In order to ensure that there is little-to-no pain, they start at x-small and go up in size (diameter – not length!) in order to allow you to put in (very, very slightly) larger and larger sizes until you are at a size of a penis. Usually dilator sets include 5-7 sizes.
Inserting dilators should really not hurt. It may be uncomfortable or feel “weird,” as some patients like to tell us. Or it may be that you feel some stretching or pulling, but ultimately if you keep it in place for a few minutes and relax around it, the muscles should soften and give in and there should be no significant pain.
Types of Dilators
There are several types of dilators and there is truly not a big variation between them. You want a dilator that is sturdy and comfortable to hold. Beyond that, the only variation is how “hard or stiff” the material is. Some women are more comfortable with a softer silicone dilator. It feels more natural to them. We find that many of our patients like the hard white plastic dilators since they have no give at all and therefore slide in quite easily, with no bending.
One set of dilators we recommend comes with a flat bottom which, when the dilator is inserted the whole way, will rest up against your vulva. Some women like this and find it more comfortable. The white, hard plastic set we carry are longer with no “bottom” to speak of. They have extra length in order to allow you to hold them at the end when they are inside.
You should always make sure you use a lot of lubricant when you are dilating. Any tension or pain that can be avoided from friction, should be avoided.
Trouble Dilating? Not to Worry!
Don’t get frustrated if you’re having trouble dilating. Sometimes women just can’t bring themselves to get that first dilator in, and sometimes women are doing fine but can’t seem to get past that medium size dilator. All of a sudden it starts to really hurt or the muscles tighten up and you “just can’t get it in.”
That’s what we’re here for. Call us and make an appointment if that’s the case. You may need to be seen to assess if there is something else that can be done to make the process more comfortable. The bottom line is that intercourse should not hurt and you should not give up treatment until you “fix” the problem.