators are tools used to help relax and expand the pelvic floor muscles and vaginal tissues to help improve confidence and reduce discomfort for those who experience pain with sexual activity, after gender affirmation surgery, or gynaecological cancer treatment. They are also sometimes known as vaginal trainers.
When would you use a vaginal dilator?
Vaginal dilators can helpful for a number of different reasons including:
- To help work towards comfortable pain-free intercourse for those who experience dyspareunia (painful intercourse due a number of different reasons including tight pelvic floor muscles, or due to decreased oestrogen around menopause or after giving birth), pelvic pain, vaginismus, or vulvodynia
- To help with pelvic floor rehabilitation after gender affirmation surgery
- To assist in working towards comfortable vaginal examinations such as cervical screening or speculum exams, or insertion and use of tampons or menstrual cups
- To maintain elasticity of vaginal tissues after gynaecological cancer treatment
·
How and why would you use them?
Vaginal dilators come as a set, that start small in size and progressively get wider and longer. Dilator sets come in different materials such as silicone or plastic, depending on the feel the user prefers.
The user starts by learning how to insert the smallest dilator without pain or discomfort, and over time gradually progresses through the dilator sizes they are able to insert the largest size comfortably and confidently. This progression provides a gentle stretch to tightened or shortened pelvic floor muscles and vaginal tissues, as well as decreases the sensitivity of the tissues.
A large part of dilator use is in retraining the brain and pelvic floor. If there has been pain, discomfort or trauma to the pelvic floor muscles in the past, they will usually subconsciously tighten upon insertion, causing pain and reinforcing to the brain that there is a threat. Dilator use retrains the brain and pelvic floor to feel comfortable with insertion, building confidence and control over the pelvic floor. When the user has achieved the largest size comfortably, they can then try different techniques to work towards their end goal, an example of which may be penetrative intercourse.
Your pelvic floor physiotherapist will guide you on the best way and specifics on using your dilators based on your pelvic floor and individual goals.
Vaginal dilators are not a stand-alone treatment and are best used with
the guidance of a pelvic floor physiotherapist or other health
professional, and as part of overall holistic overall pelvic health
care. Treatment may also include breathing techniques, pelvic floor
muscle relaxation or downtraining, assessment and stretches around the
hips and pelvis, addressing any other bladder, bowel, or relevant
musculoskeletal issues. As part of holistic treatment considering seeing
a counsellor or sexual therapist may also be extremely valuable.
Tips for using your vaginal dilators
- Using the right kind of lubricant will make a huge difference in reducing friction and making your dilator use more comfortable. The best type of lubricant to use will depend on the material your dilators are made from. For example, if you have silicone dilators, silicone lubricant is not suitable. Use plenty of lubricant and keep applying as needed when you dilate.
- Before using your dilators, it is best to engage in a warm up which includes breathing exercises and gentle stretches around your hips and pelvis. The breathing exercises will help calm and relax your nervous system, and stretching will reducing any extra tension around the hips and pelvis which will help relax your pelvic floor muscles.
- Set up your environment to be as comfortable as possible. Have lots of pillows available to support your knees and back. The more you can encourage the rest of your body relax, the easier it will be to relax your pelvic floor and use the dilators. You might even choose to have some relaxing music or aromatherapy in the background
- Use your dilators at a time when you can relax. It can be a nice evening routine after you have finished everything you need to do for the day and before you go to sleep.
- Be gentle and kind with yourself – dilator work is not a quick fix. It can take months to progress through the sizes. Expect slow but steady progress with consistency as the key.
- If you are uncertain how to use the dilators, or are experiencing discomfort or pain when you are using them, please make an appointment with your pelvic floor physiotherapist and bring your dilators with you, so they can help guide you on how to best use them.
Our pelvic physiotherapists are experienced in guiding clients in the use of vaginal dilators, and we stock a variety of quality vaginal dilators and lubricant in clinic. Please reach out if you have any questions at all.
Written by Tusanee Jierasak
