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woman in bed needing vaginal dilators
Photo: Getty Images/Sarayuth Punnasuriyaporn-EyeEm
Gabrielle Kassel of the website Well + Good reached out to me for my expertise on the proper use of vaginal dilators for overcoming vaginal tightness, pain during sex or tampon insertion, etc., and I was glad to add my two cents on this vastly important topic for many women. Here is a brief synopsis of the article along with a link to the full article below.

Heather Jeffcoat, DPT

Unless you have a medical kink or are role-playing nurse and patient, the doctor’s office and bedroom probably function as separate, non-interacting entities. But for some people who experience pelvic or sexual pain, vaginal dilators blend the experience of the two.

Below, two pelvic-floor therapists explain the purpose of these medical tools, as well as how to determine if they may be useful for your personal pelvic-floor issues or sexual pain.

What are vaginal dilators and how do you use them?

Aesthetically, vaginal dilators are akin to dildos, but their intended use is as medical devices to gradually stretch, relax, massage, or mobilize the pelvic-floor muscles.

Designed to enter and stay in the vagina for a prescribed duration of time (usually five to 20 minutes)—or manipulated to massage the internal vaginal walls—vaginal dilators are sold in kits of three to seven total dilators of increasing size, says Heather Jeffcoat, DPT, a doctor of physical therapy who specializes in sexual dysfunction and incontinence, and is the author of "Sex Without Pain".

The intention is for you to start with whatever size you can insert comfortably. Then, after a few days, weeks, or months, when your vaginal canal has learned to relax around and accommodate its size without pain, you size up. This progression continues until you reach your end-goal girth and length. Some folks have the goal of being able to comfortably have penetrative intercourse with their partner’s penis, and thus will work up to a dilator of a similar size. Others wish to use a regular-size tampon comfortably, and thus will work up to a dilator of similar size to that.

When using dilators, patience is key.

You have to respect the time your body is asking for to work up in size and through the kit,” says Dr. Jeffcoat.

Who are vaginal dilators for, exactly?

The short answer: Vaginal dilators are for anyone who has been to a pelvic-floor therapist who has recommended the use of the tool, says Dr. Ossai. And according to Dr. Jeffcoat, this may include anyone who experiences pelvic or penetrative pain, including folks with endometriosis, vulvodynia or vestibulodynia (pain around vaginal opening), vaginismus (constricted vaginal muscles), hypertonic pelvic floor (non-relaxing pelvic-floor muscles), painful bladder syndrome, and genitourinary syndrome of menopause (genital atrophy).

Vaginal dilators may also be used by people who have had pelvic-floor surgery, radiation for abdominal or pelvic cancer, or vaginoplasty to promote pelvic-floor health,” she says.

Click here for the full article containing more info on the use of vaginal dilators.

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Testimonial by T.H.

I started seeing Heather in October 2014. For more than two years, I had been suffering from painful urinary tract infection type symptoms after my bartholins gland surgery which included constant burning and urinary frequency sensation that led to more and more painful intercourse. I had made multiple visits to internist, obgyn and urologist's offices, went through a range of treatment with UTI and bladder frequency medication that included antibiotics, vesicare, estrogen cream, but nothing worked.

Read more: Testimonial by T.H.

Testimonial by J.H.

My last appointment with Heather was over 6 years ago but I still think of her every day. I don’t take for granted that I can easily get out of bed, care for my two active and busy young boys, run, play tennis, clean my house, or sit at a desk for several hours at a time. None of these tasks were easy for me before meeting Heather. Eight years ago my car was struck from behind by a tractor trailer that was estimated to have been speeding. I spent 3 years working with different PTs and Drs trying to heal and move on with my life. When I became pregnant and the hormone relaxin that “relaxes” all the joints of the body and the additional weight gain erased all my progress and I was suddenly in a lot of pain again. My OB sent me to Heather for one last try.

Read more: Testimonial by J.H.

Testimonial by A.B.

Before I was referred to Heather Jeffcoat I was living in a nightmare. I had been married to my husband for three years and I was suffering from Vaginismus. That all changed when I visited my OBGYN and she said she knew of someone with a great success rate. To be honest I was hesitant at first because my first doctor had already told me that all I needed to do was order dilators from the internet and I should overcome my problem. She was wrong because I had followed the book on how to use the dilators with absolutely no advancements in my condition. However, that all changed when I went in for my first visit and Heather took the time to explain my condition and how we were going to work together to overcome it.

I remember leaving her office with a glimmer of hope that I could live a normal life. As my sessions continued I began to see immediate results. With only four sessions and a strict dedication to my home programs I was cured of Vaginismus. In the beginning of this process I was made aware that my health insurance company might not cover the costs, which was disappointing but today I can say one hundred percent that it was the best money I ever spent. Now thanks to Heather I am finally enjoying my life to the fullest with my husband. Thank you Heather, I can’t begin to tell you how much I appreciate all that you have done for me. I will never forget it. Those who are suffering from these types of conditions don’t be afraid because she makes you feel so comfortable and the end result is worth it. Good luck to you all and I hope you experience the success I have.
-- A.B.

Testimonial by S.H., age 24

I just wanted to thank you for everything you've done for me for the past 19 months. I literally could not have reached my goals without you and your practice. You gave me the courage to keep moving forth with my treatment no matter how afraid and anxious I was. You were always there to answer questions and made this whole process so much easier than I expected it to be.

It's because of you that my marriage is on the right track, that I can get pregnant and that this part of my life is finally over. I really feel that Fusion Wellness is a team of people you can call family and are there to root for you and cheer you on until you reach your goals. There is nothing better than knowing I accomplished this with you guys by my side and as calmly and patiently as I needed. Thank you from the bottom of my heart for always being there and helping me reach my goals.

S.H., age 24

Testimonial by Julie T.

Femina PT (née Fusion Wellness & Physical Therapy) has honestly changed my life. Before receiving treatment at Femina, I was going doctor to doctor to try and find the answer to my pelvic pain. It has taken me YEARS to find someone that can help fix this. It wasn't until my gynecologist recommended your clinic that I finally felt relief. My pelvic pain is almost gone, and granted I still have a lot more to work on with Laureen (my PT), my original problem is nearly cured. I am so grateful to her.

What is even better is she gave me practical exercises to do at home that were not tedious and provided instant (and lasting) relief. Although I mainly work with Laureen, my interaction with the owner (Heather) has been great. She is very generous, kind, and committed to her business.

It hurts to know there are women out there suffering who will never know or have the opportunity to work with women like Laureen and Heather because this issue is hardly talked about and this field is so rare. I hope more doctors and physical therapists see the value in this work and can relieve more woman of their pain.

-- Julie T., 12/4/16 via Yelp!

Testimonial by M.M.

A personal journey and testimonial from one of my patients:

My husband and I were married for 5 years before we were able to have intercourse due to my vaginismus. There was nothing traumatic in my past but for some reason, even though I wanted sex, I mentally avoided "that area" of my body and didn't even admit to myself that there was a problem for a long time, even though I was never able to put tampons in. Once I finally opened my eyes up to the fact that I had a problem, I had a surgery that was supposed to fix the issue.

Read more: Testimonial by M.M.

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