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Dilators 101: a beginner’s guide to using a vaginal dilator

By Maya Khamala

Ever heard of a vaginal dilator? Many still haven’t, but that’s changing. If you have a history of painful vaginal penetration—be it during sex, at the gynecologist, when using tampons, or really with any kind of insertion at all, you may have a condition known as vulvodynia or vaginismus, both diagnoses that cover a range of symptoms doctors have a hard time understanding, even though vulvodynia has an estimated prevalence range of 10-28% in reproductive-aged women, and roughly 2 women in 1000 have vaginismus. Gendered gaps in medical research, anyone? These numbers are likely way higher, of course, as many women are too ashamed to seek help; those that do are often dismissed or misdiagnosed; and healthcare providers don’t typically keep stats on the number of women consulting for vaginal pain. It’s downright unacceptable that some women, believing they can’t be helped, resign themselves to never entering a sexual relationship. It should go without saying that with this mindset comes a truckload of anxiety and depression.

Here’s the good news: more and more women are finding real relief with vaginal dilator therapy.

Although the causes of vaginal pain can vary widely and are still being identified, common known culprits include stress, trauma, hormonal imbalances, and cancer treatments. My personal experience with vulvodynia was intimately bound up with my stress levels (rooted in trauma), which in turn affected my hormones. It’s all connected. An incredible pelvic floor therapist I had the good fortune of stumbling across pointed out something that I already knew on an instinctive level, but which I badly needed to hear: when we get stressed, our pelvic floor muscles are often the first things we seize up—almost as a protective mechanism. We don’t mean to—it just happens. Too much of this, and you end up with chronic-style pain. This pain can even mimic common vaginal infections, as it did in my case. Miraculously, it was through the use of a dilator set that I finally regained control over the whole situation and started feeling like myself again.

What is a vaginal dilator?

Put simply, a vaginal dilator is a hard plastic or silicone phallus-shaped device (much like a dildo in appearance) used to stretch your vagina. Dilators come in kits offering different sizes, from small (finger-sized) to large (cock-sized). I know people have fingers and cocks of all sizes, but you get the general idea. Most dilators also have a handle to make them easier to hold. The size you begin with will depend on the severity of your case. You might start out using the smallest dilator in your kit and slowly increase the size over time.

How to use a vaginal dilator

Whether your healthcare provider or pelvic floor therapist has recommended you try dilator therapy, or you’re exploring treatment options independently, it's crucial you learn how to best used dilators to improve your tolerance to penetration and slowly but surely do away with pain.

To get the most out of vaginal dilator therapy, follow these steps:

1. Find a quiet time and place where you can be alone and relax. Relax your pelvic floor muscles and take a few very deep breaths before you start. If you aren’t sure you can identify your pelvic floor muscles, this guide can shed some light on that.

2. Lay back (on a bed, ideally) with your knees bent. You might open your legs in a diamond shape if its comfortable. You shouldn’t be holding or tensing any of your limbs. The aim is to relax totally. Support your head and knees with pillows.

3. Begin with the largest dilator you feel comfortable inserting (better to start too small, however, than vice versa, so err on the side of caution). Apply a water-based lubricant or some coconut oil to the dilator and to your vaginal opening.

4. Slowly and gently insert the dilator. Keep inserting the dilator until you feel slight discomfort or tension. Never force it past this point, and stop if it hurts.

5. Do a set of Kegel exercises to help you relax your pelvic floor muscles—this may in turn help you insert the dilator a little further. If you can’t insert it all the way, no worries. You’ll work up to it. If you find no improvements are being made over time, talk to your health practitioner.

6. Maneuver the dilator around gently inside your vagina for 5-10 minutes (or less, if your tolerance is low). If needed, pause to add more lube. Gently push it in and out to help stretch the length of your vagina. Gently move your dilator from side to side and rotate it in wide circles at the back, middle, and opening of your vagina to help stretch the width, or apply sustained pressure according to your therapists’s instructions.

7. Slowly and gently take the dilator out.

Increasing dilator size

When you can work your dilator comfortably for 10-15 minutes and move it in and out about 25 times, you are likely ready for the next size up. This may take longer for some than for others, as every case is different, so be patient with yourself! Don’t rush anything, and know that there is no exact formula or timeframe for success.

Dilator therapy

Contrary to popular belief, many vaginas need stretching and strengthening, rather than tightening. Vaginal dilator therapy can help keep your vagina elastic (as it's supposed to be), and stop it from narrowing too much. The length of time you’ll need to practice vaginal dilator therapy will depend on many factors, but really, you should do it for as long as necessary.

While you can get started exploring dilator therapy all on your own with a proper dilator set, there’s no substitute for finding and working with an experienced pelvic floor therapist, as they can work with you to assess your muscle function, perform manual therapy to help reduce your symptoms, assign specific dilator exercises to help you maintain progress, and generally just act as a guide and a resource as questions or concerns crop up, as they do.

Bonus tips

- More lube is generally good.

- Experiment with different positions and angles of insertion to find what works best for you.

- If your dilator gets less comfortable while you’re using it, stop and come back to it.

- In terms of discomfort, anything over a 4 out of 10 means stop.

- You are in control, so move at your own pace.

- Before and after each use, wash your dilator with warm water and mild, unscented soap.

- Try our Wellness 4-Piece Vaginal Dilator Kit; it’s made with body-safe silicone and is well-suited to beginners!

Let’s face it, vaginal pain is no cup of tea, and can have you feeling really dark feelings. But contrary to what you may have heard, there is bonafide hope. You got this. <3

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