Vaginal dilators, also known as spacers or vaginal trainers, are used to reduce the pain that some women experience during vaginal penetration or sexual intercourse. If vaginal dilator therapy has been suggested for you, read on to learn more about spacers for sex, the different types, uses, and how to master using them at home.
Commonly used as part of pelvic floor physical therapy, spacers for sex, or vaginal dilators, are tube-shaped medical devices of varying lengths and widths with rounded tips. Designed to be inserted into the vagina, their function is to slowly relax tight tissues and restore vaginal muscles for more comfort during sex. Made from either plastic or silicone, vaginal dilators are normally sold in sets of ascending sizes, allowing users to start by inserting the smallest size and gradually work up toward the larger sizes.
Although dilator therapy usually begins with the guidance of a physical therapist at their clinic, patients are typically advised to continue with treatment at home until the vaginal opening and canal no longer feel tight upon penetration.
Although there are several types and brands of vaginal dilators, most are made from either plastic or silicone. While plastic dilators tend to be firm and inflexible, silicone dilators are reported by users to be softer with a more flexible and human-like feel.
The most effective dilators come in sets of ascending sizes, as recommended by pelvic health physical therapists, allowing users to start with the smallest size (roughly the size of a small female finger) and work up to the next size once the vaginal muscles feel adequately relaxed.
Some vaginal dilators come with a handle while others are equipped with a lip at the end to let users know that the dilator has been fully inserted. While some women prefer a handle to hold the dilator in place, others find it more comfortable to insert as far as the lip and then relax without having to hold the dilator.
Spacers or vaginal dilators are primarily used to relax any tightness in the vulvar, vaginal & pelvic areas to allow for more pleasurable penetration and a better quality of sex life for women and their partners.
They are also used to rehabilitate the female sex organs after pelvic trauma, cancer treatment, gender reassignment, childbirth, surgery, and menopause. Surgical procedures to remove a vaginal septum, open an imperforate hymen, or remove cervical cancer, for example, are typically followed up with vaginal dilator therapy to reduce scar tissue, increase blood flow, and relax tight muscles during the healing process.
Medical conditions that can cause painful vaginal penetration also benefit from dilator therapy, such as Interstitial Cystitis, Lichen Sclerosis, Painful Bladder Syndrome, Vaginal Stenosis, and Vulvodynia. Some women who do not experience vaginal tightness or pain also choose to use vaginal dilators to keep their genital tissues healthy and flexible as they age.
Additional female conditions that are helped by the use of vaginal dilators include the following:
Dyspareunia refers to a recurring pain or discomfort in the female genitals either before, during, or after vaginal penetration. For some women, the discomfort begins at the mere thought of penetration, while for others the pain manifests during sex and lingers afterward. Dyspareunia is typically the result of an underlying condition such as atrophy, endometriosis, irritable bowel syndrome, injuries sustained during childbirth, uterine fibroids, or vaginitis. Symptoms include pain in the vulva (outer genitals), or internally in the uterus, vagina, or pelvis.
Vaginal dilator therapy not only helps to relieve the anxiety or pain associated with dyspareunia it can also help to treat some of the underlying conditions that cause it.
Affecting upward of 10% of women of childbearing age, endometriosis is considered a painful condition that causes severe discomfort during menstruation and sex. Diagnosed when the tissue normally found on the inner lining of the uterus begins to grow outside the uterus and wraps around the pelvic organs, endometriosis is also known to affect the rectum, bowel, bladder, and urinary tract in rare cases.
When it comes to treating endometriosis to enjoy a better sex life, vaginal dilators can firstly help to relax tight muscles, which in turn reduces the pain. Scar tissue that forms on the pelvic organs due to endometriosis is also softened by dilators, and psychologically speaking, women begin to feel more confident about vaginal penetration without pain.
MRKH syndrome is a rare genetic disorder that affects the female reproductive system and results in an underdeveloped or non-existent vagina or uterus. The external genitalia for women with MRKH syndrome appear perfectly normal, and the ovaries typically function well too, but due to the absence of a vagina or uterus menstruation and pregnancy do not occur, and sex can be painful.
Some women with MRKH syndrome opt for a surgical procedure called sigmoid colovaginoplasty to enjoy more pleasurable sex, however, vaginal dilator therapy, or spacers, are used as a non-surgical option. By gradually deepening the vaginal canal with dilators, a “neo-vagina” is formed and allows women with MRKH syndrome to experience an improved sex life.
