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Illustration by Maya Chastain

For people with a vagina who experience pain with intercourse or penetration, vaginal dilators can be an effective form of therapy.

Vaginal dilators are medical devices that can be used to help reduce pain and potentially anxiety around penetration. They are usually safe and effective, and can be used to help treat a variety of conditions.

A vaginal dilator is also sometimes called an insert. It’s a plastic or silicone rod or cylinder with a rounded end that is inserted into the vagina to help stretch the tissues. Inserting it can also help train people to relax or strengthen their pelvic floor muscles.

A dilator can come in many sizes, but they’re often about 4 inches long and vary in width. They’re often used to help reduce the pain and anxiety that some people with sexual pain syndromes feel with, or in anticipation of, sexual intercourse.

Vaginal dilators often come in kits that include a range of dilators at different widths, from very narrow to thick.

As the vaginal tissues become more flexible, you can begin using wider dilators to become progressively more comfortable with larger sizes.

A variety of conditions may cause painful intercourse or penetration.

If you’re experiencing pain, talk with a healthcare professional. They will perform a gentle physical exam to determine the underlying cause of your pain. Vaginal dilator therapy may be part of the treatment they suggest.


During menopause, the vagina can narrow because of low estrogen. Many postmenopausal people report painful sex. Once the vagina narrows, it can become more difficult to insert anything.


Vaginismus is when the vaginal muscles contract during vaginal penetration. This can happen involuntarily. The muscle contractions can make intercourse or penetration very painful and difficult.


Dyspareunia is a condition in which there’s pain in the pelvic or genital area during intercourse. This can happen for a variety of reasons, including:

Vaginal septum

A vaginal septum is a wall of tissue in the vagina. It can be a vertical or horizontal wall that divides the vagina into two sections. You can’t see it externally, but it can cause pain with intercourse in some people.

Imperforate hymen

The hymen is a thin membrane that covers the vaginal opening. Most hymens have a small opening, but others don’t. This is called an imperforate hymen.

Surgery is usually needed to treat it, but dilators may be recommended to keep the entrance of the vagina open as it heals.

Vaginal issues related to cancer therapy

Sometimes, if you’ve had radiation or surgery for cancer, the vaginal tissues can be affected. This is especially true if you’ve had radiation to the pelvis or surgery that caused menopause. Vaginal dilators can help keep these tissues soft and flexible.

MRKH syndrome

People with Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome have an underdeveloped vagina and uterus, or no vagina or uterus at all. It can cause painful intercourse, or make penetration impossible. Dilators may help with this condition by stretching the vaginal canal.

There are several kinds of vaginal dilators available. Knowing the differences between them can help you choose the best ones for you.

Dilators are usually made from either medical-grade plastic or silicone. Firm dilators made of plastic may be better for some people because the firm dilators move and stretch the muscles of the vagina better than silicone dilators.

Silicone dilators are a little softer and can offer a gentler, more flexible feel. They can also be chilled or warmed, and can be less irritating than plastic dilators.

Some kits also come with a handle that can be used with the dilators for easier use.

In addition to dilators, you might want to buy a water-based lubricant. These can help make the insertion process a little easier and more comfortable.

Be sure to avoid petroleum jelly as a lubricant since it can irritate the tissues. Also, oil- and silicone-based lubricants can be harder to clean off of the dilators.

Talk with your doctor about which dilators and lubricants they recommend. They may prefer you use a certain kind over another based on your specific condition.

Using dilators may feel intimidating at first. It may be a good idea to enlist the help of a pelvic floor therapist when you start using them until you feel confident doing so on your own.

The following steps can help make the process simple and painless. In all, it generally takes about 10 to 15 minutes.

You’ll start with the smallest dilator in the kit. It should feel snug but not painful. If you don’t feel any pressure, you might want to try a bigger size.

To use a dilator, follow these steps:

  1. Wash your hands thoroughly before using the dilators.
  2. Use a water-based lubricant on the dilator and the opening of the vagina. Avoid petroleum jelly and oil- and silicone-based lubricants.
  3. Slowly insert the round end of the dilator into the vagina, straight toward your spine or slightly downward, similar to how you’d insert a tampon. Keep inserting the dilator until you feel some muscle tension, then stop. Do not force it, as this should not be painful.
  4. Do a set of Kegel exercises. This helps relax your vaginal muscles and help you insert the dilator a little more. If you cannot insert it more, take some deep breaths and try to relax the pelvic floor muscles. Don’t worry if you cannot insert the dilator completely.
  5. Gently move the dilator inside your vagina for 5 to 10 minutes. Push it in and out, or rotate it. Reapply more lubricant, if needed.
  6. Take the dilator out, and then clean it before putting it away.

This can be done one to three times per week. If you notice any blood or spotting afterward, this is normal. However, contact your doctor if the bleeding is heavy or continues.

Using vaginal dilators can be very effective in helping to keep your vagina open and more elastic. This can help reduce pain and discomfort with penetration and sexual intercourse.

The length of therapy can vary among people depending on the underlying condition. You can use the dilators for as long as you need to.

Talk with your doctor about the course of your vaginal dilator therapy and tips for using them that work best for you.

For some people who have pain with vaginal penetration or intercourse, dilator therapy can be useful. It helps keep the vaginal tissues pliable and the vagina open, and reduces pain, anxiety, or both surrounding penetration.

If this is something you think might help you, talk with your doctor about it. They can do a physical exam to check for an underlying condition, point you toward appropriate dilators to buy, and provide you with specific instructions for a therapy to help you.