How to Use Vaginal Dilators for Pain Relief – Complete Physiotherapy Home Dilator Guide

How to use vaginal dilators for pelvic pain at home, video and information with Pelvic Floor Physiotherapist Michelle Kenway.

Read on below this video to learn how to use vaginal dilators including:

• What is a vaginal dilator?
• How to start using a dilator
• Step by step instructions for how to use vaginal dilators
• Additional dilator therapy techniques for self treatment
• Precautions when using a dilator
• When to use dilator therapy
• Potential benefits of dilator therapy
• Additional considerations for successful dilator therapy
• Where to buy vaginal dilators online

How to Use Vaginal Dilators Guide

Vaginal dilator therapy is ideally implemented following thorough medical assessment and diagnosis.

Dilator therapy is often used at home in conjunction with concurrent treatment by appropriately trained health professionals including pelvic floor physiotherapists, oncology nurses and counselors.

What is a Vaginal Dilator?

A vaginal dilator is a therapy device used to prevent and treat problems including pain and anxiety with vaginal penetration.

Vaginal dilators are also known as retrainers.

Dilators are usually available in specially designed dilator kits. Dilator kits contain a range of different sized dilators to allow for appropriate size and progression of treatment over time.

Velvi Vaginal Dilators have a unique small sized dilator for the comfort of women starting out treatment (shown right).

How to Start Using Vaginal Dilators

These guidelines are intended as general information. Please follow the directions of your treating medical professional.

• Start with the smallest size dilator. Gradually progress the size of the dilator over successive treatments as comfort permits.
• Select an appropriate time and a warm comfortable place that allows uninterrupted relaxation.
• Position your body lying down with your legs bent. Place pillows or  cushions under your turned out thighs to allow your leg muscles to completely relax (shown below).

• Warm the dilator before using it by wrapping it in a flannel for 5-10 minutes to slightly warm it (avoid making the dilator too hot and test the temperature on the inside of your wrist before applying).

How to Use Vaginal Dilators Step-by-Step

Step 1 – Lubrication

Place a small amount of natural water-based personal lubricant on the tip of the dilator. Avoid lubricants containing petrochemicals as these can cause pelvic floor tissue irritation and exacerbate pain.

Step 2 – Breathing

Focus on your breathing using a series of slow deep breaths. Try to breathe with relaxed deep breaths so that your belly rises with the in breath and falls with the outbreath. This breathing technique for pelvic floor relaxation is called diaphragmatic breathing.

Continue diaphragmatic deep breathing for up to 5 minutes at the outset of the session.

Pelvic Floor Muscle Relaxation Download teaches you how to breathe and relax your pelvic floor during dilator treatment at home.

This Physiotherapist CD teaches pelvic floor muscle relaxation. This is ideal for use with vaginal dilator treatment.

Research suggests that women who use meditation and music during vaginal dilator therapy may have better long-term outcomes¹.

Step 3 – Scanning

Scan your body for any areas of muscle tension from the top of your head to your toes.

Notice any muscular tension around your eyes, jaw, throat, shoulders, buttocks and legs. Mentally encourage each area to relax and loosen with each breath out. As you exhale, let the vaginal area soften with each breath. Visualize or imagine this area in a state of softness and softening further with every breath out.

Step 4 – Dilator Insertion

• Rest the narrow end of the dilator against the vaginal opening continuing relaxed diaphragmatic breathing.
• Gently insert the end of the dilator just into the entrance of the vagina when you feel ready to do so.
• Gradually insert the dilator to a tolerable depth within your vagina. Keep the level of discomfort minimal and if you feel any discomfort pause for up to a minute at a time, continuing to breathe and relax your pelvic floor.
• When discomfort has eased, progress further as tolerated stopping at regular intervals to accommodate your body to the sensation and lengthening of the tissues.
• Never force the dilator beyond the level of personal comfort.

