There are many things you can put into your vagina. We recommend against most of them. For example, don’t put vaginal glitter or jade eggs in your vagina! Same with magnets. But then there are things for the vagina that we wish more women knew more about. Out of the many things that you could put into your vagina, we find that people do not know very much about vaginal dilators. Less glittery than their sex toy counterparts, and more medical than a finger, vaginal dilators play a crucial role in helping some women improve their sexual function. Here is the low-down, so that you can know and spread the word about this important vaginal resource.
What is a vaginal dilator?
Vaginal dilators are firm, rounded cylinders, usually made out of silicone or plastic. They come in different sizes, ranging from the width of a pinky finger to the width of a cucumber. A good word to describe dilators is “phallic” or penis-shaped. Although vaginal dilators look like dildos*, they have a different purpose than sex toys. Dilators are used to gently stretch the vagina and relax the surrounding muscles, in order to increase the length and girth of the vagina. They help users gain control over their pelvic floor muscles, including mobility and flexibility. To use vaginal dilators, a person starts with a small dilator that can fit inside the vagina without difficulty. The user then carefully inserts dilators of gradually increasing size into the vagina, one at a time, thus slowly increasing vaginal capacity. The purpose is to literally “dilate” (widen and lengthen) the vagina, creating more space inside. Dilation can make sexual penetration easier and more pleasurable, and also helps restore the vagina to a more comfortable shape and length. Dilators can be used to treat conditions like vaginal stenosis (constriction or tightening of the vagina that can occur after pelvic radiation) and vaginismus (involuntary tightening of the muscle that surrounds the opening to the vagina–the bulbocavernosus muscle).
Why would someone use a vaginal dilator?
Lots of people might benefit from using vaginal dilators. They can be helpful for a person who is having difficulty with vaginal penetration, including difficulty inserting a tampon and painful intercourse. Some cancer treatments, such as surgery or radiation in the vagina or pelvis, can shorten and narrow the vagina. Pelvic radiation for cancer may cause inflammation in the vagina. Inflammation can lead to scarring, and scarring can cause the walls of the vagina to stick together. Some women undergo pelvic radiation when they are being treated for cancers like cervical and vaginal cancer, endometrial or uterine cancer, and anal and rectal cancer. Dilators can help prevent narrowing and shortening of the vagina after pelvic radiation.
Dilators can also help address some of the effects of hormonal changes resulting from chemotherapy. Most chemotherapy treatments target rapidly dividing cells in the body. Because pre-menopausal ovaries are made up of dividing cells (that’s how ovulation happens!), chemotherapy typically makes the ovaries less productive. That means they produce less estrogen. Anti-estrogen medicines, like those commonly taken by women with breast cancer, also interfere with and lower the body’s estrogen levels. Low estrogen levels can cause vaginal tissue to become thin, dry, and less elastic. These changes can make intercourse uncomfortable and some women even experience bleeding. During menopause, the ovaries produce far less estrogen. The changes of menopause can also cause the vagina to become thinner and less flexible. Vaginal dilators may be part of treatment in all of these cases.
A note about estrogen and the vagina. With estrogen, the vagina acts like panty hose, stretching and shrinking easily. Without estrogen, the vagina is more like a garden hose – it doesn’t stretch very easily!
Dilators can also be used in the anus. Used this way, dilators can lessen tightness or pain after injury or radiation to the anus. Anal dilation can help with anal intercourse, bowel movements and medical care after anal and rectal procedures. When used to treat a medical problem, you should check with your doctor or other health care professional before using anal and vaginal dilators.
We hear women say “I want my vagina back.” It might have been a vaginal delivery, it might be dryness from breastfeeding, it might be radiation changes after cervical cancer treatment or changes due to menopause. Using vaginal dilators may be a step towards recovering lost sexual function. They could be helpful for getting your vagina back to where you want it.
Vibrate, dilate, or wait?
Before considering using vaginal dilators, it is important to talk to your doctor or other health care professional. Some women may not be ready – physically or mentally – for vaginal dilation. It’s important to understand how it works. Dilation is usually a little uncomfortable. Like working out at the gym or doing yoga, there is some stretch and effort involved. It is important to know what to expect and to have a clear goal. Here are some common questions and answers:
“I’m not sexually active right now. Why do I need to do vaginal dilation?”
Vaginal dilation is helpful for lots of reasons. Aside from sex, dilation is also helpful for gynecologic exams (including Pap smears), using tampons and having more control over your pelvic floor muscles. If you wait too long to start dilation, it may be harder to regain vaginal capacity later, or to treat the underlying problem.
“I have a vibrator or dildo at home. Can I use that instead?”
Usually, using your own dildo or vibrator works as a great substitute for vaginal dilators. Some vaginal dilators come with vibrating and moisturizing and even cooling features. You may need to start with something smaller than your regular vibrator and work your way up. Or, if your dildo is small, you may eventually want to graduate to something larger.
“I have never masturbated and I’m not comfortable touching myself down there.”
While masturbation is a totally normal human behavior, it’s also ok not to masturbate if you don’t want to. Using vaginal dilators to address a health or medical problem is not masturbation. Dilation is not an exercise intended to cause sexual arousal. Some women may feel sexual arousal during the dilator exercises. Some women choose to involve their partners, which can also be helpful. A medical professional like a gynecologist or a pelvic floor physical therapist can also help you overcome discomfort with this exercise.
“I was sexually abused or assaulted. Putting anything in my vagina right now is traumatic.”
Unfortunately, rates of sexual abuse in our society are high. As many as 1 in 3 women has a history of sexual abuse. Experiencing sexual abuse can increase a woman’s risk of having sexual function problems, such as vaginismus, where vaginal dilation can be helpful. If you feel scared or uncomfortable with the idea of vaginal penetration or dilation, you deserve help from a mental health professional. Sex therapists are specialized in helping women address these concerns. Your gynecologist may also be able to help.
Find Out More
As always, we recommend talking to your doctor or other health care professional before beginning any self-care activity. Learn as much as you can about your vagina, the effects of vaginal dilation, and what you can expect during and after dilation. Pelvic floor physical therapists and sex therapists are great resources for improving sexual function, and understanding the underlying reasons behind sexual function problems. Dilation can be empowering for some women, since it is self-administered and the results are self-generated. In a future post, we’ll talk about how to use vaginal dilators for specific conditions, including vaginismus and after radiation treatment. We want you to know about all of the tools available to preserve and recover your sexual function. Now you know about vaginal dilators. Pass it on!
*Did you know that the word “dildo” comes from the name of a tool used to lock an oar into position on a boat? Stay tuned for the amazing history of the dildo in a future blog post!