Vaginal dilation

What is vaginal dilation?

Vaginal dilation is a treatment in which you use dilators in increasing sizes to let the vagina get used to something going in. It keeps the vagina supple, prevents adhesions, and makes penetration or a gynecological exam possible again, or less painful. It’s used, among other things, for vaginismus, after radiation to the pelvis, and for other causes of a tight or painful vagina.

How vaginal dilation works

Start small, build up gradually. The organization Kom op tegen Kanker describes smooth, cylindrical rods that increase in length and diameter, meant to counter narrowing, limit adhesions, and preserve stretchability. The guideline of the Dutch gynecologists calls it a non-traumatic, mechanical method: by inserting a dilator once or twice a week, you prevent adhesions and narrowing after radiation. With vaginismus the emphasis lies elsewhere: there the body learns that something going in doesn’t have to hurt, so the tension slowly eases.

What vaginal dilation is not

“You just have to push through, even if it hurts.” No. Pushing through backfires: it actually confirms the fear and the tension. The trick is to stay small and only go a size bigger when the previous one is effortless. It’s practice in getting used to it, not in gritting your teeth.

What I make of it

I’m not a therapist, and dilation belongs to your own exercise or to guidance from a pelvic floor physiotherapist, not to a date. But the idea behind it I recognize strongly from my work as a gigolo. Small steps, no hurry at all, and checking each time whether it still feels right, exactly as with titration. For women who have come to expect pain, that calm pace often does more than willpower. If you’re working on dilation and want to discover in complete calm alongside it that touch can feel good, a patient meeting can be a gentle addition to that.

Sources

• Vaginale dilatatie. Dutch Society for Obstetrics and Gynecology / IKNL. Provides that it is a non-traumatic, mechanical method and that inserting a dilator once or twice a week prevents adhesions and narrowing after radiation.
• Wat is vaginale dilatatie. Kom op tegen Kanker. Provides that it involves smooth, cylindrical rods increasing in length and diameter, to counter narrowing, limit adhesions, and preserve stretchability.

Related terms

• Dilator. The rod you do dilation with.
• Vaginismus. One of the conditions dilation is used for.
• Titration. The same principle of getting used to something in small steps.