MSH Silicone Vaginal Dilators Set of 5
1. What do the My Sexual Health (MSH) doctors say about the MSH silicone vaginal dilators?
"This product is without doubt our pride and joy. The silicon dilators are the result of custom-made South African dilators according to the needs of the thousands of women that the MSH doctors treat for vaginismus and other forms of painful intercourse”.
The two major advantages are that the silicone dilators have a soft tip and do not cause infections when properly sterilised. We have many patients who have tried plastic or glass dilators in the past as well as other household items, but they all prefer the silicone ones because of their softness and suppleness. You can also place the silicon dilators in hot water before you use them and they will retain heat - so much more comfortable than plastic or glass objects that can cause reflex muscle spasm.
We also make a size six (6) and a size seven (7) dilator for women with a partner with a penis larger than the average size five (5). However, the penis of a typical man is between a size four (4) and five (5) dilator. The silicon dilators can be purchased individually if you do not need the whole set.
Please refer to the included image to get a better idea of the different sizes."
2. More about the MSH silicone vaginal dilators
The highest quality material possibly available for this purpose has been used in the manufacturing process namely SORTA-Clear 40, a body-safe silicone rubber with a shore A hardness of 40 and exceptional tear and tensile strength.
This product is not mass produced but individually cast and cured around an encased core or ‘spine’ to enhance its rigidity but retain its soft tip.
After the manufacturing process, products are individually sterilised by the My Sexual Health team using medical autoclaves (steam sterilisation process) and separately packaged before being supplied to patients. Silicon dilators must be kept sealed in its sterile packaging until you use it.
The silicon dilators can be cleaned either with normal fragrance free soap or the soap from the FEMAGENE range and warm water - rinsed and dried thoroughly before storing it in a cool and dry place.
Products with manufacturing flaws should be returned to My Sexual Health as soon as possible for a replacement.
3. When is the use of vaginal dilators recommended?
Dilator therapy is used for a wide range of pelvic floor problems including:
- Shortened or narrowed vaginal canalafter gynaecological surgery such as a hysterectomy or and bladder lift.
- Pelvic floor muscle spasm (increased pelvic floor muscle tensionor overactive pelvic floor muscles).
- Reduced vaginal elasticity, with narrowing and adhesion in patients who had uterus, cervix, anal or rectal cancer or radiotherapy.
- Dyspareunia or difficult/painful intercourse – the most common cause MSH doctors see is primary or secondary provoked vestibulodynia, which is caused by hormonal imbalances, the pill, menopause, recurrent infections, an overly tight pelvic floor, or in rare cases the cause is genetic.
- Vaginismusor involuntary/painful pelvic floor spasm with attempted vaginal penetration.
- Unconsummated marriages or sexless relationships where couples need to be guided to a place where they will be able to penetrate for the first time in their marriage.
- Psychological problemsand sexual health issues associated with vaginal penetration, for instance - women who did not have sex for an extended period and want to make sure that they are still able to accommodate penetration.
- Congenital abnormalitieswhere a neo vagina had to be constructed.
- Transgender womenwith neo vaginas that need to be regularly dilated.
- Virgins who are about to get married and expect that penetration will probably not be possible.
- Women who can use tampons.
- Vulvodyniapatients who use dilators to relax pelvic floor muscles in order to decrease the tension on the nerves causing pain.
- Dermatological conditions like Lichen Sclerosis and Lichen Planuswhere there is narrowing of the vaginal opening and/or canal.
- Women with partners who have abnormally large penisesand need to first stretch the vaginal walls and muscles before allowing pain free penetration.
- Lesbian coupleswho would like to incorporate a form of penetration into their sexual play, but find it physically or psychologically difficult to insert something into the vagina.
- In patients with anal spasm (anismus) that influences defaecation or sexual function.
4. Improved physical comfort with benefits of dilator therapy
When used properly, potential benefits of dilator therapy can include:
- Sexual intercourse after pelvic floor surgery for scarring and narrowing and/or shortening of the vagina
- Pain free sexual penetration by training pelvic floor musclerelaxation
- Reduced pelvic floor muscle tension or spasm in general
- Overcoming fear of penetration
- Prevention of adhesion/fibrosis from forming during and after pelvic radiotherapy
- Inserting tampons
- Facilitating ease of gynaecological examination
After a period of painful (or even impossible) intercourse, you have to teach your brain that you can allow something to go into your vagina without hurting you. The dilators help you with the process of systematic desensitisation on a physical and psychological level to get you to your goal.
