Vaginal Dilators are used in physiotherapy to treat women who suffer from pain and
anxiety with penetration. Knowing how to use vaginal dilators correctly
helps women follow up the treatment in the clinic in the privacy of their own home.
Hi, I'm Michelle, and today I'm guiding you through how to use vaginal dilators at home.
Now we're going to be looking at how to set up to use Vaginal Dilators and I'm
going to guide you step by step through this process, also to how to insert them,
how long you need to use them for the optimal time to use them during each treatment,
and also to over a period of time, and then finally to just briefly some precautions to follow
if you're using vaginal dilators at home. Now, just before we start there's no universal protocol
for using vaginal dilators so it's really important that you work with your clinician
and follow your clinician's instruction because this person has actually given you
the dilators and assessed your condition, and has given you a certain treatment protocol
according to your condition. So the information that I'm giving you is general information
only that might actually you might actually like to take some of these ideas on board
for relaxation pain reduction and so forth, and also to inserting the dilators as well.
So, this is a set of vaginal dilators here and this is a set one of the sets that I
like to use and this is the Velvi Dilators and they're linked below if you're interested in
reading more about them. I really like them because they're a medical-grade dilator and
they come with a detachable handle but the thing I like the most about this that handle detaches
like that, so it makes them much easier to use when you're actually inserting them. But I really
like them because they have one of the smallest diameter starting sizes and this is really useful
for pain and apprehension with penetration to have a really small size to start with.
So, that's really nice some of the larger sizes are a bit more threatening
too and can be a little bit more uncomfortable. So, Velvi is a nice brand to actually start with.
So, let's start by going through the basic setup for how to set up just to use your dilators,
and then we'll go through step by step for how to actually insert them and progress your treatment.
So first of all, when you're setting up set up in an area where you know you're going to be warm,
calm, and relaxed and usually, this is in the bedroom you want to be in an uninterrupted space
because this is the time you need to take maybe five to ten minutes of your time that you know
that you can feel comfortable on your own. Lying down, in the position that you can see up here,
this is the position that's really nice to relax and so you have a couple of cushions under each
knee, or a pillow underneath your knees so that you can lie back and relax during the treatment.
First of all in, your lying down position you might like to warm the dilator and you can also
warm the lubricant that you're going to use as well and I'll discuss more of that in a moment.
But just by wrapping the dilator in a warm wet flannel for five minutes or so,
can help to warm it up which can make it much more comfortable and you can also wrap the lubricant in
the warm in the warm funnel as well if you'd like to lube if you'd like to warm that up as well.
So, lying down the first things you do and these are really important things deep breathing,
now, we're going to use deep breathing to help you adjust and for your to train your brain
to relax with the treatment because part of this is not only just
applying gentle stretch to the tissues but it's also desensitizing you to touch in that area and
also to helping you become relaxed and familiar with that so the breathing and the scanning that
I'm talking through first are really important parts of this home treatment. So, when you're
breathing you start with your deep breathing for five minutes, lying down, and you take a slow
deep breath in and when you do so you breathe into the belly, so into the lower belly so the lower
belly expands forward and then relaxes down, and as you do so as you deep breathe, you imagine the
pelvic floor relaxing down, and letting go. So, with each breath out, let it relax, and let go,
and then slow deep breath out back in again. So that's how you're doing that
slow deep breathing if you've ever done Yoga breathing or diaphragmatic breathing down into
the base of the rib cage so I'll show you that you know into that space in there and allowing that
belly to raise forward that's what you're actually aiming for with this deep breathing technique.
So, after five minutes, and again you might have your soft, calming, relaxing music playing. Start
some Body Scanning. Now when we talk about body scanning we talk about noting from the
head to the toe or if you want to work from the toes through to the to the head it's up to you
but just noting any areas of muscle tension and you can do this progressively say for example
you might feel around the face, can you feel any areas of tension in and around your face, soften
your facial muscles. around your mouth. around your jaw, around your neck and working down your
body progressively into the lower tummy that's a really important part of the body to relax and to
breathe into and also into the pelvic floor the buttocks and the thighs right down to the toes.
So these two starting things your deep breathing and your body scanning are really important.
Okay to start what you actually do then is you use a small amount of water-based lubricant on the top
of the dilator. So, make sure the lubricant is water-based you don't want to be adding chemicals
that might irritate the internal tissues and so some of the lubricants have petroleum-based
or are have additives in them that are best not to use if you're prone to suffering from pelvic pain.
