Vaginal Dilators

What are vaginal dilators?

Vaginal dilators are tubelike devices made of plastic or medical-grade silicone that you put in your vagina to stretch your vaginal tissue. They’re a treatment option if you have pain during vaginal penetration due to medical conditions such as pelvic floor dysfunction.

Dilators work by gradually improving the flexibility of your vagina and the strength of your pelvic muscles so that penetration becomes more comfortable. You can use a vaginal dilator in the comfort and quiet of your home in under 20 minutes. They range in size and thickness, and the dilator you choose depends on how tight or narrow your vagina is.

While vaginal dilators are available to purchase without a prescription from most retail pharmacies and online, you should speak with your healthcare provider before using one. Your healthcare provider can tell you if they believe a vaginal dilator is a good treatment method for you based on your health history and symptoms.

What is a vaginal dilator used for?

Vaginal dilators can be beneficial if you experience pain with sexual intercourse or penetration. They work by making your vaginal tissue more flexible or elastic. They can also help to strengthen pelvic floor muscles that have become loose or weak.

Some of the health conditions that can cause painful intercourse are:

• Menopause: Menopause causes several hormonal changes that can make sex painful.
• Vaginismus: Vaginismus causes muscle spasms during intercourse or penetration.
• Dyspareunia: Dyspareunia is the medical term for persistent pain in your genital area during or after intercourse.
• Previous radiation therapy or surgery for cancer: Radiation and surgery for certain types of cancer can affect your vaginal tissue. Dilators can help give this damaged tissue its flexibility and softness.
• Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome: MRKH is a condition that causes a person to be born without a fully developed vagina, making intercourse difficult.
• Congenital conditions that affect your vagina or hymen: Treatment for congenital conditions (conditions from birth) that cause your vagina to have a small opening may involve using a vaginal dilator.
• Vaginal stenosis: Vaginal stenosis causes your vaginal opening to close or narrow due to scarring or hormonal changes.
• Gender affirmation therapy: Dilators can help support medical or surgical procedures that reconstruct your vagina.

Where can I get a vaginal dilator?

Vaginal dilators are available over-the-counter (OTC) through many online retailers and pharmacies. But you should still talk to a healthcare provider before you use one. They can help determine if it’s the right therapy for you or recommend a size and brand.

How do you choose a vaginal dilator?

Dilators range in length from about 2 inches to 7 inches (in). The circumference, or thickness, also varies from about 0.5 inches to 1.5 inches. The goal is to work your way up to a larger and/or thicker dilator. If treatment is working, you should notice you’re able to more easily insert a larger dilator over time. It’s important that you don’t try to rush through sizes or force yourself to wear a larger dilator before you’re ready.

Vaginal dilators come in plastic or silicone and resemble the shape of a penis. Both materials have their pros and cons. Plastic tends to be more firm and rigid, which may help stretch your vagina. But some people find it uncomfortable. Silicone is softer, gentler and more flexible. You can also use a silicone dilator chilled or warmed. It’s important to find one that feels comfortable to you but also provides enough tension to stretch your vagina.

Magnetic vaginal dilators are another option. They’re made of plastic, but they have a magnet inside which may help increase blood flow to further aid in healing vaginal tissue.

Some dilators are sold with a handle, wand or finger loop which gives you greater control over the dilator when you move it around inside your vagina.

Your healthcare provider may be the best person to recommend which dilator to get. They can perform a pelvic exam or physical exam to see what type and size vaginal dilator will work best for you.

How do you put a vaginal dilator in?

Inserting a dilator can be slightly uncomfortable at first. The process of putting in and using a dilator shouldn’t take more than 20 minutes. The benefit of this type of therapy is that you can do it in the privacy and comfort of your own home.

