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Rectal & Anal Dilators

Written by Emma McGeorge

When your doctor recommends trying rectal dilators to relieve anal tightness or rectal spasming, you might feel awkward about it, maybe even embarrassed, but rest assured you are not alone. Millions of people experience anorectal conditions each year and rectal dilators are an effective treatment for relieving symptoms. Read on, to learn all about anal and rectal dilators, which conditions they treat, when to use them, how to use them, and how to stop using them safely. 

What Are Anal & Rectal Dilators? 

Anal or rectal dilators are specifically designed tools to relax tight muscles around the rectum, open the anal canal, and relieve pain in the pelvic floor. Available in sets of ascending sizes, rectal dilators are used in a gradual process, slowly stretching the rectal tissues and muscles over time.  

While they are also used for pleasure by some, rectal dilators are typically used in conjunction with physiotherapy and rehabilitation to treat anorectal conditions, such as the following: 

  • Chronic pelvic floor pain
  • Levator ani syndrome
  • Strictures or stenosis
  • Functional constipation
  • Proctalgia fugax
  • Hemorrhoids, or fissures
  • After anorectal cancer surgery

Chronic Pelvic Pain 

Chronic pelvic pain is usually a symptom of a gynecological issue such as endometriosis, dyspareunia, vaginismus, or cervical cancer surgery. Regularly used in association with pelvic floor physiotherapy, rectal dilators are considered highly successful instruments to relieve chronic pelvic pain by relaxing and stretching tight pelvic muscles. 

Especially effective in relieving pain after a pelvic injury or sexual discomfort from pelvic trauma, rectal dilators can also help to soothe painful pelvic trigger points and alleviate pelvic pain to make sitting more comfortable. 

Levator Ani Syndrome

Levator ani syndrome is a condition described as chronic pain in the anus due to tight muscles in both the pelvic area and the anal region. Caused by a spasming of the levator ani muscle, symptoms typically include recurring chronic rectal pain lasting at least thirty minutes each time, a severely tender puborectalis muscle, and difficult bowel or bladder movements, as well as bowel or bladder incontinence, and pain in the rectum after sex for women.

Using rectal dilators can help to manage symptoms and reduce the pain associated with levator ani syndrome by gradually stretching the affected muscles.   

Stricture or Stenosis

Anal stricture, which is also referred to as anal stenosis, is described as a contracting, tightening, or narrowing of the anal canal to the point that passing a stool is severely painful. Known to occur after cancer treatments or surgery, anal stenosis is also a common symptom of Crohn’s disease. 

To prevent stenosis from becoming a severe problem, where the patient is unable to excrete anal waste, rectal dilators are used to relax tight anal muscles, widen the anal canal, and allow the rectum to passively constrict and release to pass stool.  

Functional Constipation

Described as chronic or long-term constipation, functional constipation is a medical condition that is usually the result of an underlying condition. While the cause is typically investigated by eliminating several other conditions, rectal dilators can be used to manage functional constipation in the interim and to heal the rectal and anal muscles once the cause has been diagnosed. 

Proctalgia fugax 

Described as a sharp pain that comes and goes in the anus and lower rectum, proctalgia fugax is known to last from a few seconds to a few minutes. While the cause remains unclear, it is believed to be connected to an involuntary tightening of the sphincter muscle that is known to occur after sclerotherapy to treat hemorrhoids. Proctalgia fugax has also been linked to the recovery period after vaginal hysterectomies when healing muscles can spasm and result in shooting pain. 

Rectal dilators help to treat proctalgia fugax by relaxing the tightness of the sphincter muscle and rectal tissues, which in turn reduces the recurring pain. 

Hemorrhoids or Fissures

Anal fissures are tears or cuts around the anal skin known as andoderm, which is abundant in nerves and particularly sensitive to touch and pain. Typically caused by a large bowel movement or rough anal sex, anal fissures often result in severe pain.  

Hemorrhoids, also known as piles, is a common condition that affects over 10 million people annually. Essentially forming as swollen veins in the lower rectum, hemorrhoids can present inside the rectum (internal hemorrhoids), resulting in rectal bleeding, or under the skin surrounding the anus (external hemorrhoids), causing muscle spasms, tightness, and pain in the rectum. 

Dilators are helpful to relieve the spasms caused by hemorrhoids or fissures that would otherwise continue to tighten the anorectal muscles and tissues, and ultimately require surgery to correct.  

Anal or Colorectal Cancer Surgery

After surgery for anal cancer or colorectal cancer, rectal dilators are often used to rehabilitate rectal muscles and widen the anal canal to allow for smoother bowel movements. This is achieved by gradually stretching the anal and rectal muscles with dilation therapy, as well as massaging scar tissue and adhesions after radiation treatment. 

How To Use Anal Dilators

While using anal or rectal dilators can feel uncomfortable at first, patients typically settle into a routine practice once they feel the muscles relaxing. Before beginning, your physiotherapist or healthcare provider will recommend which dilator size to begin with, as well as discuss detailed instructions on how to use your dilators. 

