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Why use dilators for atrophy?

Written by Emma McGeorge

Vaginal dilators, which are sometimes called vaginal trainers, are therapeutic tools for treating a number of reproductive and sexual issues. Vaginal dilator therapy involves inserting a vaginal dilator inside to help condition the vaginal tissue to stretch wider than they are currently, either due to issues with a woman’s pelvic floor muscles clenching the vagina too tightly or with vaginal tissues being too tight themselves.

The end goal is to make vaginal penetration, either during sex, while inserting tampons, or during pelvic exams, less painful and more comfortable.

What is Vaginal Atrophy?

One of the reasons that you might need to use a vaginal dilator is because of vaginal atrophy. Vaginal atrophy is often triggered by declining levels of the sex hormone estrogen, which controls many aspects of how your vaginal tissue works.

There are several things that might cause your body to experience a drop in estrogen levels, including perimenopause and menopause, surgery, pelvic radiation therapy, and chemotherapy. 

Estrogen keeps your vaginal walls plump and flowing with blood. A decrease in estrogen can cause your vagina to become dry, fragile and sensitive. Vaginal walls can become thinner and drier and lose elasticity. Sometimes your pelvic floor muscles may even shrink. The result is the condition known as vaginal atrophy. 

Vaginal atrophy has a number of complications. Vaginal atrophy can cause pain during sex (dyspareunia) as well as urinary discomfort and leaking. 

While vaginal atrophy is pretty common, it doesn’t mean it can’t be managed. Vaginal dilation therapy is an incredibly effective tool that can be used to proactively treat atrophy, help relax the pelvic floor muscles, and reduce pain.

Why Use Vaginal Dilators for Atrophy?

Vaginal dilators can be used to gently stretch the vagina walls, preventing narrowing and improving flexibility of the tissues. Because vaginal dilators come in a range of sizes you can work up from a smaller size to a larger size over time during vaginal dilator therapy. This gentle stretching can be incredibly helpful for women with lower estrogen levels as a proactive, preventative treatment for atrophy while also helping reduce instances of painful sex due to atrophy.

Vaginal dilators can also be used to retrain the body and vagina to relax when presented with stimulus around the vulva (known as desensitization therapy). If you have dyspareunia or vaginismus, dilators can help lessen pain and muscle spasms, and help you learn how to control, and relax, your pelvic floor muscles. They can also help you warm up to sex if you’re feeling apprehensive or need to prepare your tissues and muscles!

Types of Vaginal Dilators

You can make a vaginal dilator out of a number of different materials. Some are made from hard plastic, while others are made from silicone, latex, or another material. Each type of dilator has its own benefits and drawbacks, but in general we recommend silicone dilators for a number of reasons.

First, dilators made with medical-grade silicone have a natural texture. They’re softer than regular plastic dilators and feel more natural, making them easier to handle and insert. And because they have a natural texture that’s close to body tissue, a silicone vaginal dilator is incredibly comfortable and can help make your vaginal dilation therapy that much more effective.

These dilators also have a natural-feeling heft to them. Their natural weight allows for proprioceptive feedback - basically, making it easier for your body to recognize the dilator and relax. This is one of the most important aspects of treating issues like vaginismus, dyspareunia, or a pelvic floor dysfunction, as being able to relax means that it’s easier to fit the dilator completely inside you without having to worry about muscle tension making the process difficult or painful. 

Silicone also offers excellent temperature control. These dilators can be chilled in the fridge, used at room temperature, or warmed in hot water - whatever is most comfortable for you, this dilator can accommodate you. That’s why many feel that using silicone makes for the best vaginal dilators.

Silicone is also body safe. It’s not made with any nasty plastics, phthalates or BPA, so this makes any dilator safe to use without having to worry that you might be doing yourself harm while trying to help heal yourself.

The resiliency of silicone is also a great selling point when it comes to these types of dilators. You can use them for as long as you need without having to worry about them wearing out because the silicone makes them super resilient and durable.Be careful, though - if you use lubricant with your dilators, make sure to only use water-based lubes! This is because silicon-based lubricants can actually begin to break down the silicone used to manufacture your dilator - and that’s a big no-no.

Finally, these types of dilators are so easy to care for. Just a simple hand wash and air dry and they’re good to go, especially if you use a water-based lube that washes off easily. And if needed, they can also be sterilized, as well. However, regular washing after use is usually enough to keep these dilators clean and ready for their next use.

Using Vaginal Dilators Effectively

Whether you’re using a silicone one, one made of hard plastic, or any other type of dilator, they’re relatively easy to use. As many dilators come in sets of gradually increasing size, begin with the largest dilator size you can fit inside you with the least amount of discomfort. Depending on the amount of dilator therapy you need, this may be the smallest dilator in the set or one larger; what matters is that you can wear it comfortably. If necessary, use a healthy amount of personal lubricant to ensure you can insert the dilator safely.

From there, you will need to follow your doctor or physiotherapist’s instructions closely. They will tell you how long you should leave your dilator in for at a time, and how often you should train with it inside you. You may start wearing it for just a few minutes a day until you can tolerate it better before wearing it for longer, or wearing it multiple days every week.

Finally, once you and your doctor feel you have made progress with your currently-sized dilator, you can graduate up to the next largest in your dilator set and start the process all over again. This makes using dilators a process that requires patience and consistency, but the results pay off!