Many people do not need to use all the sizes in a dilator set, so how do you know which size you need? Although a pelvic health physical therapist can recommend the ideal size dilator to treat your symptoms, there are some useful tips to help you choose the dilator size you need.
Keep reading, to understand more about dilator sizes, how to choose the right dilator size for you, and when an entire dilator set is helpful.
What Are Vaginal Dilators?
Vaginal dilators are tube-shaped medical devices that are designed to improve the blood flow and elasticity of the vaginal walls, gently stretch the vaginal canal, improve natural lubrication, and restore pelvic floor strength.
Ranging in size from that of a mini tampon to an erect penis, the main goal of vaginal dilation therapy is to relieve discomfort during penetration (vaginismus) and reduce pain during sex (dyspareunia). Dilators are also used to help women recover from radiation treatment, as well as pelvic surgery, trauma, or pelvic injuries.
Although historically made from glass, then plastic, the most effective modern-day dilators are produced with medical-grade silicone for a softer, smoother, and more comfortable healing process. To ensure that you are purchasing authentic medical-grade silicone dilators, always check for FDA approval and registration.
Why Use Vaginal Dilators?
Due to a variety of conditions that result in pelvic pain, women of all ages can experience spasms of the pelvic floor during penetration or pain during intercourse. For some, it’s due to vaginal dryness after menopause or a particularly traumatic childbirth involving perineal tears.
For others, it’s due to vaginal stenosis after radiation treatment or pelvic surgery. A teenager’s fear of inserting tampons can trigger an ongoing fear of painful penetration, as can pelvic pain due to an underlying condition such as endometriosis or lichen sclerosus.
While the underlying cause is not always the same, dilators are helpful for women of all ages to relax vaginal tightness, improve the flexibility of dry vaginal walls, release psychological fears surrounding vaginal penetration, and ultimately prepare for more comfortable & pleasurable sex.
Vaginal Dilator Sizes: How Many Are There?
Vaginal dilators are typically sold in sets of 6-8 incrementally increasing sizes to allow for a slow and effective therapy, but they can also be purchased individually for women who might not need a full dilator set.
Normally starting with a size similar to a small tampon (0.45 inches in diameter x 2.8 inches long), dilators tend to gradually increase to the size of an erect penis (1.5 inches in diameter x 6.5 inches long).
For example, below are the sizes of Intimate Rose Silicone Dilators:
- 0.45 inches D x 2.8 L
- 0.7 inches D x 3.5 L
- 0.83 inches D x 3.7 L
- 0.95 inches D x 4.45 L
- 1.00 inches D x 5.0 L
- 1.07 inches D x 5.6 L
- 1.30 inches D x 6.1 L
- 1.5 inches D x 6.5 L
Dilator Sizes: Which Do You Need?
The success of dilation therapy largely depends on consistency with daily use, and beginning with the correct dilator size to treat your condition. If the starting dilator is too large it can result in additional pain and cause patients to stop dilating.
If pain was measured on a scale from 1-10, for instance, the level of pain experienced while using the first dilator should be lower than a 3 or 4. So essentially, it feels more like exercise or mild discomfort than pain. Patients typically use each dilator until they can comfortably insert the first dilator and leave it pain-free in the vagina for up to 15 minutes, before moving to the next size.
The best way to determine which dilator size is best for you is to schedule a consultation with either a pelvic health physical therapist or pelvic health occupational therapist, however, the following guidelines are also helpful to choose the ideal dilator size for you.
Smaller Size Dilators
If you are starting dilator therapy to relieve vaginismus, a condition that triggers the vaginal muscles to tighten at the thought of anything being inserted into the vagina, experts recommend beginning with the smallest dilator in a set.
Similarly, women recovering from radiation treatment, pelvic surgeries, injuries, or sexual abuse, would also be advised to start with the smallest dilator and gradually move toward their goal size from there.
