You may have been told to use vaginal dilators if you are having radiation therapy to the pelvis. Using a vaginal dilator is like a stretching exercise for your vagina. Even if you’re not planning to be sexually active, you may still need to use dilators to help make pelvic exams more comfortable.
What are vaginal dilators?
A vaginal dilator (also called an insert) is a plastic rod or cylinder with a rounded end. You put it in your vagina to open (dilate) or stretch the tissues. This will keep your vaginal tissue healthy after having radiation treatments so it’s more comfortable to have a pelvic exam or sex. You need to use the dilator at least 3 times a week for 1 year. After this time, you can use them anytime you have tightness or pain.
Getting a vaginal dilator
Your radiation therapist or nurse will tell you about dilators when they teach you about internal radiation therapy. You’ll likely get 1 or 2 dilators. You can also buy vaginal dilators online. They come in different colours and are made of different materials.
If you don't want to buy a dilator, you can also use a thin tapered candlestick, but be sure to use a finger cot or condom with it. If you have questions, talk to your healthcare provider.
Why to use vaginal dilators
You need to use dilators after radiation therapy because the tissues of the vagina are often damaged by the radiation. It’s kind of like having a sunburn to the vagina.
The tissues of the vagina will be tender and irritated while you get radiation. This may last for up to 2 or 3 weeks. Because the walls of the vagina are wrinkled, scarring and healing after radiation therapy can make it smaller and tighter than it was before. If you use a dilator regularly, however, scar tissue will break down while it’s still thin and filmy. This will let your vagina slowly heal and keep its normal size and elasticity. Dilators will only work if you use them regularly and for the time that’s recommended by your healthcare providers.
Skin reactions that immediately follow radiation therapy are best treated with water-based creams.
Using a dilator will also help you stay confident about having an object put in your vagina. Some people with pain in their vagina may develop a fear of penetration or intercourse. Practicing with a dilator will help you feel confident that you can still have intercourse or pelvic exams without pain. If you have other types of cancer and have menopause symptoms and trouble with vaginal tightness, you might also want to try using a dilator.
If you are unable to progress to the next size dilator, schedule an appointment with a pelvic floor physiotherapist or with your family doctor for a vaginal exam.
How to use a vaginal dilator
- Find a quiet, private place where you won’t be disturbed for about 15 minutes. You may want to bring a book or your phone with you if you think you might get bored.
- Lie back and relax. Practice a few
pelvic floor exercises.
- You may want to put a clean finger in your vagina first as it’s a dilator too.
- Put enough water-based lubricant (like Astroglide, K-Y Jelly, or Liquid Silk) on the dilator to cover the outside of it. If you do this in a warm bath or shower, water can work like a lubricant, but it might also wash away the natural lubrication that your body makes.
- Put the dilator at the opening of your vagina. Tense your pelvic muscles and, as you relax, gently put the dilator in your vagina until you feel any resistance or discomfort.
- The dilator will likely only go in a few inches—this is normal. When you’re not turned on (aroused), the vagina is quite short. If you can only put the dilator in 1 inch (or less), do that and relax for a minute. Then, try to gently push it in a little bit further. Keep going. It will likely be uncomfortable, but if it’s painful, don’t push any farther. If it hurts too much to use a dilator, talk to your healthcare provider.
- Don’t contract your pelvic floor muscles while you’re using a dilator.
- For the best stretching, gently press the dilator against each side of your vagina. Also press at the top end of your vagina, because most scarring happens there. If any part of your vagina wall feels tender or tight, very gently press the dilator into that area and hold it for a few seconds so that the tissue can stretch.
- After stretching the tissue, leave the dilator in and try to stay relaxed for 10 minutes. You have to hold the dilator in or it will slowly slip out—this is normal. To get the most benefit, keep the dilator in for 10 minutes.
- Take out the dilator. It’s normal to have a bit of bleeding or to see blood on the dilator. If there is more than 1 tablespoon of blood, call your doctor or healthcare provider.
- Clean your dilator with warm, soapy water and rinse well so there is no soap residue. Dry the dilator completely and store it in a clean, dry place.
Use the dilator at least 3 times a week, even if you’re still having intercourse.
What if the dilator is too big?
If you find that the dilator is too big, start with a smaller one or just use your fingers. If you don’t have a dilator that’s small enough, talk to your doctor or healthcare provider about other options. Start with whatever is comfortable for you and work up to a dilator that’s the same size as an erect penis, sex toy, or the object that you normally use.
