How to Use a Vaginal Dilator

This information will teach you about vaginal dilators, and how to use them for vaginal dilator therapy.

About Vaginal Dilators

A vaginal dilator is a tube-shaped device that’s used to stretch the vagina. They’re usually made of plastic and come in kits with many sizes. Either you will be given a kit in clinic, or you may buy your own. The kit includes different size dilators ranging from small (about the size of a finger) to large (see Figure 1). It’s recommended that you use firm dilators made of hard plastic, and not softer dilators made of silicone.

Figure 1. Vaginal dilators

After menopause, your vagina becomes drier, less elastic (stretchy), narrower, and shorter. This process can happen sooner for women who have had cancer treatments, or a surgery to lower their risk of cancer.

To help you with these changes, you can use a vaginal dilator and begin vaginal dilator therapy. You will start vaginal dilator therapy using the smallest dilator in your kit, and then slowly increase the dilator size over time as you feel more comfortable.

Vaginal Dilator Therapy

You can do vaginal dilator therapy for as long as you need to. The amount of time you will need to do vaginal dilator therapy depends on many factors. You can discuss the length of time that’s right for you with your healthcare provider.

Vaginal dilator therapy will help to prevent your vagina from becoming too narrow. It can also help keep your vagina elastic.

Vaginal dilator therapy will help:

Your healthcare provider do a full pelvic exam (when a doctor or nurse looks at your vulva and internal reproductive organs).

Make pelvic exams more comfortable.

Lessen discomfort with sexual activity

Getting Started with Vaginal Dilator Therapy

Find a time and a quiet place where you can be alone. Try to pick a space where you feel relaxed. Your bedroom is usually a comfortable place for dilator therapy. Relax your pelvic floor muscles and take some deep breaths before you begin.

Start by getting into a comfortable position:

Lie down on your back with your feet flat on the bed or couch, and your knees slightly bent.

Spread your legs, so they’re shoulder-width apart. If you find this to be a problem, you can place pillows under your knees for support.

Make sure you can easily touch the opening of your vagina with your hand. Use a hand mirror to see your vaginal opening if you need

Find your pelvic floor muscles (muscles that support your reproductive organs) and do Kegel exercises. Kegel exercises may help you insert the dilator easier. If you aren’t sure how to do them, read the resource Pelvic Floor Muscle (Kegel) Exercises for Women to Improve Sexual Health.

Inserting the Vaginal Dilator

Inserting a vaginal dilator is simple. It shouldn’t cause any pain if you do it slowly and gently. This process should take about 10-15 minutes.

Start with the smallest size dilator in your kit. Apply a lubricant to the dilator and the opening of your vagina. Use a water-based lubricant such as Astroglide® or K-Y®. This will help the dilator slide more easily into your vagina. Don’t use petroleum jelly (Vaseline), because it can cause irritation. Avoid using oil and silicone-based lubricants because they don’t wash off the dilator easily.

To insert the dilator into your vagina, follow these steps:

1. Using gentle pressure, slowly insert the round end of the dilator into your vagina. Always insert it in the direction of your spine (back) straight or at a slightly downward angle, like you would insert a tampon.
2. Continue to insert the dilator slowly until you feel slight discomfort or muscle tension, then stop. The dilator should feel snug but not painful. Never use force and stop if you feel pain. If you don’t feel any pressure when you insert it, you might need to use a larger sized dilator.
3. Do a set of Kegel exercises, as instructed in the resource Pelvic Floor Muscle (Kegel) Exercises for Women to Improve Sexual Health. These exercises will help you relax your pelvic floor muscles and insert the dilator a little further.

If it’s still difficult to insert the dilator after doing Kegel exercises, try taking some deep breaths. Then, refocus on relaxing your pelvic floor muscles and try to insert the dilator a little further.

Don’t worry if you can’t insert the dilator completely. Over time, you may be able to get the dilator in a little further. If you’re still not able to insert the dilator, talk to your healthcare provider.

         4. Once the dilator is in place, follow steps 5 and 6 for 5 to 10 minutes. You may add more lubricant if you need it during this process.

         5. Gently push the dilator in and out to stretch the length of your vagina.

         6. Gently rotate the dilator in wide circles to stretch the width of your vagina. Repeat this at the back, middle, and opening of your vagina.

Some women find it helpful to work with more than one size dilator. For example, some women may use a larger dilator at the opening of their vagina, and a smaller dilator deeper inside the vagina, until they’re able to use the next size dilator fully.

         7. When you’re finished with steps 1 to 6, remove the dilator.

         8. Wash your dilator with hot, soapy water. Then dry it with a clean towel or paper towel. Store it as instructed in your kit.

After Using Your Vaginal Dilator

You may have a small amount of vaginal bleeding while using the dilator or after you’re finished using it. This is normal. You may want to wear a panty liner after dilator therapy. If you have a lot of bleeding, such as bleeding that soaks up a sanitary napkin (pad), or if bleeding continues for longer than 1 day, call your healthcare provider.

• If you get urinary tract infections (UTIs) often, you may want to urinate (pee) after using your dilator.
• If you have any questions or problems, talk with your healthcare provider at your next appointment.

Increasing Your Dilator Size

The goal of vaginal dilator therapy is to increase the size of your dilators slowly. When you can insert one size of a dilator completely into your vagina without any discomfort, then you should start using the next size up. The goal is to insert the largest size dilator without any discomfort, if possible. Increasing the size over time will help you have more comfortable pelvic exams, vaginal sex, or both.

When to Practice Vaginal Dilator Therapy

You should practice dilator therapy 3-4 times per week, but don’t do it 2 or more days in a row. Doing dilator therapy many days in a row may cause pain or irritation. When you aren’t using your vaginal dilator, you should try to do Kegel exercises. Kegel exercises shouldn’t be painful.

You can refer to the resource Pelvic Floor Muscle (Kegel) Exercises for Women to Improve Sexual Health for tips on Kegel exercises.

If you forget to do your dilator therapy or don’t have time to do it, don’t give up. Try to start again as soon as possible. Coming up with a plan or routine for yourself can help you be successful.

Vaginal Moisturizers

Vaginal moisturizers are products that increase moisture in your vagina making dilator therapy, sexual activity, and pelvic exams easier.

Vaginal moisturizers, such as Replens and HYALO GYN can be used 3-5 times per week inside the vagina, and also on areas such as the inner and outer labia (the folds of skin around your vagina), clitoris and vaginal opening. You can use them regularly, especially if you have dryness after menopause.

The best time to use a vaginal moisturizer is right before bedtime. This is because it absorbs best while you’re lying flat and sleeping. Don’t use a vaginal moisturizer right before dilator therapy because the moisturizer won’t absorb into your skin properly.

For more information about vaginal moisturizers, read the resource Improving Your Vulvovaginal Health. You can find it online, or you can ask your healthcare provider for it.