So, you’ve add that small amount of lubricant on the tip of the dilator and you start with
the smallest possible dilator so that's really important. Now, one of the most
other important things that I can say is that when you're actually inserting the dilator,
the most you can feel the most you should feel is a minimal discomfort. You always keep this
sensation comfortable otherwise you can have reactive muscle tightness and muscle spasm if
you feel pain. So it's really important that the treatment remains really comfortable with
minimal discomfort throughout and this is where you're going to use your breathing strategies too.
So you start in that lying down position and just with the tip of the the tip of the dilator
just rest it against the entrance so just the entrance only and relax and breathe, visualize
your pelvic floor softening down, it might be like a flower opening up you can use a lot of
visualization techniques to help you relax and, also to this various cds available
that you can use to actually help you with that relaxation deep breathing process. So,
also when you're actually then you've actually managed to relax, and adjust to that sensation,
then just progressively insert the dilator a little bit. So we're not going for the
whole amount we're just going for a small amount and you do as much as you can tolerate
per session and that might be just the tip against the entrance and that is absolutely fine.
Then if you can actually insert it a little bit more and once again, you're
really focusing on your breathing, on the music around you, on that general sense of relaxation,
and noting any areas that might be tightening in your body and letting them go, and relax.
So, if that's enough for you during that treatment session, then that's absolutely fine then you
stop. If you feel that you can go a little bit further, then gently insert it you don't need
to keep holding onto the handle, you can let it go, trust in that it's not going to move,
relax your breathing, sometimes you can actually just put a gent a little pillow against the end
of the dilator there against the handle if you need to actually stabilize it if you're worried
about it slipping out. And so that's how you actually gradually progress that treatment so
increasing the depth of the insertion and then when you've finished your session,
remove the dilator and just take a moment to breathe and relax after that session's
finished when you feel calm and ready to do so then you can get up and obviously wash
the dilator with warm soapy water and store it in a dry place so store it and dry it.
So, that's how you progress your dilators and over a period of time you'd be gradually
increasing the size of the dilator you used just according to your own personal level of comfort.
Now let's talk about the frequency and the timing of dilated treatment.
Once again there's no firm recommendations with this in the literature but there is some
suggestion in some of the research that using a dilator on alternate days of the week so one
day on, one day off can give you benefits and starting with the duration of time that feels
comfortable for you working up towards five to ten minutes per session. Now the research also
suggests or some of the research also suggests that women that use dilators over a three-month
period of time so three months or longer seem to get better outcomes in terms of reduction in pain
and reduction of anxiety to allow for penetration. So what are some of the precautions we need to
take using a dilator? Well I've already mentioned the first one and that is always keeping that
dilated use within your range of personal comfort if you push too hard and too fast then you're
going to office often get some reactive spasm and that's going to go against the the whole
aim of the treatment plus two you want to give your brain time to learn not to feel threatened
by that penetration so you're actually going through a learning process as you're doing this.
The second precaution is not to use a dilator with an active pelvic infection.
The third precaution is not to use a dilator unless you've been advised otherwise immediately
after pelvic surgery so really follow your medical specialist guidelines regarding when to
start using a dilator if you need to use it after pelvic surgery and also too it's very important
that you follow your surgeon's recommendations or your oncology nurse's recommendations if you're
using a dilator after pelvic radiation therapy to stop adhesions developing.
And finally, obviously you'd never share a dilator and always be hygienic with your dilator
wash them and put them away and dry them. I didn't mention some women will sometimes
experience a little bit of blood loss after using a dilator which is okay but
if you experience a large volume of blood loss or a large amount of pain then it's really
important that you consult with your medical practitioner before using the dilator again.
So we've gone through quite a lot there haven't we? We've talked about how to start using the
vaginal dilator, how long to use the vaginal dilator, how to insert the vaginal dilator,
and also to some of the precautions to be taken with vaginal dilator use.
So, if you found the video helpful I'd really appreciate it if you can give it a like below
because then that will encourage youtube to share the information with other women that
might benefit too and I really thank you for watching today, and really hope this information
benefits you and helps you with your understanding of how to use a vaginal dilator.
I look forward to seeing you in the next video goodbye for now you.