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Pelvic Health

Dilators for Atrophy: Why You Should Use Them

Dilators for Atrophy: Why You Should Use Them

by Dr. Barb DePree, MD

Vaginal atrophy can occur as a result of several causes but is particularly common during menopause, post menopause, after childbirth, or while breastfeeding due to a drop in estrogen levels. Regularly linked to discomfort during penetration and painful sex, many women refrain from speaking with their doctor about vaginal dryness due to embarrassment.

The good news is, effective treatment options are available and atrophy is not something you have to live with. 

In this article, we’ve outlined how using vaginal dilators in the privacy of your own home can help to relieve vaginal atrophy and reignite your sexual pleasure, no matter what age you are.  

What is Vaginal Atrophy?

Vaginal atrophy, which is also referred to as atrophic vaginitis, describes the occurrence of the vaginal walls become thinner, dryer, or inflamed due to a drop in the body’s production of estrogen. In addition to vaginal dryness, symptoms of atrophy can also include vaginal itching or burning while peeing, as well as painful sex (dyspareunia), frequent urinary tract infections, and urinary incontinence. 

What Causes Vaginal Atrophy? 

As well as its vital role in the female reproduction process, estrogen is also linked to the retention of moisture in the body. Normal levels of estrogen help to maintain the thickness and elasticity of the vaginal walls and vulva, as well as vaginal lubrication, for example.

When estrogen levels are high before menstruation, many women will retain more fluid, which is effectively what causes PMS bloating. When estrogen levels drop, on the other hand, moisture retention lowers too, which can result in vaginal atrophy as the vaginal walls become thinner, dryer, and inflamed. 

Menopause, giving birth, and breastfeeding are natural causes of vaginal atrophy, however, several other factors or life situations can also be associated with atrophy. These include: 

  • Acute stress
  • Anti-estrogen medication to treat other conditions
  • Chemotherapy 
  • Endometriosis
  • Hysterectomy or ovary removal 
  • Pelvic radiation treatment
  • Severe depression 

Atrophy Due to Menopause

Although vaginal atrophy can be regularly caused by the life events mentioned above, it is most common during perimenopause, menopause and post-menopause when hormone levels in the female body undergo a natural change. 

In addition to the vaginal walls becoming dryer, thinner, and less flexible, vaginal atrophy can cause the vaginal canal to narrow and shorten during menopause, contributing further to the sensation of pain during sex. On top of the pain during intercourse, vaginal atrophy in menopausal women can also be accompanied by dry eyes, dry mouth, and dehydrated or itchy skin. 

When urinary tract infections (UTIs) and/or urinary incontinence occur in connection with vaginal atrophy during menopause, medical professionals will typically diagnose Genitourinary Syndrome of Menopause (GSM) due to the additional symptoms. 

However, just because women are diagnosed with GSM or vaginal atrophy during menopause, it does not mean that they have to live with it or abstain from sex for the rest of their lives. Vaginal dilators are not only a safe and effective treatment for vaginal atrophy they also allow women to return to a comfortable and pleasurable sex life post-menopause. 

Using Dilators for Atrophy 

Dilators can be used to naturally treat atrophy. Dilators are medical devices that are inserted into the vagina to help stretch the vaginal muschles and expand the tissues to reverse narrowing. Using dilators regularly can help the muscles and tissues over time reducing many of the symptoms of atrophy. 

How Do Dilators Work?

Beginning with the smallest dilator in the set, a generous amount of lubricant, and a relaxed rhythm of breathing are used to slowly and gently inch the dilator into the vaginal canal on each exhale. Once the dilator is inserted, holding it there for 1-15 minutes allows both the brain and the body to get used to the feeling of something inside the vagina. 

As soon as the smallest dilator can be inserted and held in the vagina for 15 minutes, patients are encouraged to move to the next dilator in the set, and so forth, until pain and dryness have been alleviated. The entire process can take anywhere from a few weeks to a few months, depending on the condition.  

During this process of vaginal dilator therapy, blood flow to the vaginal tissues gradually increases, vaginal tissues begin to relax & stretch, and natural lubrication is improved, thus reducing atrophy and pain.

Where to Buy Vaginal Dilators

Vaginal dilators made from plastic and silicone are widely available for purchase online, however, that does not mean every dilator online is safe or effective. For instance, although dilators were mainly made from plastic in the past, dilators made from medical-grade silicone, with FDA registration, are the best vaginal dilators in today’s market. 

Medical-grade silicone is not only safer for ultra-sensitive vaginal skin it is also more comfortable, more effective, and easier to use than its plastic counterpart. Intimate Rose silicone dilators, for example, are described as soft, smooth, and flexible but still firm enough to exude the perfect amount of pressure against thin, dry, or inflamed vaginal walls to improve blood flow and increase natural lubrication.

In contrast, plastic dilators are more commonly described as hard, rigid, and unbending, with many customers suffering from bruising and additional irritation after use. 

Some online brands also profess to sell medical-grade silicone dilators when in reality their dilators are made from rubber or a poor grade of silicone. While other dilators, designed by entrepreneurs instead of pelvic health specialists, are made too long or too pointy to be comfortable within a shortening vaginal canal associated with vaginal atrophy during menopause.   

A good way to ensure that you are buying a safe and effective set of vaginal dilators is to check that the brand has registered FDA approval on their medical-grade silicone dilators, that their website provides informative advice & guided instructions, and that they will directly answer your questions when needed. It is also helpful to confirm with your physical therapist or pelvic health rehabilitation specialist that the dilators you intend to purchase will be effective for your condition.   

How Long Does It Take for Dilators to Relieve Atrophy?

Vaginal dilator therapy to relieve vaginal atrophy - and the associated symptoms such as painful sex, UTIs, or anxiety surrounding penetration - is a journey that will vary from person to person.

Depending on the diagnosis, pelvic health specialists generally estimate that patients use each size dilator three times a week, with a day's rest in between, for a few weeks before moving to the next size. It is therefore realistic to expect a feeling of relief from pain and dryness within a few months.    

That said, how long it takes to alleviate vaginal dryness can also depend on how long the condition has been left untreated. For example, treating vaginal atrophy after a few years will likely take a little longer than treating atrophy after a few months. 

The best advice when it comes to using dilators is to remain patient and consistent. Over the last 80 years, vaginal dilator therapy has been proven to be enormously effective in treating vaginal atrophy, and a host of other pelvic conditions. Essentially, if you put in the work, you will feel the improvement.    


Vaginal dilators are a practical, gentle, and gradual way of relieving vaginal atrophy and accompanying symptoms like itching, burning, incontinence, and painful sex. Although it is advisable to seek an initial diagnosis and subsequent guidance for use from a pelvic health rehabilitation specialist, vaginal dilators are designed to be used in the comfort and privacy of your own home. 

When purchasing vaginal dilators, ask your healthcare practitioner about the best type and brand of dilators for you, or look for FDA-approved, medical-grade silicone dilators in progressively increasing sizes, like these, from Intimate Rose, for the most comfortable and effective results. 


Mayo Clinic – Vaginal Atrophy: Symptoms & Causes -

National Library of Medicine - Hormonal Changes During Menopause and the Impact on Fluid Regulation -

Wiley Online Library - Resistance and Barriers to Local Estrogen Therapy in Women with Atrophic Vaginitis -

Endocrine Society – Menopause -

American Family Physician - Diagnosis and Treatment of Atrophic Vaginitis -