Vaginal Dilators: What You Need to Know

Vaginal dilators are medical devices often recommended for postmenopausal women (women who’ve gone through menopause, marking 12 consecutive months without a menstrual period) who experience vaginal pain or discomfort during pelvic exams and sexual intercourse. Cancer survivors and those with pelvic floor disorders or other conditions such as vaginismus may also benefit from this type of therapy.

Vaginal dilators are meant to stretch the vagina and reduce pain during vaginal penetration.

This article will discuss vaginal dilators, the conditions they help treat, and tips on how to use them.

What Are Vaginal Dilators?

A vaginal dilator is usually a hard plastic or firm medical-grade silicone tube that comes in varying sizes and widths—from the size of a finger to the size of an erect penis—with the primary purpose to restore elasticity to the vagina and strengthen the pelvic floor muscles. Some vaginal dilators have a vibrating feature or they can be heated or cooled.

In one study on the use of vaginal dilators, researchers found that women were often advised by their healthcare providers to include the use of vaginal dilators with their pelvic floor therapy to help them experience less pain during sexual intercourse. However, not much is known regarding how often patients used or currently use dilators or how effective the treatments were. 

What Are Vaginal Dilators Used For?

Vaginal dilators are typically used to help reduce pain and discomfort during sexual intercourse and pelvic exams. Postmenopausal women, cancer survivors, and women with a wide range of pelvic floor disorders are often advised to add vaginal dilators to their therapy if they experience pain during penetration.

Healthcare providers often recommend vaginal dilators for the following conditions:

• Dyspareunia or vaginismus: Vaginismus is the tensing of the vagina that causes dyspareunia (pain) during sexual intercourse.
• Vaginal stenosis: This condition may result from the narrowing of the upper vagina after vaginal brachytherapy (radiation therapy) in both cervical and endometrial cancer treatments.
• Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome: Women with this condition either have an underdeveloped vagina and uterus or don’t have either, making penetration painful or impossible.
• Postmenopause: Due to low estrogen, the vagina can narrow, resulting in painful sex.

How to Choose a Vaginal Dilator

There are several types of vaginal dilators available, from hard plastic to medical-grade silicone. If your healthcare provider has recommended a vaginal dilator to use in pelvic floor therapy, you’ll typically start with the smallest size, measuring about 4 inches in length and with the circumference of a finger.

You will slowly increase the size as you stretch and strengthen the vaginal walls. Remember that consistency and patience are key to moving up to a larger size. Do not rush through the process, and remember to relax so your body doesn’t tighten up.

How to Use Vaginal Dilators

Using a vaginal dilator is not difficult. The entire process, if done slowly and gently, takes no more than 10–15 minutes.

When you first start, apply a water-based lubricant to the smallest dilator that’s included in the kit. When you insert the lubricated dilator, use gentle pressure. It should go easily into your vagina, It should feel snug, and it shouldn’t hurt. Once it’s inserted, do a set of Kegel exercises, which will help relax your pelvic floor muscles.

Gently move the dilator inside your vagina for five to 10 minutes. Add more lubricant if you need it during this process. Gently push the dilator in and out, which helps stretch the length of your vagina. Rotate the dilator in wide circles at the back, middle, and opening of your vagina. This motion helps stretch the width of your vagina. After you’ve completed the different movements, take the dilator out of your vagina.

To keep the dilator clean, wash it with a gentle unscented soap in warm water, let it air dry, and store it in its kit.

Tips for Using Vaginal Dilators

Below are tips for using vaginal dilator: 

• Insert the dilator straight at a slight downward angle, toward your spine. This is similar to how you would insert a tampon.
• Never force the dilator when inserting it. Instead, insert it slowly until you feel some muscle tension.
• Stop immediately if you feel pain.
• Do Kegel exercises to relax the pelvic floor, and do some deep breathing if you’re feeling too tense when inserting the dilator or if you can’t insert it completely into the vagina.
• If you can’t insert the dilator all the way into the vagina, don’t panic. After some time, you’ll be able to insert it a little deeper after more consistent use.
• If you can’t insert it at all and it causes too much pain, schedule an appointment with your healthcare provider.

Summary

Vaginal dilators are commonly hard plastic or silicone tubes that vary in length and circumference. Vaginal dilators are sometimes recommended for women who are postmenopausal, have had certain conditions or treatments that narrowed the vagina and caused it to lose its elasticity, or have other conditions that cause pain during sexual intercourse. With regular use, dilators can help strengthen the pelvic floor.

A Word From Verywell

Pain during sex after menopause or due to health conditions, should be discussed with your healthcare provider. After a pelvic exam, your healthcare provider will determine if you need to strengthen your pelvic floor and stretch your vagina to regain elasticity or help to relax vaginal muscles. If you need guidance, your healthcare provider will refer you to a physical therapist.