Dilating 101

This is not intended to be medical advice; please consult with your doctor before beginning a dilating regimen.

When I got diagnosed with vulvodynia and vaginismus, the most alarming part was finding out I needed treatment from a pelvic floor physical therapist – a therapist who would be putting her fingers inside my vagina twice a week in order to release and relax my tight muscles. (I plan on writing a whole post about my experience with pelvic floor PT in the future – but spoiler? It wasn’t anywhere near as awful or scary as I thought it would be.) After my first appointment, my physical therapist recommended also dilating at home, to which I said… what the hell is dilating?

What is dilating?

Dilating is the act of inserting a dilator (basically a dildo that comes in graduated sizes, some as thin as a finger) into the vagina (or anus) in order to relax the muscles and/or stretch the tissue. Using dilators in larger sizes over time can help with many issues, such as painful sex caused by different disorders or hormonal changes.

For example, after years of dealing with pain from vulvodynia, my pelvic floor muscles were used to “guarding” against that pain by clenching and keeping everything out. Therefore, my muscles had to relearn how to relax. These days, I only dilate from time to time when I’m feeling extra tight, and I still often have to use a dildo to “warm up” before having sex (still totally preferable to dilating three times a week, which used to be my schedule).

Who needs to dilate?

A lot of folks may need to dilate during their lifetime for different reasons. Some of the most common include:

• Vaginismus: Vaginismus is an involuntary clenching of the pelvic floor muscles that can make sex very painful or impossible. Dilating allows a person to experience vaginal penetration at their own speed, and trains the muscles in the vagina to learn how to relax.
• After gender-affirming surgery: Many trans women need to use dilators after undergoing gender-affirming surgery such as vaginoplasty, in order to lengthen the vaginal cavity and/or get used to penetration.
• During cancer treatment or menopause: Women going through chemotherapy or menopause (not to conflate the two, but both involve hormonal changes that can affect the elasticity, size, and lubrication of the vagina) sometimes need to dilate in order to have comfortable sex again.
• Male pelvic floor dysfunction: Pelvic floor dysfunction can happen to anyone, male or female. For men, symptoms of a tight pelvic floor can include painful ejaculation or erectile dysfunction. Dilation can be done anally to help relax the pelvic floor muscles, for men and other folks without vaginas.

How do you dilate?

It’s simple (though I can only speak to my personal experience using dilators for vulvodynia; check with your own doctor regarding your specific circumstances before getting started): you basically just plunk it inside your vagina and let it sit for a while. Easy enough, right? That’s really all you have to do in order to make progress.

Say you have a set of four dilators; choose the largest size you can insert without pain (there might be some pressure, and you may feel some anxiety when you first start out, but there shouldn’t be any pain). Lube it up good with some water-based lube (Good Clean Love’s water-based lube is my personal go-to) – there’s no reason to cause yourself discomfort by skipping the lube, trust me. Insert the dilator gently and as slowly as you need to until the full length (or as much as you can handle without causing yourself pain) is inside you. You can move the dilator in and out to relax muscles more or to get it fully inserted. Then just let it sit there for a while; you can read a book at the same time, watch TV, or masturbate, if you’re comfortable and in the mood to do so.

I often feel some discomfort at the beginning of this process, but as I sit with the dilator inside me, my body relaxes around it and it gradually starts to feel less obtrusive. Ideally, I do this until my muscles feel totally relaxed (sometimes it takes five minutes, sometimes more like half an hour). When dilating for pelvic floor issues, it’s mostly about getting the muscles used to something being in there.

Over time, and always at your own pace, you can move on to the larger dilator sizes. Only insert the largest dilator you can without feeling pain – some pressure or a little discomfort is normal, but listen to your body and go slow. You don’t want to retraumatize a sensitive area by forcing things too quickly.

Your doctor or physical therapist will probably give you specific instructions (if you have vaginismus, for example, they might teach you how to use dilators for trigger point release), but I promise it’s not a scary or mysterious process. That being said, please consult with a doctor before starting to dilate! Without guidance from a physical therapist, I could have easily done more harm than good dilating on my own.

Where can you buy dilators?

There are a ton of dilator sets out there, some of which are very scary-looking and medicalized. Personally, I prefer something that doesn’t make me feel like a lab rat, which is why I recommend the following sets that don’t look straight out of a doctor’s office:

• Inspire Silicone Dilator Set, $85: Includes five different dilator sizes, which are curved to the shape of a typical vaginal canal, making them extra comfy.
• Soul Source Silicone Dilator Set, $79-$140: Has eight different size options that come in different packages. I bought one of these sets eons ago when I was first diagnosed with vaginismus (you can see them in the header image of this post), and it’s a solid set that will last a lifetime. On the other hand, I don’t love that the dilators are completely straight, which is why I put the Inspire Set (above) higher than this one on my recommended list.
• Sheology Silicone Dilator Set, $59: Another set of five curved dilators (these ones are also apparently wearable, though I don’t think I would recommend walking around with a dilator in when you’re just getting used to them).
• VuVa Plastic Dilator Set, $60: If you want plastic dilators instead of silicone (plastic can be lighter to hold and less draggy than silicone once it’s lubed up, so these might be more comfortable for some folks).

You want to make sure that whatever dilators you get are body-safe, i.e. made of medical-grade silicone or plastic. I know that a whole set of dilators can be expensive, but it’s always worth it to make sure that anything going inside your body is safe and won’t cause other problems for you.

Eventually, you may want to move on from dilators altogether and get a dildo that feels more fun and less medical, even if you’re still using it for largely the same purposes (getting warmed up before penetrative sex, for example). Check out my small dildos label for a few unintimidating recommendations.

That’s all there is to it!

And that’s it! It may not be the most fun, but dilating doesn’t have to be scary, and it shouldn’t be painful. That being said, please consult with a doctor or pelvic floor physical therapist before starting a dilation program – it’s always good to have a medical professional in your corner to talk to if any questions or problems arise.

(Note: I am not a doctor and this is not medical advice; I’m presenting my own experiences for informational purposes, but you should consult with your doctor before making any changes that may affect your health.)