Although embarrassment often prevents the subject from being openly discussed, vaginal dilators have proven particularly helpful for women seeking to reduce discomfort during penetration and pain during sex.
In fact, dilators are used to treat a wide range of conditions that affect the vagina, vulva, and pelvic floor. So, do dilators really work for relieving pelvic pain?
Keep reading to learn more about what causes pelvic pain and how dilators work to relieve it.
What is Pelvic Pain?
Pelvic pain is common in females and may stem from the pelvic organs, the genitals, or the pelvic floor muscles. It can also be caused by trauma or abuse resulting in subsequent clenching of the muscles that drives pain.
Typically separated into two categories, pelvic pain is categorized as either acute or chronic. Acute pelvic pain is diagnosed when the pain is sudden and severe, while chronic pain is constant, or comes and goes, for longer than six months.
What Causes Pelvic Pain?
Pelvic pain can be caused by a wide selection of conditions including constipation, premenstrual syndrome (PMS), a urinary tract infection (UTI), or a sexually transmitted infection (STI). However, if pelvic pain is constant or it comes and goes for longer than six months, it is best to schedule a consultation with your healthcare provider to rule out anything more serious like appendicitis, ovarian cysts, or an ectopic pregnancy.
Some of the questions you can expect to be asked at a pelvic pain consultation are:
- Where does the pain occur?
- When does the pain occur?
- How long does the pain typically last?
- Is the pain worse when you urinate or have sex?
- Is the pain worse before, during, or after menstruation?
- Describe how the pain feels – e.g. dull, twisting, stabbing, burning?
Types of Pelvic Pain That Require Treatment
Pelvic pain can vary according to the source of the pain and whether it is acute or chronic. The area in which it is felt can also vary – for example, for some women pelvic pain is localized to a small area in the lower belly, while others feel pain in the entire pelvic area.
The different types of pelvic pain that typically require treatment include the following:
- A stabbing or sharp pain that comes on suddenly
- A throbbing pain that comes and goes
- A constant pelvic ache that developed slowly and does not go away
- Pain that is felt only when urinating, having sex, or exercising
- A dull ache or sense of pressure in the pelvic area
- Pain that manifests as a twisting or knotting sensation
If your healthcare provider suspects that your pelvic pain is originating from an underlying condition, they will either perform additional exams, prescribe medication, or refer you to a gynecologist or pelvic health physical therapist for further treatment that may include vaginal dilator therapy.
What is Vaginal Dilator Therapy?
Vaginal dilator therapy is a structured program that involves the use of tube-shaped medical devices known as vaginal dilators, vaginal trainers, or vaginal inserts.
Specifically designed in sets of incremental sizes (slightly increasing lengths & diameters), dilators are inserted with lubrication to gently and gradually restore blood flow, relaxation, flexibility, and function to the vagina, vulva, and pelvic region in general.
Due to the combination of benefits experienced from gently massaging, relaxing, and stretching the vaginal tissues, pelvic floor, and pelvic floor muscles, dilators are hugely beneficial when seeking to relieve pelvic pain.
How Dilators Work to Reduce Pelvic Pain
Treating any type of pain is a journey, and reducing pelvic pain is no different, in that, it requires patience, commitment, and consistency.
As medical tools, dilators are specifically designed in sets of incremental sizes to gradually relax tight, dry, or inflamed vaginal tissues and encourage them to return to normal function after conditions like vaginismus, atrophy, vaginal stenosis, or pudendal neuralgia.
This gradual treatment allows women experiencing pelvic pain to feel increasing relief and confidence as they move through the process of dilation at a pace that suits their level of pain.
Scar tissue after pelvic surgery, injuries, childbirth, chemotherapy, or radiation treatment, which is also known to cause pelvic pain, can be successfully massaged and lengthened with the use of dilators.
Exercising the pelvic floor, and improving the control, strength, and flexibility of the pelvic floor muscles is also crucial when releasing pelvic pain. Dilators allows them to gradually relax and lengthen as patients progress through the dilator sizes.
