Dilators: What Are They and How To Use Them
I only recommend products I have used or would use myself and all opinions expressed here are my own. This post contains certain affiliate links or discount codes that at no additional cost to you, I may earn a small commission to support the OncoPelvic PT mission. As an Amazon Affiliate I earn from qualifying purchases.
Imagine. You’re about to be intimate with your partner, get a pelvic exam, or insert a tampon or menstrual cup.
But then you remember: it’s going to be painful. You tense up, get nervous, and either grit your teeth as you deal with the pain or skip the activity altogether.
This is where dilators (or trainers) - and pelvic health physical therapy - come in!
What is a dilator?
Vaginal dilators, or trainers, are small devices made of silicone or hard plastic that are used to help treat pelvic pain. Although these tools are more commonly known as “dilators”, I prefer “trainers” because it’s a more accurate term! Trainers are recommended for people who have pain or difficulty with something being inserted into the vagina or anus. They are used to help desensitize the tissues, allow them (and your brain!) to get used to something being inserted, and provide tissue flexibility to accommodate whatever is being inserted. Although trainers can be used anally, they are most often recommended for vaginal use and this blog post focuses more on using them for vaginal treatment.
Why would I need a trainer?
You may benefit from trainers if you experience pain or difficulty with:
Inserting tampons or menstrual cups
Vaginal or anal penetrative sex
Inserting toys vaginally or anally
Pelvic exams (including speculums, transvaginal ultrasounds)
Inserting a pessary
You may also benefit from trainers if you:
Have been diagnosed with vaginismus, vulvodynia, or other type pelvic pain condition
Had a vaginoplasty
Experience vaginal dryness and thinning due to menopause
Completed pelvic radiation therapy for cancer treatment
Think about it. If every time you try to insert something in the vagina and you have pain, your muscles and nervous system will start to associate that activity as being harmful. This starts a cycle of pain > fear > muscle spasm that can be difficult to get out of. Trainers help to retrain the tissues and nervous system that something being inserted is a-ok.
Trainers are also recommended after a vaginoplasty, a type of gender affirming surgery, as well as for those who have had pelvic radiation therapy for cancer treatment. Trainers in these instances are used to help improve and maintain the vaginal length and integrity of the vagina and decrease any shortening, scarring, or radiation fibrosis that may occur after.
Dilator/trainer sets come with multiple sizes in graduated diameters for you to progress through as the tissues learn to accommodate something being inserted and as the pain and/or flexibility of the tissues improves.
What type of trainers should I get?
If you've started looking at different trainer options, you may be overwhelmed with all the different varieties. The type that is best for you will depend on your particular condition, your symptoms, and what your goals are. It's always best to work with a medical provider to see what type is best for you and for you to get an individualized plan. In the meantime, let's check out a couple of different types and brands!
I only recommend products I would use myself and all opinions expressed here are my own. This post contains certain affiliate links or discount codes that at no additional cost to you, I may earn a small commission. As an Amazon Affiliate I earn from qualifying purchases.
Silicone Trainers
I recommend this type of trainer for people who need to work more on the superficial muscles, which are closer to the skin (think: pain with initial insertion of something).
Silicone trainers are soft, smooth, and bendable.
The length of silicone trainers increase, or get longer, as the diameter gets larger with each size up.
You need to use a water-based lubricant (Check out the OncoPelvic PT Amazon Storefront for options).
Silicone trainers tend to be a little more pricey, so if money is a factor, keep reading to learn more about hard plastic trainers.
Intimate Rose
8 sizes of diameters
Prices range from $14.99 for an individual trainer to $179.99 for the whole set of 8 sizes
BONUS: Intimate Rose also has a dilator handle that you can attach to the dilator to make it easier to hold
Soul Source
8 sizes of diameters
Prices range from $17.99 for an individual trainer to $209.99 for the full set of 8 trainers
Soul Source was the first company to design silicone trainers in the US!
