QUICKIES: How to use a vaginal dilator

If you have had trouble tolerating vaginal penetration, you may have been told that dilators can help.

A dilator cannot help with all times of pain with sex. But if you have pain because of a spasm in the pelvic floor muscles, then dilator therapy may be just the ticket.

How do you know if you have pain due to constricted, tight pelvic floor muscles? One big tip off is that it feels like you are hitting a wall inside the vagina when you try to have sex.

The best way to know is to have a complete vulvovaginal exam with your primary care provider, gynecologist or even a sexual medicine specialist. You can also see a pelvic floor physical therapist. These are professionals, just like other physical therapists, who focus specifically on pain or dysfunction related to the pelvic floor.

So if you have been told you have a hypertonic pelvic floor or vaginismus, or if you are pretty sure this is your issue, and you want to know more about dilators, this article is for you.

The Vaginal Dilator

A vaginal dilator does not technically dilate the vagina. Meaning it does not make the vagina wider. It simply helps relax the muscles at the opening to the vagina so that penetration is possible and also potentially pain-free. Think about it like this–the dilator is providing trigger point therapy (like a massage) and relaxation/lengthening (like yoga). A yoga massage for your yoni!

Many companies make dilators. Check out Hope & Her, Intimate Rose, & Soul Source for examples.

There are also many different sizes of dilators. What are you able to insert in your vagina now? What are you hoping to be able to insert in your vagina in the future? Pick a set of dilators that will include several diameters in this range.

Goals of Dilator Therapy

There are many goals of working with a dilator. Here are a few of the most important ones to keep in mind.

  1. To be able to have pleasurable sexual experiences that involve penetration whenever you like.
  2. To provide trigger point therapy to painful, contracted pelvic floor muscles, allowing them to lengthen and relax.
  3. To put vaginal penetration in your control.
  4. To increase your awareness of your pelvic floor.
  5. To have pain-free experiences of penetration so that the mind can stop expecting pain.
  6. To notice your thoughts, feelings and beliefs during penetration. To see how more realistic, and perhaps even optimistic, thoughts can change your experience.
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Though their use may seem pretty straightforward (and it’s not hard!), there are some subtleties that can improve your success. So read on to learn how to use a vaginal dilator.

It may help to set time aside to allow yourself to relax before doing dilator therapy. Take a hot bath, light a favorite candle, take a few nice deep belly breaths. Do what works for you. Give yourself time to settle in and turn inwards, if you can.

  1. Assume a comfortable position. Many women choose to lie on their backs with their knees bent at a 45 degree angle. You may want to try different positions over time.
  2. Choose a dilator that you can currently accommodate comfortably in your vagina.
  3. Apply lubricant to the dilator liberally. Don’t forget that silicone lubricant should not be used with silicone dilators. (See Viva La Lubricant! for more detailed information on safely maximizing pleasure with lubricants.)
  4. Place the lubricated dilator at the opening to the vagina. Take a few more deep breaths. Notice how the pelvic floor expands to meet the tip of the dilator on an inhalation. Notice your thoughts. Are they negative? Are they helpful? Consider how shifting your thoughts could help shift your experience.
  5. Using the dilator, apply gentle pressure along the bottom of the vaginal opening. If the vagina was a clock, apply pressure at 4:00, 6:00 and 8:00. Hold each position for 1 minute.
Vaginal Dilator Positions
  1. Notice if you are having pain. If no, continue. If yes, release some of the pressure. Again, notice your thoughts. Notice any bodily tension that is developing.
  2. Slowly move the dilator into the vagina. The overall angle of the move is “down and back”. However, the muscles of your pelvic floor are likely contracted and this will be felt as a “bump” or “wall” as you try to enter. You want to move the dilator inwards a few centimeters until you reach this bump. Then tilt the dilator gently up and over this contracted muscle. Continue to advance the dilator until it is fully inserted. If you are not able to advance beyond this muscle, try using a smaller dilator.
  3. Again, apply gentle pressure downwards at 4:00, 6:00 and 8:00. Hold each position for one minute.
  4. If at any time you have pain (more than a 3 on a 1 to 10 pain scale), Stop. The goal is not to “grin and bear it,” but rather to have experiences of vaginal insertions that are not significantly painful. A dilator may feel uncomfortable but it should not ever feel unbearable.
  5. From here you can personalize your dilator therapy. What does your body need next? You can repeat the sequence with the same or a larger dilator. You may want to try moving the dilator in and out of the vagina. You may also leave the dilator in the vagina while your perform deep belly breaths.
  6. When you are finished, wash the dilators with warm, soapy water. Allow them to dry before returning them to storage.
  7. Find a routine of dilator therapy that works for you. Try to do dilator therapy a few times a week. The more you do, the more progress you are likely to see. However, don’t pressure yourself for instant results. Take it slow and steady, keep up a routine as much as possible. Be gentle!

The Value of Pleasure

Dilator therapy is usually described as a type of physical therapy. As physical therapy it is like exercise, just put your head down and get through it.

However, dilator therapy can be greatly enhanced by incorporating vibration, pleasure, and arousal.

Vibration brings blood flow to the vulva. Blood flow means greater oxygenation to the tissues, including the overworked, spasming pelvic floor muscles. Vibration is used all the time to treat sore muscles, why not use it on the vulva and/or vagina, too?

Pleasure and arousal also bring blood flow to the tissues.

Arousal also decreases the sensation of pain and is, in fact, one of your body’s natural analgesics. Why not bring pleasure and arousal into your dilator therapy from time to time?

Ultimately, pleasure itself is an antidote to pain. Pain tends to beget more pain. The cycle of chronic pain can quickly become entrenched, keeping you stuck and miserable. By teaching the brain that the vulva and vagina are sources of pleasure, and not just pain, you can begin to unwind this cycle and rewire your relationship to your body.

So don’t be afraid to bring vibration, pleasure, and arousal into your dilator therapy. You have my permission, nay even my encouragement!

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