Have you been diagnosed with vulvodynia or vaginismus? Have you noticed your pelvic floor muscles are overactive and have a difficult time letting go and might also be painful? Did your pelvic floor physical therapist recommended using vaginal dilators to decrease vulvar pain? Did your doctor recommend dilators to help with vaginismus? If so, where do you start?

My friend and colleague Tracy Sher has compiled loads of helpful information for you! She discusses indications for using dilators, how to select the right dilator. She discusses indications for using dilators, how to select the right dilator (there are different materials available), and the “three effects” of using dilators.

Desensitization or neural system effect

Recent pain science has demonstrated that working with the nervous system is very effective in healing persistent pain. This can be extrapolated into dilator use, and as clinicians we have seen this approach to be quite effective.

We can train the brain to not perceive the painful area as “dangerous” by nourishing the parasympathetic nervous system and introducing non-painful stimulus to the area.

These are the same concepts I wrote about in my blog “Yoga for Pudendal Neuralgia.”

Stretching effect

A more traditional use for dilators is for stretching the vaginal opening and pelvic floor muscles along the vaginal canal.

We use the dilator to apply consistent pressure to the pelvic floor muscles to cue them to lengthen. This increases blood flow to the muscles which the muscles and nerves appreciate.

Some people find use leg movements during dilator practice in different positions helpful to access the full scope of pelvic floor function.

Functional effect

Some patients use dilators to decrease pelvic pain.

Other will use dilators in preparation for using a tampon or other objects used for sexual pleasure.

You can read Tracy’s tips about how to select dilators and dilator progression.

Exploring mindfulness with dilator use

I have found that patients have the best results with dilators when they take a mindful approach, especially if they are experience discomfort.

Pranayama, or breathwork, has been shown to be a helpful strategy for those healing pelvic pain. We can use the breath consciously with the dilator to assist our pelvic floor to lengthen.

Imagine that as you inhale, your belly expands (but doesn’t push out) and your pelvic floor lengthens towards your feet. Call in softness at the hips, buttocks, jaw, and wherever else you can discover unconscious holding patterns.

I believe in the power of mindfulness with dilators so much that I have created a mindfulness meditation for dilator use.

Please share this freely with anyone who you think might benefit from it. It is also a helpful meditation in preparation for a gyn visit.

Download meditation

You may also find this short film by Shelby Hadden and Sebastian Bisbal helpful: