• Emily Reul, PT, DPT

Vaginal Dilators

Hi friends, don’t run off! This week we are going to dive into vaginal dilators, or sometimes called vaginal trainers. Vaginal dilators are used to help individuals who have difficult or painful penetration.


The term penetration can take on many forms. Penetration may be a penis or finger during sexual intercourse, but it also includes being able to insert a tampon, or have a gynecological exam. Dilators are a great way to practice inserting something into the vagina in a gradual and comfortable way.


Vaginal dilators can be extremely helpful in treating a variety of pelvic pain conditions. One of the most common is called vaginismus. With vaginismus (va-ja-niss-mus), the pelvic floor muscles are in spasm. The pelvic floor muscles wrap around the vagina so when they are in spasm, they can close off the vaginal entrance preventing penetration.


You may also hear a healthcare provider talk about dyspareunia which is recurrent pain with sexual penetration by a penis, finger, or other object. This can be common when trying to have sex postpartum. If this is you, check out our Postpartum Pain with Sex Course to help you return to a happy, healthy sex life after baby.


Along with painful conditions like vaginsmus, there can be a need to use vaginal dilators after cancer treatments like radiation and chemotherapy, especially with breast or colorectal cancers. These treatments can cause vaginal stenosis (narrowing/shortening of the vaginal tissue and canal).


While it may be obvious that vaginal dilators are used to stretch out the pelvic floor muscles, they also work in many other ways. They help to increase the elasticity of the vaginal tissue—like a rubber band, we want the tissue to be able to expand and contract to allow for penetration but also to keep the vaginal canal closed when needed.


To keep it simple, the brain controls what muscles do. In order to make a lasting change in muscle, we need to train the brain as well. Vaginal dilators help to retrain the brain to allow the pelvic floor muscles to relax when something is being inserted into the vagina and to contract once that item is inserted. Having the pelvic floor muscles can hold a tampon inside the vaginal canal or increase pleasure for both partners with intercourse.


So, how do you use a dilator?

First, we highly suggest using a dilator with the help of a pelvic floor physical therapist. Pelvic pain and dysfunction can be very complex and often requires the help of a skilled clinician.


Dilators come in several different sizes and different materials (typically silicone or plastic). Speak with your provider about which type is best for you.


When it’s time to use your dilators, find a comfortable, relaxing, and private space to do so. If your kids are screaming outside or you are nervous about someone walking in the room, it will be very hard to insert even the smallest dilator. Relaxation is an important part of using a dilator!


Once you’ve found your space, get into a comfortable position. This can be lying on your back, laying with your legs resting up on the wall, or a deep squat with a chair for support.


Now it’s time to use the dilator. You will want to use a lubricant to help decrease any friction between your vaginal tissue and the dilator. Just like there are different types of dilators, there are different types of lubricants, including water and silicone based. Read the instructions on your dilator to decide which type of lubricant to use. There are many different types of lubricants, with some as simple as coconut oil (be sure to keep a separate jar than the one you use in your kitchen!)


You may need to start rubbing the dilator along the vaginal introitus (opening) before trying to insert it. As this becomes comfortable, you can start to insert the dilator just to the opening of the vagina and gently sweep it along the sides. As you progress, you can slowly insert the dilator into the vaginal canal.