7 Things We Want You to Know About Vaginal Dilator Therapy Work
February 4, 2025
Vaginal dilators (also called vaginal inserts or accommodators) are tube-shaped devices used in pelvic health physiotherapy to help the vagina accommodate stretch and down-train tense pelvic floor muscles. As pelvic health physiotherapists, we might recommend them as part of a treatment plan to address sexual pain, decrease vaginal sensitivity, and increase comfort.
When using vaginal dilators, it’s best to work under the direction of a pelvic health physiotherapist, whether it’s during a physio appointment or at home according to their directions and guidance. Because sexual pain can be related to other conditions and factors, it’s also important to be screened by a physiotherapist to determine what’s contributing to the pain before beginning work with vaginal dilators.
Often, vaginal dilators are sold in kits that include a range of different sizes, from small (about the size of your little finger) to large (don’t think too much about large yet!). Working with vaginal dilators can train your pelvic floor muscles to allow for pain-free penetration. This is important because it:
- Allows for internal pelvic exams
- Makes sexual vaginal penetration more comfortable
- Improves the function of your pelvic floor
If you’re curious about vaginal dilator therapy and if it can benefit you, book an appointment with us or talk to your Cheerful physio.
3 Key Ways We Support Clients with Dilator Work
If we’ve recommended dilators as part of your treatment plan, we often teach you how to use them during your physio appointments. Here’s what that might look like.
1. Prioritizing your emotional safety
This one is always a given. When doing this work, we want to help you feel as comfortable in your body as possible. So if you feel like something’s a bit “off,” we want to help you adjust accordingly so you can relax. Whatever it is, let us know. Don’t be shy!
For example, having your physio move closer or further away from you or position themselves at a different angle can make you feel more at ease. Or adjusting the curtains an inch. Don’t feel like you have to rationalize this; it doesn’t have to mean anything more than how we can adapt to get you the best results!
2. Helping you slow down and be present
Dilator work is as much about managing stress in the body as it is about getting the dilator in. We will coach you through this and help you go at the pace of your body. This inherently means that we take our time and focus on the process over the goal.
Some of our go-getter clients might need to adjust to a slower pace, but it’s a much more comfortable and effective approach! Dilator work is the epitome of the phrase, “If you want to go fast, go alone; if you want to go far, go together.”
3. Supporting you in processing and troubleshooting challenges
Often, working with dilators can bring up emotions or frustrations as people connect with their bodies in this new way. We can support you in seeking counselling as needed, or just be there to listen as you share.
From a physical standpoint, sometimes there are stops and starts with dilator progress and we use our physio tricks to problem-solve and help you move forward. Our priority is to get you alllllll the way to the goal that underlies this work, not just to get a dilator in for the sake of it.
4 Tips for Dilator Work at Home
We recognize that using dilators can sometimes feel uncomfortable or intimidating, so we wanted to share some tips to help set yourself up for doing this work at home.
A general note: using a dilator should be snug, but NEVER painful. Always start with a size you’re comfortable with and work your way up over time.
With that in mind, here’s what we recommend before getting started.
1. Curate Your Surroundings
Dilators are a tool for you to help push the edges of what feels safe in terms of vaginal insertion, and your nervous system has a lot to do with this, too. So if something doesn’t feel right about your environment, fix it! Don’t give your nervous system anything else to worry about. It might be something as simple as opening or closing a blind, turning a light on or off, or facing a certain direction. There’s no such thing as being too picky here.
2. Get into a Comfortable Position
Before you begin, make yourself as comfortable as possible. For example, rather than lying flat on your back, prop yourself up with pillows: this will make it easier to reach and avoid creating strain elsewhere in your body. Wear comfy clothes, surround yourself with blankets and pillows, and create a safe space to settle into. (Check out this video to see what we mean!)
This is not a “go, go, go” exercise – really let yourself feel the weight of your body on whatever surface is supporting you, whether it’s a bed, a couch, or the floor. Take time to breathe, check in, and notice how you feel. Just let yourself arrive.
3. Focus on Being Present
Once you’re set up, try to stay present in your body. Often, when we get to putting the dilator in, we feel challenged. That’s when we might start to try and push it, go past our edge, and potentially disconnect from ourselves a little bit.
But the goal of this exercise is really to stay present and relaxed as much possible, focusing on the reaction of your body. Work with any anticipation you might experience and try to calm it, as opposed to just putting the dilator in.
4. Don’t Worry if Your Progress Isn’t Linear
Depending on where your nervous system is at, using the dilators might feel different from day to day. That means your progress might not be linear – and that’s totally normal!
It’s why taking the time to set yourself up is so important: if you are having an off day and you can’t get yourself to feel present, your dilator work will probably not go very well. On the other hand, if you are feeling really good and safe that day, using the dilator might feel better.
Remember that this treatment is about exercising muscles and practising to find a feeling of safety in your body.
You can have a cheerful pelvis too!
If you’re a new client, get matched with a physiotherapist here. If you’re a current client, book here. We also sell dilator kits at the clinic; ask your physio or at the front reception desk.