| Robert J. Echenberg, MD
Sex and Vaginal Dilators After a Hysterectomy
Sexual problems for women occur for a variety of reasons. Sometimes it’s the onset of menopause causing vaginal dryness, leading to painful penetration. For some, it's from the uterus, cervix, and part of the vagina being removed due to a radical hysterectomy as a treatment for cervical cancer.
For those who've had a hysterectomy, one of the most common questions is, will it hurt to have sex afterward? Painful intercourse is a possible side effect of a hysterectomy, but this doesn’t mean there aren’t ways to improve your sex life and find pain relief. One way to improve sexual health is vaginal dilator therapy. In this article, we will first discuss the effects of hysterectomy on sexual function, the benefits of vaginal dilators, and how to use them after a hysterectomy.
Table of Contents
- The effects of hysterectomy on sexual function
- Sex and vaginal dilators
- Reasons for Using Vaginal Dilators
- Benefits of Vaginal Dilator Therapy
The effects of hysterectomy on sexual function
Although everyone heals differently, a hysterectomy shortens the vagina and may cause the genital area to feel numb or raw. Sometimes painful scar tissue inside the vagina makes vaginal penetration painful. Women also report feeling "less feminine" and "empty." When women have these negative thoughts and emotions, speaking with a trained sex therapist might help.
Since the vaginal capacity is tighter after a hysterectomy, deep penetration might not be possible right away. Extra time spent on foreplay can help ensure the vagina is lengthened to allow for pleasurable intercourse. Treating painful intercourse, known as dyspareunia, after a hysterectomy can include different treatment methods, but one proven way is vaginal dilators.
Sex and vaginal dilators
Once you've had a hysterectomy, it's essential that you wait until the vaginal tissue heals completely before resuming sexual activity or using vaginal dilators. The American College of Obstetrics and Gynecologists recommend waiting six to eight weeks before inserting anything in the vagina. Talk to your doctor about any concerns you may have before dilator therapy after hysterectomy.
Reasons for Using Vaginal Dilators
A vaginal dilator is a tube-like device used to stretch the vagina. Some people might view them as vibrators or dildos, but vaginal dilators are not used for sexual pleasure. The VuVa Neodymium Magnetic Dilator comes in a set of five including smaller (about the size of a finger) to larger sizes. The dilator size you use will depend on your pain threshold and pelvic condition. It is recommended that you use firm dilators made of medical grade polycarbonate plastic and not softer silicon. Women use vaginal dilators for different reasons, including:
- Vaginismus (vaginal muscle spasms)
- Vulvodynia (chronic vulva pain)
- Vaginal Atrophy (dryness)
- Vulvar Vestibulitis (painful intercourse)
- Dyspareunia (painful sex)
- Vaginal Stenosis (loss of vagina flexibility)
- Post radiation therapy and cancer treatments
Benefits of Vaginal Dilator Therapy
Vaginal dilator therapy will help stretch and prevent your vagina from becoming too narrow. Once approved for treatment by healthcare professionals, you can undergo therapy as long as needed.
Vaginal dilator therapy will help:
- Increase the comfort of having a pelvic exam
- Lessen pain and discomfort connected to sexual activity
- Ease pain associated with using tampons
- Help strengthen pelvic floor muscles
When you use a vaginal dilator, your soft vagina tissue lengthens, causing muscles and ligaments to relax. As you relax, blood flow increases to the skin and muscle causing pain. The increased blood flow calms nerves, allowing the pain to ease.
How to use dilators after hysterectomy
After a hysterectomy, it is common to feel pain and discomfort due to a shortened or tight vagina. Using a non-vibrating vaginal dilator will help ease pain and improve sexual function. Using a dilator can be scary for some, but it's easier than you think.
Privacy is important
Finding a quiet place to relax in private is the first step in dilator therapy. You want to make sure you're alone without interruptions. Just the thought of someone interrupting you might impair muscle relaxation, making the treatment harder to undergo.
Start with baby steps
The VuVa Dilators come in different sizes and lengths. When first beginning dilator therapy after a hysterectomy, don't push yourself too hard. It takes time to heal vaginal tissue and recover from major surgery. While not living in pain and having a healthy sex life is vital for women's health, don't push yourself too hard at first.
Prepare the dilator
Make sure dilators are clean buy using a non fragrant soap and letting them air dry. Then, apply a water-based lubricant before inserting. Lubricant is an excellent vaginal moisturizer that encourages the vaginal wall muscles to relax.
Insert the dilator
Lean back on pillows with your knees up in a comfortable position. Open your legs wide to allow easy insertion. You can use a mirror to see the opening of your vagina. Slowly insert the dilator a little at a time. Stop when you experience too much discomfort and go slowly. Medical professionals recommend deep breathing and imagining your pelvic floor relaxing.
Don’t force it
Once the dilator is in place, don’t force it. Move the dilator in and out slowly, to stretch and lengthen your vagina. Add more lubricant, if needed to help make the process easier. Gently move the dilator in wide circles to further widen the vagina. Repeat this in the front, middle, and back of the vagina. Once finished wash and dry the dilator and store in the kit.
Healthcare professionals recommend using vaginal dilators three to four times per week. Each session should be about 20 minutes, but if this isn’t possible at first, you can’t work up to it. Sometimes you only need a few minutes a day to help ease pain and discomfort.
Women have hysterectomies to alleviate excruciating pain, heavy bleeding, and other health concerns. However, a hysterectomy is a major surgery that can cause short and long term side effects. Vaginal dilators help ease pain, promote a healthy sex life, and encourage a life fully lived.
This post was informed by or approved by staff, writings or colleagues of Dr. Robert J. Echenberg, MD is an Obstetrician-gynecologist in Bethlehem, Pennsylvania.