For reference, instructions on how to use the Intimate Rose Rectal Dilators, which are made with medical-grade silicone for added comfort, are as follows: 

Preparing Anal Dilators for Insertion

  • Before starting each session, always wash your hands as well as your rectal dilator with mild soap and warm water to ensure it is clean, and gently pat it dry with a towel.  
  • Decide on a quiet and private space for your rectal dilator sessions i.e. your bed, bedroom floor, or the study floor on a yoga mat. 
  • Next, find a comfortable position that suits your body. Not every person will find the same position agreeable, so experiment to find the most relaxing posture for you. The most comfortable positions recommended by physiotherapists are; laying on your back with the knees bent, lying on your left side with your hands on your knees, or a deep squatting position.  
  • Once you’ve found the most comfortable position, gently rub 1-2 tablespoons of water-based lubricant around the anus and another 1-2 tablespoons on the tip of the rectal dilator that your physiotherapist has recommended as your starting size. (Note: Never use petroleum or silicone-based lubricants with your Intimate Rose rectal dilator or it will damage the medical-grade silicone.)  

How To Insert Anal Dilators

Once you’ve prepped your dilator as described above and decided upon the most comfortable position, you are ready to insert your dilator. 

  • Place the tip at a 45-90 degree angle to the rectum. You may notice some natural resistance in the anus here, but breathing deeply and calmly will help. 
  • Take an inhale through the nose and as you exhale through the mouth, gently push the tip of the dilator into the anus. Keep breathing deeply but gently and ease the dilator deeper into the rectum with each exhale.     
  • Once the rim base of the dilator touches the outer skin of the anus, it is fully inserted. Stay still, don’t attempt to walk around, and continue to breathe deeply and gently, allowing yourself, your muscles, and your nervous system to relax while the dilator is in place. 

How Long Do Anal Dilators Stay Inserted?

How long the dilator is left in the rectum will depend on your dilation goal and the advice of your doctor or physiotherapist. Depending on your condition, sessions generally start with a few seconds twice per day and incrementally increase to 30 minutes per day. 

How To Remove Rectal Dilators Safely

  • Just as you eased the rectal dilator gently into the rectum with deep breathing, it should also be removed gently, releasing little by little with each breath. You can also gently bear down as if you were trying to pass gas quietly.  
  • After each rectal dilator session, make sure that you wash your dilator with mild soap and warm water again, before patting it dry with a clean towel. 
  • Lastly, keep your dilators somewhere safe and never share them with another person.

Moving To the Next Size Rectal Dilator

Using rectal dilators is a gradual process, typically beginning with the smallest dilator in the set. As a general rule, once the smaller dilator is easy to insert without feeling any pain or discomfort, it is time to move up to the next size dilator. Changing to the next size rectal dilator can feel a little uncomfortable to start with, but the discomfort will usually subside within a few days. 

To ease into the next size rectal dilator it can help to use the larger size for a minute or two at the end of your session with the smaller dilator. This will help the rectal and anal muscles to get used to the bigger size. A little bleeding is to be expected when moving to the next size anal dilator, however, if excessive bleeding occurs or the pain is not subsiding, contact your healthcare provider for guidance.   

How To Stop Using Rectal Dilator Safely

To experience the true benefits of rectal dilator therapy, it is vital to commit to regular practice until relief is ongoing and you’ve reached your goal. Then your physical therapist will advise you on how to wean yourself off your dilator therapy. Usually a maintenance program of 2-3 times per week is advised for 2-6 months or longer if needed. 

It’s important to understand that you cannot stop using a rectal dilator from one day to the next. Typically, once you have reached your goal, your dilation routine will continue over the coming months but become less frequent as time passes.  

For some, the weaning period can result in a return of the original symptoms, but this is usually nothing to worry about. For most, it simply means returning to the practice of daily dilation for a prolonged period, and as soon as any returning symptoms are relieved, you will be advised by your healthcare practitioner to wean yourself off the dilators once again.  


While sometimes used for pleasure, anal & rectal dilators are medically used in conjunction with physiotherapy for pelvic floor disorders, rehabilitation after anorectal surgery, or as a treatment for symptoms associated with anorectal conditions. When used correctly, as described above, rectal dilators help to open tight anal canals, reduce rectal spasming and pain, as well as alleviate hemorrhoids, bowel obstructions, and severe constipation. 

If you can relate to any of the above-mentioned conditions or symptoms, make an appointment with your doctor to discover if rectal dilators are right for you. 


National Library of Medicine – Common Anorectal Disorders - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4076876/

Science Direct - Anal Stenosis - https://www.sciencedirect.com/science/article/abs/pii/S0002961000003445

Web-MD – What Is Proctalgia Fugax - https://www.webmd.com/digestive-disorders/what-is-proctalgia-fugax

Cancer.Org – Colorectal Cancer - https://www.cancer.org/cancer/colon-rectal-cancer/about/key-statistics.html