Why are vaginal dilators used in treating vaginismus?

Dilators are very helpful with certain parts of vaginismus treatment.

Medical-grade DilatorsWhen used properly, vaginal dilators are very helpful with certain parts of vaginismus treatment. Vaginal Dilators can be very effective tools in helping to eliminate the PC muscle reflex, the underlying cause of vaginismus tightness, burning, and penetration difficulties. Dilators help enable women to have precise control over the size, speed, and angle of insertions and provide a substitute means to trigger the PC reflex in a sex-like context. Together with appropriate exercises, as women consciously and consistently squeeze and relax the PC muscles with dilator insertions, they learn how to override the involuntary muscle contractions that had previously caused tightness or closed the entrance to the vagina to sex. The process helps create new ‘muscle memories’. Through the proper use of dilators, women can more easily develop control over involuntary tightness and simultaneously desensitize their vaginal muscles, body and mind to the sensation of having something in their vagina. This is all done as transition preparation for inserting the “real thing” (i.e. the man’s penis) without pain or tightness. Together with appropriate exercises, they help women retrain their bodies to respond correctly to penetration and to transition to fully pain-free intercourse.

Note that there is more to treating vaginismus then simply inserting dilators. Contrary to popular believe, the focus of dilator use in treating vaginismus is not to ‘stretch’ the vaginal tissues or vaginal opening, but rather to assist women to gain control of their pelvic floor. Women with penetration difficulties related to their vaginismus often mistakenly assume that dilators are used to stretch their vaginal opening so that it will be larger, when, in fact, their penetration problems relate to problems with involuntary tightness of the pelvic floor. The name ‘vaginal dilator’ is actually a bit of a misnomer, since dilator use is not normally focused on ‘dilation’ (which means to make wider or larger). For this reason, some specialists refer to them as vaginal trainers or spacers. There are also alternatives to dilator use, but in practice women usually find dilators to be the easiest aid for completing the specific pelvic floor exercises needed.

A portion of women, especially those who are recovering from pelvic surgery or suffering from age related hormone changes like menopause, have a dual purpose for the dilators, both in the rehabilitative stretching of the tissues and the rehabilitation of the pelvic floor musculature responses (tightness from vaginismus). Dilators are helpful aids that are most effective when part of a complete process with proper physical instruction and transition steps.

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"I can recommend use of this resource by all patients with vaginismus" - APTA Journal of Women's Health Physical Therapy
- Beth Shelly, PT, BCIA-PMDB

 

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