Your journey towards pain free sex has been difficult. You have been undiagnosed, misdiagnosed, and may feel like you are going crazy. You are frustrated that there is no medical treatment for your pain. Your doctor has talked to you about the importance of exploring the psychological and emotional issues that could cause sexual pain. The thought of talking to one more personal about your sexual pain is terrifying. The hope that this psychological and emotional exploration may lead to more sexual pleasure gives you the courage to pick up the phone and make an appointment with a sex therapist.
You may be curious about common interventions used by sex therapists for women who experience sexual pain. One of the most common interventions is the use of vaginal dilators. Vaginal dilators are used to help women expand their vaginal walls and practice relaxing the vaginal muscles. Vaginal dilators come in a variety of lengths, diameters, weights, and colors. The shapes of vaginal dilators are cylinder or mimic the shape of a penis. Vaginal dilators are usually sold in a set with all dilators varying in size.
The goal of using vaginal dilators is to make sexual penetration more comfortable. Specifically, through the use of vaginal dilators you will learn how to relax your vaginal muscles and increase sexual responsiveness. Vaginal dilators are helpful because they allow you to graduate to larger size dilators after you have been successful with smaller sizes. Many women opt to begin with a vaginal dilator that is thinner and shorter than the size of a finger. The use of vaginal dilators is a process that should not be rushed. Identifying how to relax your vaginal canal muscle is frequently the most difficult part and will often require women to continue to use the smallest dilator for a while. After identifying how to release the muscles, the rest is practice and takes time to gain skill at inserting larger sizes. Lastly, associating pleasure with penetration is another skill that will require experimentation and patience. Each client has their own process and the rate of acquiring each skill will look slightly different depending upon the exact nature of the initial presenting problem.
You may be intimidated thinking about using a vaginal dilator. This is normal. You have experienced sexual pain. Having negative emotions surrounding this experience will happen. It is suggested that you start a journal while embarking on this journey. Journaling will provide you with a space to reflect on your experience, discuss your emotions, and describe your pain. Also, journaling is a way to document your progress and successes!
It is important to be prepared for this process. Understand that you will experience discomfort, but by using vaginal dilators you can help minimize the discomfort you will experience. Allow yourself to take a risk. You are very courageous for starting this process, and not allowing your sexual pain to dictate your sexual experiences.
Before you get started you need to know how to do use vaginal dilators properly. Below are suggestions when using vaginal dilators.
1. Clean the vaginal dilator.
You want to make sure that you have thoroughly cleaned the vaginal dilator before you insert the dilator into your vagina. Use hot water and a non-irritating soap (do not use soaps with any harsh chemicals, fragrant, or by-products). You want to make sure you clean the dilator thoroughly (lots of suds). Also, the hot water can warm up the dilator making it more comfortable to insert. It is important that you clean off any germs found on the vaginal dilator. Germs can lead to infections, which can further irritate your vagina.
2. Find a safe and relaxing room.
Choose a space in your home where you feel most relaxed. You want to make sure you have privacy and will not be worried about any interruptions (children, husband, pets, phone, etc.). Dedicate this time for yourself.
3. You need to prepare your body.
Before you insert a vaginal dilator, it is important to get your vagina ready for it. You need to prepare your body by relaxing the vaginal muscles. You can help to relax your vaginal muscles with a reverse Kegel exercise. The reverse Kegel exercise helps to relax the pelvic floor muscles. You do reverse Kegel exercises everyday when you release your urine or try to urinate faster. To practice reverse Kegel exercises follow these steps:
1. Empty your bladder.
2. Sit or lie down in a comfortable position.
3. Allow your body to mimic the motion of urinating faster or harder (do not urinate). This motion works the Bulbocavernosus muscle.
4. Repeat 3 to 5 times.
5. Allow your body to mimic the motion of letting out gas or a bowel movement. This motion works the Pubococcygeus muscle.
6. Repeat 3 to 5 times.
After you relax the vaginal muscles, you want to engage in sexual self-stimulation – otherwise known as masturbation. Masturbation is a type of foreplay that can help your body produce natural lubrication and arousal.
When masturbating you will want explore and touch your genital area. You may want to just gently touch the outside lips of your vulva (labia majora). Notice how this feels. Next gently touch and rub your clitoris, moving toward your smaller lips (labia minora). Again, notice how this sensation feels. I suggest you finish right outside the vaginal opening (vulvar vestibule). Continue to notice the sensations you feel. Our body has natural lubrication that is activated when we explore our erogenous zones. You want your body to work with you during this process.
4. Use the right lubrication.
Put the lubricant on the vaginal dilator and in your vagina. An easily accessible and effective lubricant is an everyday household product; olive oil. Use it. It is cheap and most likely in your kitchen cabinet. My favorite is olive oil but you can also experiment with saliva and water-based lubricant. After you experiment, use your favorite!