5. Does it really work?
According to statistics from our MSH clinic, patients progress on average to the number four (4) and five (5) dilator within three (3) to four (4) weeks if they take their medication and see the physiotherapist. Those who do not progress well, might need Botox (about 1/20) or more intensive psychological treatments.
1. Explaining the My Sexual Health (MSH) treatment process
After you have been evaluated by one of the MSH doctors, you will probably get a prescription for a special medicinal cream to address the hormonal and nerve problems you might have, as well as treatment for infections or treatment to prevent infections, muscle relaxants and further medication to help you cope with anxiety when you are dilating or going to the physiotherapist.
MSH patients see a specialist pelvic function physiotherapist to teach them breathing and positioning techniques, evaluate their pelvic floor muscles, show them how to actively relax their pelvic floor muscles, demonstrate to them how to use the dilators and progress from the different sizes, and help them with trouble shooting when they get stuck. Specialist pelvic function physiotherapists also attempt to find and treat the cause for tight pelvic floor muscles, rather than just addressing the symptoms.
We also recommend that you use the medication for about ten (10) days before visiting the physiotherapist and preferably first see the physiotherapist before you attempt to use the dilators.
Some patients experience painful intercourse due to solely medical reasons. If, however, you expect that there might also be a psychological component for experiencing painful intercourse (especially if you were victim to childhood sexual abuse or traumatic sexual experiences), we strongly recommend that you also see one of the specialist psychologists or preferably a trained hypnotherapist on our team.
If you have not seen one of the MSH doctors and you are struggling with your dilators, please visit one of them as soon as possible. There is usually an untreated medical condition preventing you from progressing, or psychological issues which have not been attended to.
You can find our whole team of pelvic pain specialists here: http://mysexualhealth.co.za/about-us/
Thousands of women around the world have cured their vaginismus and other sexual pain conditions by only using dilators. If you feel comfortable to first try it on your own – go for it! (But please do see a doctor who specialises in pelvic pain if you have any concerns).
2. How to use your dilators step-by-step
- Select an appropriate time and a warm comfortable place – allow for relaxation and no interruption.
- Position your body lying down with your legs bent – place pillows or cushions under your turned-out thighs to allow your leg muscles to completely relax.
- Warm the dilator before using it – put it in hot water for 5-10 minutes to slightly warm it (avoid making it too hot).
- Apply your prescribed cream if you are a MSH patient. Make sure you rub it in, around the opening and with the tip of your finger into the opening for at least two (2) minutes.
2.1 Step one – lubrication
You can use any kind of lube with these dilators, however we recommend that you use Pjur Body Glide Lube or Pjur Med Premium Glide if you struggle with recurrent infections or if you are very sensitive. If you are being treated by one of the MSH doctors, you can also use the cream they have prescribed as a lubricant. These lubricants can be ordered online from www.MySexualHealthShop.co.za.
Place a small amount of lubricant on the tip of the dilator and around the opening of the vagina.
Avoid lubricants containing petrochemicals as these can cause pelvic floor tissue irritation and exacerbate pain. Even natural oils can disturb the natural balance of your vagina and contribute to painful intercourse.
2.2 Step two – breathing
Focus on your breathing by using a series of slow deep breaths. Try to breathe with relaxed deep breaths so that your belly rises when breathing in, and falls when breathing out. This is called diaphragmatic breathing and its purpose is to switch on your parasympathetic nervous system, which makes you feel safe and relaxed and switch off your fight and flight reaction, which is often over-active in people with vaginismus or painful intercourse.
Count while you are breathing. If you take four (4) counts to inhale, try to take eight (8) counts to exhale. Continue diaphragmatic deep breathing for up to five (5) minutes at the outset of the session.
2.3 Step three – scanning
Scan your body for any area of muscle tension from head to toes.
