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This information sheet explains what vaginal dilation therapy is and includes a step-by-step guide to how it should be performed. If you have any questions about the therapy or information provided, please talk to your healthcare team.

What is a vaginal dilator?

A vaginal dilator is a smooth cylinder-shaped plastic object which is specially designed to prevent or treat vaginal tightness or shortness.

Why do I need vaginal dilation?

Following external beam radiotherapy and/or brachytherapy, your vagina may become narrowed and shortened due to formation of scar tissue. Vaginal dilators help to keep the vagina open, making it more comfortable for you to be examined during your follow-up clinic appointments. Vaginal dilation also helps to maintain a comfortable and healthy sex life.
However, we recommend that you use the dilators whether you are sexually active or not.

When do I start vaginal dilation?

You will have an appointment with a clinical nurse specialist (CNS) four to eight weeks after completing your radiotherapy treatment. The CNS will explain and demonstrate how to use the dilators, and examine you to assess the correct dilator size. She will also ask you to use a dilator during the appointment to make sure that you understand what you need to do. At the end of your appointment you will receive a set of vaginal dilators with a lubricating gel and basic instructions on how to use and care for them.

Your CNS will also offer you a Holistic Needs Assessment (HNA) to help to identify and prioritise your needs and concerns. This will involve completing an online or paper checklist, talking to the CNS about your concerns and creating a personalised care plan. For more information about the HNA, please ask your CNS for a copy of our leaflet.

Are there any risks of using vaginal dilators?

Rarely the dilators can cause injury to the bladder or bowel if used incorrectly. Your CNS will teach you how to use them correctly to minimise this risk.

Are there any alternatives?

There are no alternatives to this treatment at present. If you decide not to use the dilators, talk to your CNS who will advise you how this may affect you.

Using the dilators – step-by-step guide

  • Wash the dilator thoroughly with warm soapy water. Make sure that you wash all traces of soap away
  • Using the appropriate size of dilator (your CNS will explain this to you during your appointment), assemble the dilator and the handle provided (fits all sizes of dilators)
  • Lubricate the tip of the dilator and vaginal opening using the lubrication gel provided
  • Find a comfortable relaxing position similar to inserting a tampon. For example, lying on your back with your knees bent and legs slightly apart
  • Insert the dilator into your vagina as far as is comfortable for you. Don’t force the dilator, light pressure is acceptable
  • Once comfortable, move the dilator from left to right for two to three minutes. After that, if possible, rotate the dilator in a circular motion using the handle
  • Remove the dilator slowly and gently. If you are able, move the dilator in a circular motion, or side to side, as you remove it
  • Clean the dilator with warm soapy water and dry it
  • You should perform vaginal dilation three times a week

How long will I have to use the dilator for?

The current recommendation for the dilation therapy is to be life-long.

Are there any side effects?

  • You may experience some discomfort the first time you use a dilator. This is normal and you can take a mild painkiller such as paracetamol to help with it
  • A small amount of bleeding or ‘spotting’ after dilator use is normal – it is the breakdown of scar tissue. If you continue to bleed in between dilator uses, contact your CNS for advice
  • If there is a lot of new bleeding and pain during or after dilator use, stop using the dilator and contact your CNS
  • If you experience vaginal dryness, you may use a moisturiser. There are different types of moisturisers and some may need a prescription, so please discuss this with your GP. If you pay for your prescriptions, please ask your GP or a local pharmacist for an exemption form

Contact us

If you have any queries or concerns about vaginal dilation therapy, please contact your CNS or key worker on 020 3447 8636 (Monday to Friday, 9am to 4.30pm). If your CNS is not available to answer your call, please leave a message with the service coordinator.

We aim to return calls within 24 hours and messages received after 4.30pm on Friday are usually returned on the following Monday.