Hard Plastic Trainers
I recommend hard plastic trainers for people who need a little bit more “oomph” and firmness with their trainers (examples: working more on tissue flexibility, addressing vaginal length, scarring, or fibrosis).
Hard plastic trainers are rigid and not flexible like silicone dilators.
These trainers are typically less expensive than silicone trainers.
You’re not limited to the type of lubricant you need to use; you can use water-, oil-, or silicone-based lubricant (Check out the OncoPelvic PT Amazon Storefront for options).
Some brands have both graduated length and diameter like the silicone trainers, while others have the same length for all diameters. Trainers of all one length are ideal for people who need to work at the outer muscles as well as deeper tissues, and to maintain vaginal length.
Soul Source
Genital Reassignment Surgery (GRS) Dilators
6 sizes of diameters
Prices range from $40 for an individual dilator to $200 for the large set
Designed with a surgeon to help with vaginoplasty post-op management
Syracuse Medical
7 sizes of diameters
Lengths are all the same
Price ranges from $11 for an individual trainer to $77.50 for the full set of 7 trainers
CalExotics Dr. Laura Berman Dilator Set
4 sizes of diameters
Includes handle
Vibration setting can help with muscle relaxation
Price is $19.88 and can be purchased through the OncoPelvic PT Amazon Storefront
Hope & Her
6 sizes of diameters
Includes handle
Price is $44.95
Ok, I bought the trainers…so how do I use them?
I know, I know. It can be intimating looking at all these sizes! But don't worry - the rate that you progress with the trainer sizes is based on how YOU feel and respond. Just take it one step at a time!
Before starting with trainers, see a medical provider/pelvic health physical therapist for training. If trainers aren’t used properly, they can cause more discomfort or problems. Once my patients purchase their trainers, I have them bring the set in to clinic so we can walk through exactly what to do together.
Step 1: Lie on your back with your knees bent and supported with pillows or rolled blankets. Try supporting yourself in a more upright/semi-reclined position with pillows behind your back to make it easier to reach and use the trainers. If you’re using the trainers for anal/rectal treatment, you may find lying on your side with pillows between your knees is more comfortable. The key is to be as relaxed and comfortable as possible!
Step 2: Apply a generous amount of lubricant at the vaginal (or anal) opening and on the smallest trainer that you have. Don’t forget: if your trainer is silicone, only use water-based lubricant.
Step 3: Gently and slowly insert the tip of the dilator to just inside the opening.
Step 4: If there is no pain or resistance, you can progress to the next larger size. You should start with the size that causes a little discomfort and resistance but there should be NO pain.
Step 5A: With your starting trainer, leave it in place for up to 10-15 minutes (less time for anal/rectal work!). If this is your first time using trainers, try having it inserted for about 5 minutes to start with and check-in with how you’re feeling. Focus on letting your muscles relax around the trainer and perform deep breathing.
Step 5B: If you need to work on deeper muscles, scar tissue, or fibrosis, insert the trainer deeper. Do this once your tissues are used to the trainer being at the vaginal opening. Provide gentle pressure and stretch to the deeper tissues.
Extra tips:
Try to use the trainers 3-5 times per week, but if you’re having soreness then use them less.. The frequency will depend on your medical condition.
If you have soreness or just need a mental break from using trainers, make sure to take a break between days!
When you don't experience any resistance or discomfort with using a trainer, then you know it's time to go up to the next size. There's no "set time" for you to go up to the next size. It may take days or weeks!
When you start using a larger size, always start with the smaller size(s) first as a "warm up".
If you have pain or difficulty with movement at the opening, once you don’t have any problems with the trainer being inserted, you can gently and slowly move the trainer in and out.
Make sure to wash your dilators with soap and warm water and dry them before and after each use.
Some people find cooling the trainers in the fridge or running cool water over them can be soothing to the tissues. If cold is helpful for you, check out the Cool Cone!
It can be a daunting task to start working on pain or difficulty with vaginal or anal insertion. Start with small steps (and trainers!) and take it slow. Trainers are only one part of a comprehensive program, so work with a pelvic health physical therapist to get the best results!