Notice any muscular tension around your eyes, jaw, throat, shoulders, buttocks and legs. Mentally encourage each area to relax and loosen with each exhale. As you exhale, let the pelvic area soften with each breath. Visualise or imagine this area in a state of softness, relaxing further with every exhale.
2.4 Step four – insert the dilator
- Start with the smallest size dilator and gradually progress the size of the dilator over time as comfort permits.
- Rest the narrow end of the dilator against the opening continuing relaxed diaphragmatic breathing.
- Gently insert the end of the dilator into the entrance when you feel ready to do so.
- Gradually insert the dilator to a tolerable depth. Keep the level of discomfort minimal and if you feel any discomfort, pause for up to a minute at a time, continuing to breathe and relax your pelvic floor.
- When discomfort has eased, progress further while stopping at regular intervals to get your body accustomed to the sensation and lengthening of the tissue.
- Try to keep the dilator in for 30 minutes at a time.
- If you find that the dilator goes in easily, it is time to progress to the next size. Some people will start the session with a smaller dilator, leave it in for five (5) minutes and then feel ready to progress to a larger dilator.
- Never force the dilator beyond a level of personal comfort.
2.5 Step five – dilator withdrawal
- When you are finished, gently withdraw the dilator and allow yourself to rest and recover before getting up.
- Make sure you are completely relaxed before withdrawing the dilator. The pelvic floor will often contract as a reflex reaction when you start to withdraw. Just give your body time to relax.
- It is normal to feel a burning sensation after dilating. This is due to the stretched muscles that irritated the nerves. If you are a MSH patient, you can use the cream your doctor prescribed after dilating again. If you do not have the cream, you can also use the FEMAGENE Soothing Gelafter dilating.
- Wash the dilator with warm soapy water, thoroughly dry and store. No need to wash or wipe the cream or lubricant from your genital area. It will only irritate the area more.
2.6 Frequency and timing of dilator therapy
- Aim to use your dilator for 30 minutes during each session, however when starting out this time frame may be well reduced.
- We recommend that you dilate every day for 30 minutes. Many of our patients get comfortable enough to sleep with their dilators a few hours every night (wear leggings to keep it in) or buy the shorter ones and walk around with them during the day.
- Once you have established pain free intercourse, we recommend that you maintain the relaxation of the pelvic floor muscles by either dilating, having sex or having physiotherapy three (3) times a week (i.e. if you are having pain free sex three (3) times a week, there is probably no need to keep on dilating, but if you are getting to sex only once per week, you will need some regular dilating to maintain the relaxation of the pelvic floor.
3. Additional dilator therapy techniques
The following dilator techniques for lengthening tissues and minimising adhesion should never feel painful. These are the types of dilator therapy techniques that may be discussed with your therapist or doctor regarding their suitability for use:
- Gradually increasing the depth of dilator penetration
- Massaging in a circular motion
- Moving the dilator diagonally i.e. forwards and backwards, and left to right
- Moving the dilator in and out of the vagina while maintaining gentle pressure against the vaginal wall
- Maintaining gentle pressure against an area of discomfort for up to 60 seconds
- Progressing the size of the dilator
- Involving your partner in dilator therapy
4. Important precautions to take while using a dilator
- Keep discomfort to a minimum – we do not want you to feel physical or psychological discomfort when you are dilating. Of course you are going to have to push yourself a little bit to progress to the next size, but if you feel overly anxious, first speak to your doctor, your physiotherapist or psychologist about it.
- Avoid using a dilator with active pelvic infection and see your doctor if you think that you might have an infection.
- Avoid using a dilator immediately following pelvic surgery – be guided by your specialists’ recommendations regarding all forms of post-operative penetration and dilator use.
- You should not be bleeding due to dilating – if you are, you MUST see a doctor. It can be due to infection or extreme thinning of the outer layer of your vagina.
- Never use someone else’s dilator.
- Clean and dry your dilator thoroughly after use.
5. How to progress to intercourse
Once you can insert the number five (5) dilator without physical or emotional discomfort, we recommend that you involve your partner in the process. Only when your partner can insert the number five (5) dilator without causing discomfort for you, you can progress to attempt penetration as if your partner is the next dilator (rather than through a passionate love making session). We find that it is better if you take the first few attempts at penetration very slow and then progress to normal intercourse when you are comfortable with penetration.