What are dilators?

Vaginal dilators, also commonly known as vaginal trainers, have been used therapeutically for over 50 years to treat pelvic pain and painful intercourse.

Dilators are usually a set of smooth cylindrical devices that gradually increase in both length and width. Dilators are placed inside the vagina, starting with small sizes and progressively using larger sized dilators. By gradually increasing the dilator length and width, we are stretching the vagina and pelvic floor muscles, decreasing sensitivity and pain, as well as reducing psychological anxiety and fear related to pelvic pain.  

With pelvic pain conditions in mind, BIEN Silicone Vaginal Dilators have been custom tailored by a physiotherapist and pelvic floor expert so that they have the silkiest, smoothest, and most comfortable feel possible. Our BIEN Silicone Vaginal Dilators are produced with the best ingredients available, including medical grade (USP Class VI) silicone and can be purchased individually or in sets that meet your current and future needs.

Our dilators can be used to treat vaginismus, vaginitis, vulvodynia, vaginal changes or pain after radiation treatment, vestibulodynia, post trauma or in individuals who are experiencing pain with penetration, post-surgery for gender affirming surgery, vaginal stenosis and/or Vaginal atrophy as a result of menopause.

The BIEN Australia dilators are available in 8 sizes, designed for pain free, gradual progression. 

 

What are the barriers for getting treatment?

According to a study completed in 2020 by Krychman et alia, 56.8% of dilator users had suffered for more than 2 years prior to seeking treatment and 52% had seen more than 3 clinicians prior to beginning dilator therapy. Individuals reported that a major barrier to seeking help is the apprehension about discussing “intimate issues” with their health care professionals.

At BIEN we would go further, and say that some general health care professionals are also ill-equipped with the correct language, and confidence to ask the right questions regarding sexual wellbeing. Often a general practitioner will not have the correct referral pathways should someone discuss pelvic pain or painful intercourse with them. We know that due to these barriers to accessing the proper treatment and referral, many women self-diagnosed and seek over-the-counter treatment options. It has been cited in the literature that up to 70% of women who were using dilators had been using them without clinical guidance and found them either online or via talking with friends.

At BIEN Australia we aim to equip you with the language and knowledge to seek correct treatment pathways. We aim to empower you to take control of your treatment and increase awareness about pelvic floor dysfunction and potential treatment options.   

 

What can help make dilator therapy more effective?

Based on what evidence we have available here are some general principles to apply to your therapy:

• Frequency is more important than duration: it’s better to do 5 minutes 5 times a week than half an hour twice a week. Or twice daily for 5 minutes may be better than 20 minutes once a day - depending on your symptoms and goals.
• The more times you can dilate per day or per week may be better (if your symptoms aren’t flaring up). If your problem is true pelvic floor tightness, then using dilators frequently and often may be the best thing. But if you are having increased pain after dilation, then more isn’t always better! Seeking individual guidance with a pelvic floor physiotherapist is always recommended. 
• Don’t push through pain. The aim of dilators is to retrain the brain’s ability to process touch, pressure and stretch as non-threatening instead of as threatening and therefore painful. If you push yourself too hard and into pain, then you are more likely to reinforce the pain cycle rather than disrupt and break it. Always listen to your body and try to keep discomfort levels less than a 4/10. 
• Using dilators in conjunction with other therapy is the most effective! Pelvic pain is complex and using dilators alone, is unlikely to be as successful as doing it in conjunction with pelvic stretches, breath work, body scans and ideally in conjunction with a pelvic floor physiotherapist!

For more information about dilators click here. You can view our full range of BIEN Silicone Vaginal Dilators here. 

 

References: 

• Oelschlager AM, Debiec K. Vaginal dilator therapy: a guide for providers for assessing readiness and supporting patients through the process successfully. Journal of Pediatric and Adolescent Gynecology. 2019 Aug 1;32(4):354-8.

• Callens N, De Cuypere G, De Sutter P, Monstrey S, Weyers S, Hoebeke P, Cools M. An update on surgical and non-surgical treatments for vaginal hypoplasia. Human reproduction update. 2014 Sep 1;20(5):775-801.

• Krychman, Michael, et al. "Vaginal Dilators: A guide for health care professionals: These therapeutic medical devices can be used by patients to effectively treat pelvic pain and anxiety related to intercourse." Contemporary OB/GYN, vol. 65, no. 11, Nov. 2020, pp. 38+. 

•  Liu, Marisa; Juravic, Mark; Mazza, Genevieve; Krychman, Michael L. (2020). Vaginal Dilators: Issues and Answers. Sexual Medicine Reviews, (), S2050052119301258–. doi:10.1016/j.sxmr.2019.11.005 

• Bergeron S, Corsini-Munt S, Aerts L, et al. Female sexual pain disorders: a review of the literature on etiology and treatment. Curr Sex Health Rep 2015;7:159-169.

• Conforti C. Genito-pelvic pain/penetration disorder (GPPPD): an overview of current terminology, etiology, and treatment. Univ Ottawa J Med 2017;7:48-53.

• Lee Y. Patients’ perception and adherence to vaginal dilator therapy: a systematic review and synthesis employing symbolic interactionism. Patient Prefer Adherence 2018;12:551- 560.

• Idama O, Pring T DW. Vaginal dilator therapy-an outpatient gynaecological option in the management of dyspareunia. J Obstet Gynaecol (Lahore) 2000;20:303-305.