In addition to exercising the pelvic floor muscles and relaxing the vaginal tissues, dilators also assist in the treatment of vulvar and vaginal hypersensitivity, which can often contribute to pelvic pain. Irritation or sensitivity of the vulva or vagina are often symptoms of vulvodynia, dyspareunia, low estrogen levels during menopause, or lichen sclerosus – all of which respond positively to dilation therapy.
Are Plastic & Silicone Dilators the Same?
No, they are not. Perhaps one of the most significant factors of dilators and how well they function is the material from which they are made. Although dilators were mainly made from plastic in the past, and glass before that, the more modern silicone dilators have proven far more effective in reducing pelvic pain due to the soft, yet still firm, sensation they offer to sensitive vaginal skin.
See our comparison of Plastic vs Silicone Dilators
While many medical institutions still recommend old-fashioned plastic dilators to help with recovery after pelvic surgeries and cancer treatments, the resounding feedback from the women who use them is that dilators made from medical-grade silicone are by far the best due to their soft yet firm pressure, smooth surface, and ease of insertion.
Unfortunately, some silicone dilators sold online are advertised as medical-grade silicone when that is not the case. Therefore, if you are thinking of purchasing dilators to relieve pelvic pain or any of the conditions previously mentioned, look for silicone dilators that are FDA-approved to ensure you’re getting the expected excellence and compatibility that a medical device should offer.
Pelvic Conditions that Benefit from Dilators
The root of some of the conditions listed below can be attributed to hormonal fluctuations, pelvic injuries, trauma, pelvic surgeries, or cancer treatments. The good news is, dilators have been proven to significantly reduce the associated pelvic pain and additional symptoms.
- Lichen Sclerosis
- Pudendal Neuralgia
- Scar tissue after pelvic surgery
- Vaginal Agenesis
- Vaginal Atrophy
- Vaginal Stenosis
How Long Do You Have to Dilate to Reduce Pelvic Pain?
As mentioned earlier, relieving pain is a journey and that journey can be different for everyone. When it comes to dilation therapy, depending on the underlying condition that causes pelvic pain, women generally begin to feel an improvement within a couple of weeks or months.
Some women will no longer need to dilate while their pelvic pain is treated, others might prefer to continue dilating before having sex, and some might feel better continuing with dilation as a routine because it makes them feel better down there. The tip is to listen to what your body is telling you and go with that.
Pelvic pain is common in females, but while some types of pelvic pain are temporary, other types can be chronic, debilitating, and life-changing when it comes to enjoying sex. Thankfully, dilators really do work to reduce pelvic pain, as well as alleviate pain during sex, discomfort during penetration, and hypersensitivity of the vulva.
Dilator therapy is typically performed in the privacy of your own home; however, pelvic health professionals advise seeking guidance and instruction from a pelvic health physical therapist or pelvic health rehabilitation specialist before beginning.
An initial consultation with a professional will ensure you start with the right size dilator and use your dilators correctly for the best results.
Johns Hopkins Medicine - Pelvic Pain - https://www.hopkinsmedicine.org/health/conditions-and-diseases/pelvic-pain
Cleveland Clinic – Dyspareunia - https://my.clevelandclinic.org/health/diseases/12325-dyspareunia-painful-intercourse
Web MD – Vaginismus - https://www.webmd.com/women/guide/vaginismus-causes-symptoms-treatments
The North American Menopause Society – Pain with Penetration - https://www.menopause.org/for-women/sexual-health-menopause-online/sexual-problems-at-midlife/pain-with-penetration
The American College of Obstetricians and Gynecologists - Disorders of the Vulva: Common Causes of Vulvar Pain, Burning, and Itching - https://www.acog.org/womens-health/faqs/disorders-of-the-vulva-common-causes-of-vulvar-pain-burning-and-itching
National Library of Medicine - Vaginal dilator use to promote sexual wellbeing after radiotherapy in gynecological cancer survivors - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8797530/
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.