Pelvic floor dilators are therapeutic medical tools used to gently stretch and desensitize vaginal or rectal tissues. They are typically used as part of a prescribed rehabilitation program to restore comfort and function. The goal of this therapy is to safely and gradually improve the ability to tolerate penetration or internal examination. This guide provides step-by-step instructions for dilator therapy.
Understanding Pelvic Floor Dilators
Pelvic floor dilators are cylindrical devices sold in graduated sets, incrementally increasing in diameter and sometimes length. They are made from materials like medical-grade silicone or rigid plastic. Plastic dilators are firmer, which can be beneficial for stretching tissue, while silicone options are softer, more flexible, and often feel more natural.
Dilators function by gradually improving tissue pliability and increasing the space within the vaginal canal. They are recommended for individuals experiencing painful penetration (dyspareunia) or involuntary muscle tightening (vaginismus). Dilator therapy is a standard approach for managing scar tissue after childbirth, pelvic radiation, or surgeries like hysterectomy or gender-affirming procedures. Consistent use helps recondition the body/brain connection, reducing discomfort and facilitating muscle relaxation. These devices are most effective when integrated into a comprehensive therapeutic program, often overseen by a pelvic floor physical therapist or healthcare provider.
Essential Preparation Before Use
Before beginning a dilation session, establish a calm, private environment where you will not be disturbed. Wash your hands thoroughly with soap and warm water to maintain hygiene before handling the device. The dilator should also be cleaned with mild, unscented soap and warm water before and after each use.
Select the correct starting size, which is usually the smallest dilator in the set that can be inserted comfortably without causing sharp pain. Generously coat the dilator with lubricant to ensure smooth insertion. Only use a water-based lubricant, as oil-based products like petroleum jelly can irritate delicate tissues and may degrade silicone dilators.
A settled nervous system is important for effective dilation, as muscle guarding can make the process difficult. Before insertion, practice slow, deep diaphragmatic breathing, inhaling into the belly and slowly exhaling. This focus on relaxed breathing helps calm the pelvic floor muscles, increasing the potential for a comfortable and successful session.
Detailed Step-by-Step Usage Guide
Find a comfortable position for your session, such as lying on your back with knees bent and legs slightly apart, or semi-reclined with pillows supporting your upper body. Once settled, apply additional water-based lubricant to the opening of the vagina. Separating the labia with one hand can help guide the dilator toward the vaginal opening.
Using your other hand, apply gentle pressure to the rounded end of the dilator at the entrance. Slowly insert the dilator at a slight downward angle, directing it toward your tailbone, similar to inserting a tampon. The movement should be slow and deliberate, stopping immediately if you feel intense pain or resistance. The goal is to reach a point of snugness or mild tension, not sharp pain.
Once the dilator is inserted to a comfortable depth, keep it in place for 10 to 20 minutes. During this time, continue focusing on relaxed, deep breathing to encourage the pelvic floor muscles to release tension around the device. Your therapist may suggest gentle movements, such as slightly rotating the dilator or moving it in and out to stretch the vaginal length and width.
Some individuals find it helpful to perform a gentle pelvic floor contraction (Kegel) and then fully release the muscle around the dilator to improve awareness of muscle control. A rolled towel beneath the dilator can help maintain its position, allowing you to relax your hands and body more completely. If discomfort progressively increases during the session, gently remove the dilator and end the exercise for that day.
Progression, Cleaning, and Safety
After the prescribed duration, gently remove the dilator and wash it immediately with warm water and a mild, fragrance-free soap. Thorough rinsing is necessary to remove all soap residue. The dilator should be dried completely before being stored in a clean, dry place, which prevents the buildup of bacteria and ensures the integrity of the device.
Progression to the next size should only occur when the current size can be inserted and worn comfortably for the full session length without pain. Avoid rushing the process, as using a dilator that is too large can cause discomfort and lead to muscle guarding. Many individuals find it beneficial to start a session with the smaller, previously mastered size before attempting the next size.
While minor spotting or slight discomfort can occur initially, severe pain or heavy bleeding is a sign to stop immediately. If you experience increased discomfort, persistent bleeding, or are unable to progress to the next size despite consistent effort, contact your healthcare provider or pelvic floor therapist for guidance. Consistency and patience are important, and regular follow-ups with a professional ensure safe and effective therapy.