The vagina can lose elasticity or become excessively narrow due to a number of conditions. When this happens, sex can become painful and urinary function can be impaired. Loss of vaginal elasticity also presents challenges for a woman and her health care provider during a routine pelvic exam or when there is a need for vaginal medications, which can lead to serious health consequences.
In these instances, a vaginal dilator may be useful. Unfortunately, many women are reluctant to use vaginal dilators due to insufficient education or feelings of embarrassment, modesty, or anxiety, as well as fear of pain or fear that dilators may cause damage. These factors have limited the use of vaginal dilators.
In this article we’ll discuss some of the circumstances in which a vaginal dilator may be recommended and how it can help.
What Is a Vaginal Dilator?
A vaginal dilator is a device that gently restores elasticity to the vagina so that it can function properly. Dilators are round-tipped cylindrical devices made of either flexible silicone or a hard plastic material. Your vaginal dilator will most likely consist of a kit made up of several dilators of progressively larger sizes, starting as small as ¾” in width up to the width of an erect penis. This allows you to start with a size that is snug without being painful and gradually increase the dilator size.
Should You Be Using a Vaginal Dilator?
Some of the conditions in which a woman may choose to use a vaginal dilator or vaginal dilator therapy may be recommended by a health professional include:
Advanced Age
Decline in estrogen levels as you transition through menopause causes the vagina to atrophy and become less pliant. Vaginal dilator therapy has been found to help restore the ability of menopausal women to have comfortable sexual intercourse.
Radiation Therapy
Pelvic radiation treatment for cancer can cause scar tissue to develop in the vagina, leading to narrowing and decreased elasticity. Studies have shown that using a dilator before scar tissue and vaginal narrowing set in is a safe and effective preventative strategy and is considered a “best practice”.
Vaginal Surgery
In women, pelvic surgery for conditions such as urinary incontinence, prolapse of the uterus or vagina, or vaginoplasty – procedure used to repair vaginal injury or create a vagina as part of gender confirmation surgery can lead to vaginal scarring and narrowing.
Inflammatory Diseases
Certain diseases may cause inflammation of the vaginal wall; for example, lichen planus, a systemic inflammatory immune condition that causes swelling of the skin and mucous membranes and may cause painful sores in the vagina.
Vaginismus
An anxiety-based disorder, vaginismus results in painful vaginal spasm in response to any type of attempted vaginal penetration, including the use of tampons, manual pelvic exams, the use of a speculum during a medical procedure, or sexual intercourse. During treatment for vaginismus a dilator may be used under sedation, or an indwelling dilator may be placed in combination with other forms of therapy to address the underlying anxiety issue.
Vaginal Agenesis
This is a congenital condition in which the vagina doesn’t fully develop, resulting in a narrow vaginal opening or a shortening and/or narrowing of the vagina. A vaginal dilator can help stretch the vaginal wall and increase the size of the vaginal canal.
Benefits of Vaginal Dilators
Vaginal dilator therapy offers a range of potential health benefits, including:
Overcoming Emotional Barriers
Experiencing the benefits of vaginal dilation often means first getting past anxiety and other emotional barriers or aversions. A study of girls and women with genital agenesis found that lack of motivation, uncertainty about whether the therapy will work, and viewing the dilator as a negative reminder of their condition were prominent barriers to dilation therapy. With education on proper use along with counseling more participants were able to use and benefit from dilator therapy.
Resolving and Preventing Secondary Health Effects
Depending on the cause, vaginal narrowing can lead to a variety of secondary physical health complications including urinary retention or incontinence, constipation or diarrhea, spontaneous bleeding, vaginal discharge, and odor. Women who use vaginal dilators have reported significant improvement in these symptoms.
Providing an Alternative to Surgery
In some instances, at-home dilation therapy is offered or suggested as an alternative to vaginoplasty. A study that tracked the results of each found that women who opted for dilation therapy reported greater genital and overall body image satisfaction than their counterparts who underwent surgery. Additionally, problems with lubrication were less prevalent in the dilation group compared to the surgery group.
Counteracting Menopause-Related Atrophy
Though more studies are needed on the benefits of vaginal dilators for peri- and postmenopausal women, the available data show it may help counteract menopause-related vaginal atrophy and alleviate pain during intercourse..0