At Maze, we generally recommend dilating for 10 minutes per day. We find that 10 minutes is a good amount of time, because it is long enough for the muscles to begin to lengthen and stretch around the dilator but is short enough to be physically tolerable. Usually even the busiest of us can carve out 10 minutes in our day, so it helps with making consistent dilation more realistically attainable for women to fit into their already packed to the brim lives.
Sleeping with a dilator inserted may have diminishing returns, mainly because for many women the hardest part of dilation is the initial insertion. Once the dilator has passed through the pelvic floor muscles at the vaginal opening, advancing the dilator further in the vaginal canal is often easier. Many women also have tightness of the puborectalis muscles, located several centimeters deeper in the vagina. For this reason, it’s helpful to have the dilator inserted about ¾ of its length – long enough to pass through this set of deeper muscles, but not too long where it is pushing into the cervix.
However, we do recommend sleeping with a small dilator the night after having the Botox procedure for vaginismus. The pelvic floor muscles have been stretched during the procedure for perhaps the first time and we want to be sure that they don’t spasm into their default state of contraction. This allows your body (and your mind) to get used to the new sensation of vaginal expansion.
Some women have reported that if they sleep with a small-medium dilator, then morning dilation with a slightly larger size may be easier. Glass dilators are not as long in length, so are less likely to protrude from the vaginal opening; some women opt for these. Also, it’s suggested that you wear a somewhat tight pair of underwear (or even cycling shorts) to prevent the dilator from getting expelled by the pelvic floor muscles. Use a good quality lubricant in order to help reduce discomfort with removal. Also be sure to urinate first thing in the morning after removing the dilator, to minimize any risk of a UTI.
However, for the majority of women beginning their vaginismus treatment, the thought of dilation is the polar opposite of rest! We get it – vaginismus and the dilation process can be stressful and anxiety-producing. We want you to take extra good care of yourself during this time. And getting a good night’s sleep is right up there at the top of the best self-care practices list!
Please hop on our Vaginismus Forum and let us know about your experience – if you’ve slept with dilators, did you find it helpful or not so much? We look forward to hearing from you!