A vaginal dilator is a tool that may reduce pain from sex - here's why a doctor might recommend it for you

• A vaginal dilator is a device that allows you to gradually stretch your vaginal opening.
• They usually come in sets, so that you can start small and increase the size when you're ready.
• Vaginal dilators help treat conditions like vaginismus, vulvodynia, and vaginal atrophy.

Vaginal dilators can help you get back to your sex life after a major surgery, medical condition, or menopause.

Believe it or not, the vagina can significantly shrink in size, making sex too painful to withstand. That's where vaginal dilators can help stretch out the vaginal opening and elongate and stretch the vagina.

Here's what you need to know about why you might need a vaginal dilator and how to use one.

What is a vaginal dilator?

Vaginal dilators usually come in sets of various sizes, which gives you the option to start small and work up slowly. The smallest dilators can be the size of a small pinky finger, while the largest can be about six inches long and 1.9 inches wide.

Vaginal dilators are generally made from either silicone or hard plastic. Though the softer silicone models may seem more comfortable, experts advise that hard plastic may be more effective to stretch out your vaginal muscles.

When choosing a dilator, it's best to talk to your doctor, who can give you advice based on your medical condition. "The type and size of the dilator that is recommended varies based on the underlying vaginal anatomy," says Anne-Marie Amies Oelschlager, MD, an OB-GYN at Seattle Children's Hospital.

Your doctor may have vaginal dilators available in their clinic, or you can find options online, like the Soul Source or VuVa dilators.

What are the benefits of a vaginal dilator?

"Vaginal dilators are a very effective therapy for many conditions," Amies Oelschlager says. In some cases, using a dilator can even prevent the need for surgery.

They may also help improve a person's sex life. "The dilators can make the vagina wider and longer, this can make sex more comfortable for many people," Amies Oelschlager says.

Some medical conditions that can be treated with a vaginal dilator include:

Vaginal agenesis is a birth defect that occurs when your vagina doesn't develop fully, leaving you with a very short vaginal cavity. Using a vaginal dilator can help stretch out your vagina so it's long enough for you to have penetrative sex.

Vaginal stenosis occurs when scar tissue develops in your vagina, causing it to become narrower and shorter. This can be related to prior surgery, cancer treatment, or diseases of your vaginal tissue, Amies Oelschlager says. A vaginal dilator can help break down the scar tissue in your vagina and stretch the walls.

Vaginoplasty is a surgery in which a vagina is created from your genital tissue, usually as a part of gender confirmation surgery. For the first few weeks after your surgery, you will need to use a dilator to maintain the depth and width of your new vaginal canal.

Vaginismus is a condition in which the muscles at the entrance of your vagina tighten painfully during penetration either from a tampon or during sex. Using a vaginal dilator can help retrain and desensitize your muscles and encourage blood flow to your vaginal walls.

Vulvodynia is a painful condition of the vulva and vagina causing burning, stinging, itching, throbbing, swelling and soreness Using vaginal dilators can help gently stretch the vaginal opening and vagina making it easier to have penetrative sex.

Vaginal atrophy happens when your vaginal walls grow thinner, drier, more fragile, and less elastic. This most often occurs after menopause when your estrogen levels naturally decline. However, your estrogen levels can also drop when:

o You're breastfeeding

o You're using hormonal birth control

o Your ovaries are removed

o You're getting chemotherapy or radiation treatment for cancer

Using a vaginal dilator along with pelvic floor exercises can help stretch and stimulate your vaginal muscles to reverse any narrowing.

How to use a vaginal dilator

You need to follow instructions carefully when using a vaginal dilator, and it may help to get a tutorial from your doctor.

"It is important that people learn how to use dilators properly so that they do not cause trauma to their urethra," Amies Oelschlager says.

To use a vaginal dilator, follow these steps:

1. Make sure your dilator is clean.
2. Lie down on your back with your knees slightly bent and your feet flat on the bed or floor. Make sure you can easily reach your vaginal opening.
3. Relax your pelvic floor muscles (the muscles you use to hold your urine) by taking a few deep breaths and focusing on squeezing and releasing the muscles.
4. Spread a water-based lubricant on the dilator and your vaginal opening.
5. Start with the smallest size dilator - slowly and gently insert the dilator at a straight or slightly downward angle.
6. Keep inserting the dilator until you feel any tension or discomfort, then stop and leave the dilator in this spot. If you don't feel any tension at all, you may need to use a larger size.
7. Squeeze and release your pelvic floor muscles to help relax them. Each time you release, try gently sliding the dilator further in.
8. If the dilator can't go in any further, take a few deep breaths and try again.
9. Once you've reached your limit, try moving the dilator in and out in addition to making horizontal circles at different depths. Do this for five to ten minutes, adding more lubricant as needed.
10. Gently remove the dilator from your vagina.
11. You may want to pee before and after removing the dilator to prevent urinary tract infections.

After using a vaginal dilator

It's normal to have a small amount of bleeding after using a vaginal dilator, but if your bleeding soaks a pad or goes on for longer than one day, reach out to your doctor.

How often you need to use your dilator will depend on what condition you're treating, and it's best to ask your doctor for specific instructions. In many cases, it's best to use vaginal dilators 3 to 4 times per week.

"Dilation may be recommended daily for many months and then some conditions require maintenance dilator therapy throughout their lifetimes," says Oelschlager.

It's important to properly clean your dilator after use to get rid of any bacteria that could cause infection. "We usually recommend that they are cleaned with a gentle soap and water after use," Oelschlager says.

You should also store vaginal dilators in a cool location, as some dilators can melt or change shape with excessive heat.

Insider's takeaway

Vaginal dilators can be helpful for many conditions that cause your vaginal muscles to narrow or react abnormally. But there are specific steps you need to follow to make sure that you use your dilator safely and effectively.

"If you have a condition where vaginal dilators may help, I would recommend seeing a health care provider who has experience coaching and supporting patients through the process," Oelschlager says.