Research has shown that although only 15% of women experience vaginal atrophy (dryness) before menopause, as many as 57% of women experience it after menopause due to the substantial drop in estrogen. Vaginal dryness often results in a thinning and narrowing of the vaginal walls, which leads to a tight or painful feeling during penetration or sex.
If you are suffering from vaginal dryness due to menopause, vaginal dilators will help to restore elasticity to your vaginal tissues and relieve pain or discomfort during sex.
Vaginismus is described as an unintentional tightening or spasming of the pelvic floor and vaginal tissues at the thought of vaginal penetration. The spasming can be triggered by trying to insert a tampon, the thought of a gynecological exam, or sexual penetration. Symptoms include feelings of anxiety, a constriction of the vaginal opening, a burning sensation upon penetration, and the sensation of the penis hitting a barrier within the vagina during penetrative sex.
Using vaginal dilators can help to relieve the anxiety that triggers the spasming associated with vaginismus and give previous sufferers the confidence to enjoy a healthy sex life. By gradually moving through the ascending sizes of dilators, blood flow to the vaginal tissues increases, tight muscles relax, natural lubrication is elevated, and penetration becomes more comfortable.
Although it is always best to seek the guidance of a pelvic floor physical therapist or gynecologist before starting vaginal dilator therapy, the following guide gives clear instructions on how to master using your vaginal dilator at home.
1. Always wash your vaginal dilator with warm water and soap before using it.
2. Designate a private place in your home where you feel safe and will not be interrupted.
3. Drizzle or rub a generous amount of water-based lubricant over the dilator as well as the entrance to your vaginal opening. (It is important to use a water-based lubricant to protect the medical-grade silicone of Intimate Rose Vaginal Dilators.)
4. Select the size recommended to you by your pelvic floor physical therapist, or start with the smallest size dilator.
5. Lie down on your back, on your bed, on a yoga mat, or on some comfortable blankets with your knees bent and feet planted on the floor. Some patients prefer to lie on their sides with the knees bent and a cushion or pillow placed between the knees to support the upper leg.
6. As you inhale, allow your belly to expand and as you exhale, allow your belly to drop. Continue to consciously breathe like this for a few more breaths to relax the vaginal opening with each exhale.
7. When you feel ready, bring the tip of the dilator to the vaginal opening, and during the next exhale, gently insert the tip. As you continue to breathe calmly, ease the dilator into the vagina with each exhale until the lip at the end reaches the vaginal entrance.
8. Continue to breathe deeply and calmly, relax your shoulders, allow your body to sink into the support of the floor beneath you, and leave the vaginal dilator inserted in the vagina for 10-15 minutes, or however long your healthcare practitioner recommended.
9. Once you become comfortable inserting each dilator, it's helpful to practice insertion in different positions to mobilize the organs around the vaginal canal and encourage a gentle and gradual stretching of the tissues. As well as laying on your back or your side, recommended positions include a deep squat and a table-top position with your hands and knees on the floor.
10. It is also helpful to gently press the dilators against the walls of the vagina by imagining the opening of the vagina as a clock and slowly moving the dilator in a circular position. Pause at each “hour” of the clock, gently compressing the dilator against the vaginal wall in each position.
Spacers, vaginal trainers, or vaginal dilators are medical devices used to alleviate anxiety or pain surrounding vaginal penetration and improve women’s sexual experience after surgery, childbirth, sexual assault, pelvic trauma, and menopause.
If you can relate to any of the conditions discussed above, you don’t have to continue living with the pain. Contact a pelvic floor physiotherapist in your area about the possibility of vaginal dilator therapy today.
Mayo Clinic – Dysapeurnia - https://www.mayoclinic.org/diseases-conditions/painful-intercourse/symptoms-causes/syc-20375967
Endometriosis Foundation of America – What Is Endometriosis - https://www.endofound.org/endometriosis
My Health Alberta – Female Sexuality & Cancer: Vaginal Dilators https://myhealth.alberta.ca/cancer-and-sexuality/female-sexuality-and-cancer/vaginal-tightness/vaginal-dilators
Cleveland Clinic - https://my.clevelandclinic.org/health/diseases/15723-vaginismus
National Library of Medicine - Management of Recurrent Stricture Formation after Transverse Vaginal Septum Excision - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4442265/
National Library of Medicine - Dilator Use following Vaginal Brachytherapy for Endometrial Cancer: A Randomized Feasibility and Adherence Study - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5650953/
National Library of Medicine - Low Dose, High-Frequency Movement Based Dilator Therapy for Dyspareunia: Retrospective Analysis of 26 Cases - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8240346/