5. Get in position.
For the least sexually painful experience you will want to insert the vaginal dilator like you would insert a tampon. You want to be squatting. I suggest squatting over laying down or standing up because when you squat, your vagina becomes wider, making it easier and less painful for you to insert the vaginal dilator. There is a reason tampon companies have been telling us to insert tampons this way. In case you do not trust me, I would like you to try a brief exercise.
1. Squat down. (Your feet should be on the floor and your knees should be bent)
2. While you are squatting tighten your pelvic muscles.
3. Stand up.
4. While you are standing tighten your pelvic muscles.
5. Did you recognize a difference?
When you are squatting down it is more difficult to tighten your pelvic muscles. We do not want you pelvic muscles tight, so squatting will help you to be more successful in loosening up your vagina and prepare yourself for inserting the vaginal dilators.
6. Practice proper insertion techniques.
After you have relaxed your body, applied the right lubricant, and are in the squatting position you are prepared to insert the vaginal dilator. Place the tip of the vaginal dilator at the opening of the vagina. Apply gentle pressure to the dilator in order to slowly insert the dilator into your vagina. It is important that you go slowly so that you recognize when you feel discomfort or pain. When you notice the pain or discomfort stop inserting the vaginal dilator.
When you start to become more comfortable with inserting the vaginal dilators you can begin to us different techniques. You can move the vaginal dilators around in a circular motion, increase the depth of the dilator, or practice Kegel exercises (the tightening and releasing of your pelvic muscles).
When you have finished, just gently remove the dilator from your vagina.
* the first time you attempt penetration stop at the 1 inch mark and do some Kegel exercises Feel the vaginal dilator. Now stop. Congratulate yourself.
* The second time you attempt penetration apply some extra pressure and see how far you can go. Remember, the other third of your vaginal canal is the most sensitive. Once you have inserted it as far as you can go, do 5 Kegel exercises then stop.
*On your third attempt (third day), do 5 long Kegel exercises and then push as you release. Once you are successful at penetration, try leaving the dilator inside and masturbate. Note how the pressure of having something inside of you changes the sensations your experience during masturbation. Frequently women report liking a change in pressure of speed of touch when something is inside of her.
*Once you have mastered penetration, try with the smallest dilator inside of you, to bring yourself to orgasm with it inside of you. Either the dilator can become part of the masturbation process of simply something resting inside of you. Either way is fine. The dilator won’t care. This is all about you and your pleasure!
7. Only graduate to longer lengths of time and larger vaginal dilators when you have been successful.
I first recommend you start off inserting the vaginal dilator for a short amount of time. Start out inserting the vaginal dilator for no longer than one minute. As you become more comfortable with the process and technique of using vaginal dilators you will begin to increase the frequency of use, length of time, and size of the dilator. Using vaginal dilators is a graduated process. You must first win small victories in order to advance to bigger victories. It is crucial that you celebrate ALL victories, no matter how big or small.
Typical treatment recommends using the dilators for between 5 and 15 minutes on a daily basis. You will work up to this amount of time. Notice how varying sizes and techniques impact your experience of pain. Continue to journal these experiences. Be curious about the process. The more you understand about how your body responds, the better equipped you will be to make adjustments that lead to more pleasure sexual experiences.
8. Explore your sexual pleasure.
As you increase the amount of time you will be using the vaginal dilators, you will want to explore your pleasure. Think about how you can incorporate all of your senses into your experience. This may include experimenting with watching porn or reading erotic literature. This will help you understand how incorporating visual stimulation, a plot line, or sexual fantasy changes your sexual experience. You can incorporate music to enhance the mood and help you loose yourself in your sexuality. Try different genres of music to see what feels best. Mood lighting and candles are other options to explore. Experimenting with how your different senses interact with your sexual pleasure will give you tools to have decedent sexual experiences. By discovering what you find most enjoyable you are actively creating more positive sexual experiences.
9. Clean the dilator.
Make sure you thoroughly clean the vaginal dilator after each use. You want to practice safe sexual practices. Cleaning the dilator before and after every use helps to eliminate germs. When you clean the dilator remember to use hot water and a non-irritating soap (do not use soaps with any harsh chemicals, fragrant, or by-products).
10. Use the bathroom.
After penetration women should get in the habit of urinating. What urinating does is help to eliminate vaginal bacteria that may have entered the urethra during vaginal penetration. The vaginal canal and urethra are very close in proximity, making it easy for bacteria to enter the urethra. Urinating decreases the rate of infections, especially urinary tract infections, which can increase the amount of discomfort during sexual penetration.
Deciding to use vaginal dilator therapy will put you one step closer to decreasing you experience of sexual pain and increasing the amount of pleasure you receive.. Just remember to have patience with yourself while starting to use vaginal dilator therapy. The first few steps are always the hardest. You are embarking on a new experience, and like with any new experience it will take some practice.
If you find yourself really struggling with sexual pain, feel free to reach out to one of the counselors at The Center for Growth / Sex Therapy in Philadelphia. Please call 267 324 9564.