Since the late 1980s, vaginal dilators have been used in my practice as part of pelvic floor functional recovery therapy. Vaginal dilators, also known as vaginal trainers or pads, are designed to restore or expand the tissue and muscle tissue of the vaginal opening. They help hundreds of patients recover or start penetrating activity, which is the common goal of many women. The tool can help improve the comfort of vaginal penetration and improve the quality of sexual life of women and their partners. Physiotherapists trained in women ’s health are ideal healthcare providers who can introduce and develop dilators. We have the ability and time to evaluate and treat the pelvic girdle, vulva area, and pelvic floor muscles.


Women with multiple diseases benefit from the use of vaginal dilators. Based on my clinical experience with dilators, the disease is divided into 4 types.


The first group involves women with anatomical changes in the pelvis. This includes genetic diseases (Müller's dysplasia or Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome), surgery (after hysterectomy, prolapse repair, or gender redistribution surgery), and response to medication (graft versus host) Disease-GvHD) and cancer patients, have sex after receiving radiation therapy, breast cancer treatment and surgically induced menopause.


The second group includes women with medical conditions that may cause pain or restricted vaginal penetration or sexual intercourse. This category includes but is not limited to vulvar pain, vestibular gout, vulvovaginal atrophy, vaginal stenosis, lichen sclerosis, painful bladder syndrome, interstitial cystitis, perineal tears, periosteal incision and pelvic pain after delivery.


The third group included women with chronic pelvic pain with pelvic girdle (SI joint, coccyx, pubic bone area) and / or bladder and bowel symptoms. In this case, the dilator is usually used as a method of stretching the pelvic floor muscles.


The fourth category includes women who are unable to perform a pelvic gynecological examination despite their desires and repeated attempts, wear tampon or sexually active and vaginal osmotic activities during menstruation. This condition is called vaginal cramps. Women with vaginal cramps usually need to learn to control muscle response, focus on insertion techniques and understand the neuroscience of pain, fear and anxiety. Physiotherapist Tracy Sher (MSPT.CSCS) provides other needs of these women in her blog on Vaginal Speculumtechniques and overview of vaginosis patients.


When working with patients who recommend the use of dilator technology, I often encounter the emotions of many patients. Knowing which dilator to use and having clear instructions can help women recover. With the support of physical therapy, they often change from embarrassment, confusion and frustration to confidence, encouragement and empowerment. Many women have achieved the goal of painless vaginal penetration.


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