How do I choose the right dilators ?
is a frequently asked question, not only by customers but also by health professionals who want to know the best set to recommend for their patients.
Let's start by looking at what conditions you might use vaginal dilators or trainers for and then look at the differences in the available sets.
Common conditions that may benefit from the use of vaginal dilators:
- Vaginismus - inability to have penetrative sex, use tampons or undergo inetrnal examinations due to spasm of the superficial layer of the pelvic floor muscles
- Dyspareunia - painful intercourse or penetration. This can be primary ( from the first attempts at penetration ) or secondary - usually at times of low oestrogen such as postnatally and at menopause
- Vulvodynia, vestibulitis - pain and/or inflammation of the tissues around the opening of the vagina which can prevent comfortable sex, use of tampons or medical examinations
- Scar tissue following surgery or vaginal birth
- To maintain the patency or stretch and length of the vagina following radiation therapy.
- To assist post gender reassignment surgery
- Pelvic pain
- History of sexual trauma
- Vaginal narrowing
- Vaginal agenesis (absence of a vagina)
Benefits of using vaginal dilators or trainers :
- generally using dilators alone will not fix the problem but should be seen as a part of treatment. Other things that may be included are relaxation techniques, stretching , pelvic mobility and hands-on treatment with a pelvic floor physiotherapist
- reduce anxiety associated with touch and penetration around the vaginal area as well as pain
- part of a graded exposure progress in teaching the pelvic floor muscles to gradually and gently stretch and not spasm painfully with touch or the thought of touch.
- they can be used in the privacy of home where you will feel most comfortable
- they allow you to progress at your own pace.
What is the difference between the types of dilators?
- Femmax dilators
- Berman dilators which have a battery operated vibration function
- Vaginismus dilators
- Amielle dilators which come in 2 sets: Amielle Care and Amielle Comfort
- Inspire silicone dilators
- Berman Isabelle silicone vibrating set and Alena silicone small dilator set.
FEMMAX dilators were designed by an oncology nurse in the UK, specifically for post-radiation treatment for the maintainence of vaginal patency and help prevent scarring and fibrosis. They have become very popular for vaginismus and pelvic floor self-massage due to their nicely rounded ends.
Some peole prefer them because the two smaller and the two larger sizes screw into each other with one becoming the handle for the other. This can be less confronting for some than the screw in handles.
Berman dilator set is made by Dr Laura Berman , a sexual counsellor in the US, and is the only one with a vibration function. It is not medical grade and is sold as a novelty product but many women find the vibration function helpful with arousal which is an essential part of penetrative sex and therefore using dilators whilst in a state of arousal means they are being used in a more functional way, and the situation in which penetration is more comfortable (1)
We also have a range of discreet , quality vibrators which can be used either alone or with any of the other dilator sets. You will find them in our SEXUAL HEALTH category
VAGINISMUS dilators are the set direct from the vaginismus.com website in America but at an affordable price. They comprise 6 sizes of dilator and two satchets of lubricant.
- Amielle Comfort has 5 dilators, Vaginismus has 6 with the extra one being larger than the other sets in diameter ( but the Amielle Comfort largest one is longer )
- The handle for the Amielle and Vaginismus is different. Vaginismus have introduced a new handle where the flanges of all sizes fit completely into it
- Amielle Comfort comes in a storage purse with a tube of lubricant.
- see below for a comparison chart of diameters and lengths of all the dilators.
VAGINISMUS (Diameter/Length) AMIELLE COMFORT 5 SET (Diameter/Length)
- 15mm x 88mm 15mm x 70mm
- 22mm x 101mm 20mm x 90mm
- 26mm x 113mm 25mm x 110mm
- 30mm x 126mm 30mm x 140mm
- 34mm x 138mm 35mm x 160mm
- 38mm x 151mm -----------------------
Amielle Care is a 4 pack of dilators with squared ends which were designed for use following radiation therapy. The squarer shape is ideal for regaining and maintaining vaginal shape and help prevent scarring and shrinkage of the tissues. This set comes with 4 sizes, a handle, lubricant and a storage purse.
Silicone dilators are made of body-safe, phalate free silicone which many women find softer and nicer to use particularly for conditions such as vaginismus and vulvodynia. They are not as suitable post radiation therapy when the treatment goal is to maintain patency (shape) of the vagina and prevent fibrosis or scarring.
Silicone vaginal dilators tend to be shaped slightly curved which is more realistic anatomically especially when the treatment aim is penetrative sexual activity.
Inspire Silicone Dilator Kit 5 pack These are not sold as medical dilators but are a popular set of 5 dilators of increasing size. They have a loop for insertion and removal which gives them a less medicalised look.
Berman Isabelle is a set of two dilators, equal in size to the two largest of the Inspire set. They come with a small bullet vibrator which can be inserted into them giving a nice gentle vibration which has been shown to aid with relaxation, dilation as well as arousal.
Berman Alena is a set of 3 dilators, the smallest being the same size as the smallest Inspire, the other two are the same width as the next Inspire but differ in length so can be ideal for women aiming to improve or maintain vaginal length.
Dilator therapy is best done under the guidance of an experienced health professional such as your women's health physiotherapist.
If you need some more guidelines in how to use your dilators, you can download the fact sheet physiotherapy advice for using your vaginal dilators
(1) Talli Y. Rosenbaum (2013):An integrated mindfulness-based approach to the treatment of women with sexual pain and anxiety: promoting autonomy and mind/body connection, Sexual and Relationship Therapy, Journal of Sex and Relationship Therapy DOI:10.1080/14681994.2013.764981