Vaginal dilators 101

Did you know that sometimes Kegel exercises are not the entire answer? A strong pelvic floor is important but, if you are experiencing pain during sex, your first step should be to speak to a health care professional about using a vaginal dilator.

Why do you have pain? Women of all ages may experience vaginal pain.

• Vaginismus is a condition where your vaginal muscles contract during or even when thinking about penetration. This means intercourse, a tampon or a doctor’s examination. Reasons for developing vaginismus are many and include trauma and other experiences that train the limbic system that penetration is wrong or harmful.

• After menopause your vagina may become less stretchy, drier, and even a little narrower and shorter. This may also happen after radiation treatments for cancer, certain surgeries or as a result of other pelvic floor disorders. 

No need to have painful sex or to stop having intercourse. These symptoms are completely normal and there are many ways to help retrain your limbic system and increase elasticity in your vaginal wall. Good lube and dilators are an essential part of any treatment program.

Vaginal dilators are inserts that usually come in sets with progressively larger diameters used to help stretch the vaginal lining and decrease pain. Dilators are medical devices that are often prescribed by your health care professional to decrease anxiety and pain experienced in anticipation of and during sexual intercourse among populations of women with sexual pain syndromes. Many women who experience Genito Pelvic Pain Penetration Disorder (GPPPD) may incorporate vaginal dilators into their pelvic floor rehabilitation program and treatment regimens to enable penetrative intercourse with less pain. Here are some characteristics of dilators.

Material

• Dilators maybe hard plastic, latex, silicone, glass or even surgical steel.
• There is no science to support one material as more effective than another.

Sizes/Colors

• Dilators come in a variety of colors and sizes. They usually come in sets with various sizes included so that you are able to gradually increase the size you are inserting.
• Consult your health care practitioner to choose the sizes or set that best suits your medical needs.

Price Point

• Dilators range from inexpensive to over $200 a set.
• Price does not always indicate superior quality.

Features

• Dilators have a variety of specific features. Some vibrate when others do not; some have handles, and some are able to be heated or cooled. These features are a personal choice.
• Again, a medical professional, counselor or pelvic floor therapist will be able to help you to decide what’s best for you.

Treatment Suggestions

There is no universally accepted treatment program in terms of dilation but consistency is key. We currently do not know what the optimal frequency of dilation is (how often you should use your dilators in a week) nor duration of use (how long each dilation session should be). We are aware that frequent follow up visits to your health care professional help by evaluating your progress and reminding you to be diligent about your dilation exercises. Also:

• It is important to use proper lubricant with your dilator to ease any discomfort you may experience.
• Überlube is a long lasting, silicone-based lubricant that helps ease the comfort of inserting a dilator and feels good too.
• Make sure that your lubricant is compatible with the material of your dilator.

The only way that a dilator works is if you use it consistently. Create a routine that includes a comfortable, soothing time and place and your favorite compatible lubricant. Begin your journey to wellness by finding a professional medical care provider who is well educated in sexual pain syndromes.

Remember, you do not need to have pain during sex. It may take a little bit of work, but your vagina and your brain can be re-trained to help you enjoy a satisfying, pain-free sex life.

Some examples of commonly used dilators are at Vagnismus.com (https://vaginismus.com) These are static hard dilators that come in a variety of sizes.

Soul Source Dilators (https://www.soulsource.com/) come in a variety of colors and packaged sets of 4-5 dilators. These do not have vibration and are made of silicone.

Other popular dilators include the Berman Center Dilator Set, which are hard plastic, have 4 sizes and a vibrational feature. They are available on amazon.com.

The Milli® Dilator is a unique and novel patient controlled soft silicone, electronic dilator with vibration features, that increases in circumference one millimeter at a time (https://www.millimedical.com/).