pelvic health, physical therapy, postpartum, pregnancy, Sex, women's health

Loosen Up for Valentine’s Day

Vaginal Dilators and Perineal Stretching

If you’re new to intercourse OR you’ve been at it for a while, but are experiencing new or persistent pain/difficulty with sex, keep reading!


This is information I wish I would’ve known before my first go, so first timers listen up.

Progressing through vaginal dilators is a great way to provide feedback to your pelvic floor muscles (and your brain) to allow them to stretch without pain. There is usually a lot of anxiety and excitement surrounding your first go at sex and this can make your muscles tense and resist penetration, as well as, prevent adequate vaginal lubrication. So progressing through vaginal dilators (they start at about the size of a light day tampon) allows your brain to recognize that this is a safe, non-painful activity and therefore will ease your anxiety/fear when the real deal happens.

If you have pain with insertion of a tampon, you may benefit from trying perineal massage before using dilators. This will, again, provide feedback to your superficial pelvic floor muscles and brain, to allow effective relaxation and pain-free tampon insertion and penetrative sex when the time comes. This can be a technique that you implement often if you find yourself tense or not well prepared for penetration.

Perineal/Hymenal Stretching Diagram via “Intended for Pleasure” – Dr. Ed Wheat

DON’T FORGET THE LUBE! When working through the dilators, perineal stretching AND during sex – put it on you, him, in and around.. you can’t use too much. You can always use less or none later on when you know you don’t need it.

If you’ve gone through the dilators and sex is still painful, read below for the “been around for a while-er’s” use of dilators.


Been around for a while-ers

…but still have pain with penetration or pain is new. Read advice above for initial use of dilators. Then, if you’ve gone through the dilators without a problem, then have your partner go through them with you. Meaning, he inserts the dilator. He doesn’t necessarily have to go through every single one, just start at the level that he can insert the dilator without causing you any discomfort. Once you get to the size that he is, and he is able to insert it without pain, then you’re likely ready to attempt sex. The point in having him insert the dilators is that you are not in control (or as in much control) and this allows for trust and reassurance that penetration/sex will not be painful. (First-timers, this is the additional dilator use advice)

Perineal stretching comes into play if you need to give your muscles some feedback prior to penetration to get them to relax. You can do this or he can! Add it into the foreplay, yay-yeah! Make it sexy, not medical.


Ok, so how the heck do I use the dilators?

Slowly, gently, with lots of lube (have I mentioned lube?), jaw relaxed, and breathe. Lie on your back, legs supported, or get in the bathtub, comfort is key! Start with the smallest size, and gently approach the vaginal opening. If no pain with initial penetration, try inserting a little further, and a little more until the dilator is in completely (to the level of the green handle).

You should have ZERO PAIN along the way. If you do, stop what you’re doing and do some diaphragmatic breathing, reset your mind and try again. If you can’t make any progress after a few attempts, try again another day. Do some yoga or meditation before you try again. The goal is to have no pain associated with this activity or else your mind will relate the two experiences – vaginal penetration and pain. Two things that should not go together.

Have no expectations for yourself or your partner. Move slowly through the progression of the dilators. This may take weeks/months or it might just take a day or two. So be sure you are communicating with your partner and help them understand what your doing and why you are doing it. Try to avoid sex while progressing through the dilators because you can start the pain/penetration relationship over again and that is the most difficult thing to break-up. But in the meantime, there are lots of other super fun sexy activities to do with your partner that don’t include vaginal penetration. I highly encourage this as it improves the excitement and mind-body relationship with sex and intimacy. This may give you the time to discover new places of pleasure you didn’t know you had!

Here’s the link to the dilators I recommend (the most nontoxic I can find):

Stretch my peri-whatty-huh?

This is the area between your vagina and rectum.. I think the urban dictionary so classily defines it as your “taint.” (lolol) And where so often those that give vaginal birth experience tearing.

You stretch by inserting the tip of a clean lubricated finger (just one finger initially) into the entrance of the vagina and gently press downward to stretch the perineum. If that isn’t painful, you can try slowly massaging the perineum by sweeping your finger back and forth over this area while inside the very entrance of the vagina. Do this for 2-5 minutes about every other day. If you find yourself sore, back off on the pressure next time and wait until the soreness is gone until you perform again.

Again, stop if you have any pain at all, do the relaxation techniques I mentioned for dilator use and try again.

Let me know if you have any questions or concerns!!!



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