Step 5 – Dilator Withdrawal

When you have finished, gently withdraw the dilator and allow yourself to rest and recover before getting up.

Wash the dilator with warm soapy water, thoroughly dry and store.

Frequency and Timing Dilator Therapy

Aim to use your dilator for 5-10 minutes each session however when starting out this time frame may be much shorter according to individual tolerance.

Aim to complete dilator therapy for at least 3 alternate days of the week. Research suggests that women who use vaginal dilator therapy longer than 3 months have a trend towards improved treatment outcomes¹.

Women often need to use dilator therapy for an indefinite time course, especially since vaginal changes can still occur for up to 5 years after radiotherapy.

How to Use Vaginal Dilators – Therapy Techniques

The following vaginal dilator techniques for lengthening tissues and minimizing adhesions should never feel painful.

These are the types of dilator therapy techniques that may be discussed with your therapist or doctor regarding their suitability for use:

• Gradually increasing the depth of dilator penetration
• Gently rotating the handle of the dilator
• Massage in a circular motion
• Moving the dilator diagonally i.e.forwards and backwards, and left to right motion
• Moving the dilator in and out of the vagina while maintaining gentle pressure against the vaginal wall
• Maintaining gentle pressure against an area of discomfort for up to 60 seconds
• Progressing the size of the dilator
• Involving your partner in dilator therapy.

Precautions Using a Vaginal Dilator

Some of the important precautions to take when using a dilator include:

• Keep discomfort to a minimum when using a vaginal dilator
• Avoid using a dilator with an active pelvic infection
• Avoid using a dilator immediately following pelvic surgery. Be guided by your doctor’s recommendations regarding all forms of postoperative vaginal penetration and dilator use.
• Slight vaginal loss and blood staining is not uncommon following dilator use. In cases of pain or heavy vaginal loss then seek medical advice and referral for ongoing support and management.
• Never use someone else’s dilator
• Clean and dry your dilator thoroughly after use

When is Dilator Therapy Used?

Dilator therapy is used for a range of pelvic floor problems including:

• Shortened or narrowed vaginal canal resulting from gynecological surgery
• Pelvic floor muscle spasm (increased pelvic floor muscle tension or overactive pelvic floor muscles)
• Reduced vaginal elasticity, narrowing and adhesions resulting from pelvic radiotherapy
• Dyspareunia or difficult and/or painful intercourse
• Vaginismus or involuntary/painful pelvic floor spasm with attempted vaginal penetration
• Psychological problems and sexual health issues associated with vaginal penetration

Benefits of Dilator Therapy

When used appropriately, potential benefits of dilator therapy can include:

• Improved physical comfort with sexual intercourse after pelvic floor surgery with scarring and narrowing and/or shortening of the vagina
• Allowing pain free sexual penetration by training pelvic floor muscle relaxation
• Reducing pelvic floor muscle tension or spasm with vaginismus
• Overcoming fear of vaginal penetration
• Prevention of adhesions/fibrosis from forming during and after pelvic radiotherapy
• Allowing for use of tampons
• Facilitating ease of gynecological examination.

Additional Considerations for Successful Dilator Therapy

There are some important considerations to be taken into account before and during dilator therapy.

Considerations include:

• Whether or not to use dilators during the course of pelvic radiotherapy (as determined by the treating medical specialist)
• Decreased vaginal lubrication with menopause and/or oophorectomy (removal of ovaries)
• Thinning of the vaginal tissues with menopause
• Concurrent counseling for associated emotional issues
• Relaxation education and training
• Involvement of a partner with dilator therapy.

References

1. Liu M, Juravic M, Mazza G, Krychman ML. Vaginal Dilators: Issues and Answers. Sex Med Rev. 2021 Apr;9(2):212-220. doi: 10.1016/j.sxmr.2019.11.005. Epub 2020 Jan 31. PMID: 32014450. https://www.sciencedirect.com/science/article/abs/pii/S2050052119301258?via%3Dihub