Sexual Wellness Resource Center
For Adults over 50.

Vaginal Dilators

Intimate Senior Couple
By Michael Bates, M.D.

Occasionally during my practice, a menopausal patient would ask me if it would be possible to have sex after many years of no sexual activity. This usually occurred in the context of a new relationship and the possibility of resumption of intercourse.

With the menopause there is a natural loss of lubrication and a thinning of the vaginal lining, which can lead to painful intercourse in patients who are regularly sexually active. Combine this loss of lubrication and thinning with no intercourse for many years, which can result in the vagina shrinking, and yes, sexual intercourse may be impossible.

What advice did I give such patients? A combination of topical vaginal estrogen cream with the use of vaginal dilators to return the vaginal tissues to an elastic, comfortable condition ready for sex.

Vaginal dilators come in a set and are tubular shaped devices which progressively increase in diameter. They are used to slowly and gradually increase the size of the vaginal opening and to increase the width and depth of the vagina. 

They are useful not only in the above patient but also for sexually active menopausal patients who are interested in keeping the vagina comfortable and ready for sex. They are also very useful for patients who have undergone pelvic radiation or surgery that has resulted in a shortened, dry vagina.

So how are vaginal dilators used?

Lie down in a comfortable and private place, like the bedroom. Bend and spread apart your knees with your feet planted on the bed. Slowly and gently, with lubrication (Astroglide, Replens, K-Y sexual lubricant), insert the smallest dilator in the kit into the vagina. If it causes pain, stop and try to relax the pelvic muscles. Push it in no further than you can comfortably.

Leave it in place for 5-10 minutes. Once you are able to completely insert the dilator without pain, it is time to move to the next largest size.

Do this 3-4 times a week and don’t expect immediate results. It can take a few weeks to a few months to have expanded the vagina enough for comfortable sex. Dilators continue to be a good tool for the maintenance of vaginal dimensions and the readiness for comfortable sex.

The estrogen cream requires a prescription from your doctor. I usually recommended daily use, application externally and fingertip vaginal insertion at bedtime, for two weeks followed by use twice weekly indefinitely. Estrogen used in this manner is not absorbed by the body and can be used in patients who are usually advised not to use estrogen, i.e. breast cancer patients.

So what is the take home message? Vaginal dilators can:

  • restore and maintain vaginal width and depth
  • keep the vagina more elastic
  • permit comfortable vaginal sex

If you are menopausal and want to maintain the vagina in good condition for vaginal sex, if you have not been sexually active for many years and want to become active again, if you have had pelvic radiation or surgery and want to rehabilitate the vagina for sexual activity, talk to your doctor about vaginal dilators.

About the Author

Michael Bates, M.D.

Dr Bates practiced obstetrics and gynecology for 34 years in Wichita, Kansas, until his retirement in 2011.

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