Depending on the severity of perennial tears or episiotomies, new mothers might also be advised to begin with the smallest dilator in a set and work toward comfortably inserting a dilator similar in size to their partner’s penis. Before beginning dilation therapy after childbirth, it is always best to get the all-clear from your gynecologist.
Medium Size Dilators
Women experiencing ongoing discomfort during sex due to vaginal atrophy or pelvic floor pain who generally do not need to use the smaller-size dilators are advised to begin with a dilator that that they can tolerate which may be one that resembles the size of an index finger.
Becoming used to penetration with dilators that are smaller than your partner’s penis will encourage the vaginal muscles to relax, blood flow to increase, and the production of natural lubrication to be enhanced.
Larger Size Dilators
Sexually active women who suffer from dyspareunia, or ongoing pain during intercourse, are typically advised to start with a dilator 2-3 sizes smaller than the size of their partner’s erect penis to improve blood flow and increase the elasticity of the vaginal walls for more pleasurable sex.
They are then advised to work toward becoming comfortable with their goal size – that which most resembles their partner’s erect penis – over the following weeks/months.
As soon as sexually active women suffering from dyspareunia or vaginal dryness have progressed to dilating with a dilator size similar to their partner’s penis, many find it helpful to continue to dilate 15-20 minutes before sex. This pre-intercourse dilation helps to improve blood flow to the vaginal walls, relax any tightness, and enhance natural lubrication for a more enjoyable sexual experience.
The Largest Dilator
If your partner’s penis is not as big as the largest dilator in a set, then it may not be necessary for you to use it as part of your dilation therapy. Every woman is different when it comes to dilation therapy – set your goal, stay consistent, and you will see results.
What If You Feel Pain While Dilating?
Some pain will be felt when a dilator is first inserted, and depending on your symptoms or underlying condition the initial few minutes can feel quite intense for some.
As you practice calming breathing, however, the vaginal tissues will begin to relax and this initially intense pain should subside within a few minutes, to a level of 3 or 4 out of 10. If you experience intense pain for the duration of your session, you might need to drop down a size in dilators to become more comfortable.
When Do I Need to Buy a Full Set of Dilator Sizes?
The answer depends on what symptoms you want to treat. Some patients, as in the cases mentioned above, only need 2-3 dilators to regain their confidence in pain-free sex, while others may need the complete set.
Most women recovering after surgery for cervical cancer, vaginal septum, or an imperforate hymen are advised to work with a complete set of dilators, as are women recovering from radiation treatment or transgender (gender affirming) surgery. A full set of dilators is also recommended for women healing from severe dyspareunia, traumatic pelvic injuries, or sexual abuse.
Varying in size from a small tampon to an erect penis, vaginal dilators are used to relieve vaginal and pelvic pain associated with various female conditions. A full set of vaginal dilators is typically recommended to recover from vaginismus, severe dyspareunia, vaginal surgery, radiation treatment, or sexual abuse. Whereas 2-3 individual dilator sizes are often sufficient to treat vaginal dryness after menopause or mild dyspareunia.
To learn more about dilator sizes and which size you need, read above, or schedule a consultation with a pelvic rehabilitation specialist near you.
Healthline - Vaginal Dilators 101: Everything You Want to Know - https://www.healthline.com/health/womens-health/vaginal-dilators
Science Direct - Low Dose, High Frequency Movement Based Dilator Therapy for Dyspareunia - https://www.sciencedirect.com/science/article/pii/S2050116121000246
BMC Women’s Health - Women’s experiences of using vaginal trainers (dilators) to treat vaginal penetration difficulties diagnosed as vaginismus: a qualitative interview study- https://bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-015-0201-6
My Health Alberta – Female Sexuality & Cancer: Vaginal Dilators https://myhealth.alberta.ca/cancer-and-sexuality/female-sexuality-and-cancer/vaginal-tightness/vaginal-dilators
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/
Dr. Barb DePree, M.D., has been a gynecologist and women’s health provider for almost 30 years and a menopause care specialist for the past ten.