Nicole L. Dugan, DPT Penn Therapy and Fitness < Last Modified: September 18, 2013
If you receive radiation therapy to the pelvis, your doctor may recommend that you use a vaginal dilator to improve the elasticity of your vagina. This is important to make follow up examinations easier and more comfortable. Your doctors, nurses, and physical therapist can answer any questions or concerns you may have. Don't hesitate to ask them.
About Vaginal Dilators
After radiation treatment to the pelvic area, scar tissue begins to form in the vagina and the tissue becomes less elastic and dry. There may be some shrinking of the vagina and vaginal opening. Scarring of the vaginal tissue result in "adhesions, or areas where scar tissue forms, sealing the sides of the vaginal together. This can make it difficult for the doctor to perform vaginal exams and makes sexual intercourse difficult and uncomfortable.
A vaginal dilator is a smooth plastic or rubber cylinder, similar in shape to a tampon. It is about 6 inches in length and comes in three different widths. The vaginal dilator works by stretching the scar tissue that has formed in the vagina. This helps to make intercourse more comfortable, but also to make physical exams by your physician more comfortable as well. It is recommended that you use the dilators for the rest of your life, as scarring can occur at any time after treatment.
Use and Care of Your Dilator
When to Use the Dilator
You can start using the dilator 2-4 weeks after your last radiation treatment (after vaginal irritation has decreased).
For the first month, use the dilator 5 days a week.
For the 2nd to 6th month, use the dilator 3 days per week.
After 6 months, use the dilator 2-3 times per week for life. This will keep the vagina healthy and supple.
How to Use the Dilator
Wash the dilator with warm soapy water and rinse well.
Apply a water-soluble lubricant (K-Y Jelly, Fem Glide) to the rounded end of the dilator and a small amount to your vaginal opening. Do not use oil based lubricants, lotion or Vaseline.
Lay on your back with your knees bent and slightly apart. You may also lie in a bathtub of lukewarm water.
Relax the muscles of the pelvic floor. You may try a couple of squeezes (like you are trying to stop urine flow) and then allow those muscles to relax. Also, take a few deep breaths. While you inhale, your belly should expand. The belly should fall when you exhale.
Using your fingers, separate the skin outside the vagina as you would when inserting a tampon. Place the rounded end of the dilator into the vagina as far as possible. Use firm and gentle pressure - do not use force. Sometimes, rotating the dilator makes it easier.
Hold the dilator in place for 20-30 minutes while keeping muscles relaxed. Again you may try a couple of gentle squeezes (like you are trying to squeeze around the dilator – don't squeeze so hard that you push the dilator out) and then allow those muscles to relax. Also, take a few deep breaths. While you inhale, your belly should expand. The belly should fall when you exhale.
Perform this exercise once daily.
Alternate Method: You may also try this method depending on what your doctor recommends and how well you are able to tolerate it:
Insert the dilator, hold for 5 seconds while you take a couple deep breaths, then remove.
Repeat the insertion and removal for a 10-15 minute period.
Remove the dilator. Wash your hands and the dilator with warm water and soap. Let the dilator dry completely to prevent bacteria build-up.
What to Expect
It may take 8-12 weeks to feel an increase in the size of the vaginal opening and a softening of the tissues. Be patient. You may find that your emotions are somewhat sensitive as you begin this process. It may help to talk to your doctor, nurse or therapist. For most women, there is a period of adjustment, and then using the dilator becomes more routine. Feel free to talk to your health care team if you are having difficulty. They are there to help you.
At first you may have a small amount of bleeding or spotting. This is normal and should stop as the vagina begins to stretch. The spotting may also occur after using the dilator and/or after intercourse for a couple of months. Heavy bleeding or excessive pain is not normal and you should contact your doctor if you experience this.
Call you physician if you have signs of an infection such as:
Vaginal discharge with strong odor
Other Ways to Stretch Vaginal Scar Tissue
Regular sexual intercourse, about 3 days per week, can also help to prevent vaginal shrinkage and can be a substitute for using the dilator.