Here are the steps to help you use a vaginal dilator:

1. Apply a water-based lubricant (like KY® or Astroglide®) to the dilator. Don’t use oil-based lubricants or products like Vaseline®. Remember, you should use a small dilator to start and work your way up over time.
2. Lay in a comfortable position on your back with your legs bent at the knees. Allow your legs to fall outward if possible, similar to how you would during a pelvic exam.
3. Insert the dilator into your vagina similarly to how you’d insert a tampon (at a downward angle toward your spine). You should feel tension and the dilator should feel snug without causing pain. Once you feel this tension, stop. Don’t force it in further.
4. Often, your provider will recommend doing Kegel exercises with your dilator in to help relax your pelvic floor. Taking long, deep breaths can also help relax your muscles.
5. Spend the next five minutes moving the dilator around while it’s inside your vagina. This part is easier to do if your dilator has a handle or “holder” with it. Rotate the dilator in circles towards the front, rear and sides of your vagina. Then, move it in and out (similar to what occurs during penetration).
6. Gently remove the dilator after 15 minutes.
7. Clean your dilator with gentle soap and warm water. Then, let it air dry or blot it dry with a paper towel.
8. Use dilator therapy as directed by your healthcare provider. Some providers recommend daily use while others recommend every other day.

As you go through vaginal dilator therapy, aim for deeper penetration and/or a thicker dilator over time. You should notice the smaller dilator feels too easy and that you’re ready for a larger or thicker dilator.

It’s important to use the dilator as directed by your healthcare provider. Vaginal dilators will come with instructions from the manufacturer on how to use their product. Contact your provider if you have questions or experience pain while using a dilator.

What size dilator do I use?

Most people begin with a small vaginal dilator, which can be about 3 in long and as thin as a pencil. These dilators may be labeled as small or size one. As you progress through the sizes, the dilator gets longer and thicker/wider. Not everyone starts as a size one, though. You should start with a dilator that feels snug but isn’t painful to insert. This is where talking to your healthcare provider is helpful because they can recommend what size to start with.

Over time, you should be able to graduate to larger dilators. These may be labeled large, extra-large or size seven, for example. The largest vaginal dilator is meant to replicate an erect penis, so it can be about 7 in long and 1.5 in thick.

Many manufacturers sell vaginal dilators in kits or packs that include several sizes. This can remove the guesswork because you have all the sizes you may need. As always, you should discuss dilator treatment with your healthcare provider to make sure you’re using it correctly.

How long should you keep a vaginal dilator in?

You should keep a vaginal dilator in for about 10 to 15 minutes each time. How often per week you use a dilator depends on the underlying condition and your provider’s recommendation. Some people find relief after several weeks, while others continue using a dilator for several months.

What are the benefits of vaginal dilators?

Vaginal dilators are safe and effective. Most people who have pain during sex feel some relief after consistent, regular use of a dilator. Dilators work by gently stretching and expanding your vaginal tissue over time. This improves its elasticity and reduces the pain you may feel with sexual intercourse.

What are the side effects of using a vaginal dilator?

The most common side effect is light bleeding, but the bleeding shouldn’t exceed light pink spotting. Call your healthcare provider if you experience heavy bleeding or bleeding for longer than 24 hours after using a vaginal dilator.

Other side effects of vaginal dilator therapy include mild discomfort. You should discuss your pain level with your provider to make sure you’re using the dilator correctly. Don’t continue using a dilator if you’re experiencing pain.

How long do dilators take to work?

It depends. How long you need vaginal dilator therapy depends on your symptoms. You should arrange regular follow-ups with your healthcare provider and/or a pelvic floor physical therapist while you’re using dilator therapy. Your healthcare provider will help you determine how long you may need treatment.

You might wonder if this type of therapy is working for you, and you may feel embarrassed or have negative perceptions about using a device inside your vagina. You should discuss these feelings with your provider, as they could impact the success of therapy.

Try to be patient with yourself as you explore different options with your provider. They’ll work with you to find a treatment that allows you to experience comfortable intercourse.

When should I call my healthcare provider?

If you have pain during sex, vaginal dilator therapy may be a safe and affordable at-home option for relief. Talk to your healthcare provider if you have pain during sex due to a medical condition, menopause or pelvic floor disorder. They may recommend using a vaginal dilator as part of your treatment plan.

A note from Cleveland Clinic

Sex shouldn’t hurt. If you have pain during vaginal penetration, vaginal dilators may be a good option for you. They work by stretching your vaginal tissue gradually, which eventually allows for a more comfortable sexual experience. You should start with the smallest size and work your way up to a larger size over time. Follow any instructions in the packaging, especially instructions on how to clean and insert your dilator. Even though you can purchase a vaginal dilator without a prescription, you should discuss using one with your healthcare provider.