Why experts recommend a gigolo for vaginismus
Why psychologists and sexologists suggest a gigolo alongside vaginismus care: safe guidance, patience, and a step back toward pain-free intimacy.
Glossary
Dilator
One word for two things: a tool from pelvic floor therapy and a piece of gear from the playroom.
What is a dilator?
Dilator (Dutch: dilator, the same word) is a rod that lets a body opening gradually get used to something going in. Dilators come in sets of increasing sizes. The word covers two things that have little to do with each other: a tool from pelvic floor therapy and a piece of gear from BDSM.
| Dutch term | dilator, identical. In medicine the full name is vaginal dilator; in play the words dilator and sound get used interchangeably. |
| Medical meaning | a set of increasing sizes someone uses on their own for vaginismus, pain during penetration or after radiation, usually within pelvic floor therapy |
| BDSM meaning | a rod for the urethra, related to sounding, or an anal variant to get used to size |
| What it’s made of | silicone or hard plastic for the medical sets; stainless steel, glass or silicone in play |
| Main limit | urethral use risks irritation, tears in the urethra and urinary tract infection |
How a dilator works
Getting used to it, not stretching it open. The Cochrane review on vaginismus describes the method as systematic desensitization: deep muscle relaxation combined with gradually inserting a dilator or finger, to reduce the fear and tension around penetration. The size only goes up once the previous size no longer causes a reaction.
In the BDSM meaning the goal is different, but the build-up is the same: start small, and the next size only once nothing pulls anymore.
Why people use a dilator
Medically: to make penetration possible without pain, at your own pace and without anyone else having to be there. In play: because the urethra is a place where nothing else goes, and that makes every sensation there new.
Cochrane concludes that statements about the effectiveness of vaginismus treatments should be drawn carefully, because the evidence is thin. And for urethral use, the description of sounding names irritation, tears and urinary tract infections, with the warning that such an infection can become serious if it spreads to the bladder or kidneys. Sterile material actually made for it is no luxury with this form.
Sources
- Interventions for vaginismus. Melnik, Hawton & McGuire, Cochrane Database of Systematic Reviews, 2012. Backs up the description of systematic desensitization with increasing dilator sizes and the conclusion that statements about effectiveness must be drawn carefully.
- Urethral sounding. Wikipedia. Backs up the distinction between the urological procedure and recreational use, and the risks of irritation, tears in the urethra and urinary tract infections.
Related terms
- Butt plug. The anal relative that stays in place instead of increasing in size.
- Buttplug. The same family, with the medical rectal dilator as its forerunner.
- Dildo. Meant for movement and not for gradually getting used to size.
- CBT. The area in which the urethral variant of the dilator is usually used.
- Duckbill speculum. The instrument that holds open instead of stretching open.
- Speculum. The technical term for that same instrument, and the reason holding open and stretching open are two different things.
- Sounding. The act these rods are meant for, with the difference between sounding out and stretching open.
- Urethral play. The whole area the dilator is one object of, with the infection risk that comes with it.
- Vaginismus. The condition the medical dilator set in increasing sizes is used for, usually within pelvic floor therapy.
Frequently asked questions
What people still ask about dilators.
What is a dilator?
A dilator is a rod that lets a body opening gradually get used to something going in, usually supplied as a set of increasing sizes. The Dutch word is the same. The medical and the BDSM meaning do not run together.
What is the difference between a medical dilator and a dilator in BDSM?
The goal and the place. A medical dilator is a set of increasing sizes someone uses on their own for vaginismus or pain during penetration, usually within pelvic floor therapy. In BDSM a dilator mostly goes into the urethra, related to sounding, or anally to get used to size.
Is a dilator dangerous?
Urethral use is the risky part. Named are irritation, tears in the urethra and urinary tract infections, which can become serious if they spread to the bladder or kidneys. So use only sterile material that is actually made for it, and let the size go up only once nothing pulls anymore.
Who can you turn to with questions about dilators?
With Victor, a gigolo with twenty-five years of experience in BDSM and a background as a psychotherapist. He’s glad to talk about building up calmly and about pain during penetration; for the medical side, a pelvic floor physiotherapist belongs in the picture. You can ask him a question with no strings attached through the contact form or first free chat.
Blog
Articles about pain during penetration
The dilator carries two meanings that have little to do with each other. The first article is about the medical side, the second about where the rod becomes play.
Medical play without the white coat: the exam is the scene
The most-played form of medical play uses no instrument at all. What happens instead, why lying still works, and where the law begins.
Learn more
Still have questions about dilators?
I'm Victor. I regularly get questions about pain during penetration and about building up calmly, and I have all the time for them. Feel free to ask yours. No obligation, I'll message you back at your own pace.