Vaginal Atrophy and VuVa Dilators: Your Questions Answered


Many women suffer from painful intercourse after menopause and it is completely normal. I get so many phone calls where women think vaginal atrophy is uncommon and they are the only ones having painful intercourse or no intercourse at all, and that is just not the case.


"I wanted to put together this vaginal atrophy facts page because it is hard for me to take all the phone calls and spend quality time with everyone as I try to run the business. So I hope this helps, if you have more questions please email or call us. - Tara L (founder)"
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Is Vaginal Atrophy Normal?

Even though it is painful, I get hundreds of phone calls from women with vaginal atrophy due to menopause, cancer treatments or just not having enough intercourse. Yes, not having sex enough can cause vaginal atrophy and no one tells us that. Over 32 million women in the United States have vaginal atrophy. You are not alone.


Why Do I have Vaginal Atrophy?

Due to atrophy, the tissues of a woman's vagina no longer work in their normal, healthy way. It happens slowly as the lining of the vagina begins to shrink or thin out. It often occurs in women during the change of life (menopause). This is because women lose the hormone estrogen at that time. 

When a woman doesn’t have intercourse or other vaginal sexual activity on a regular basis following menopause, her vagina may also become shorter and narrower. Then, when she does try to have intercourse, she is likely to experience pain, even if she uses a lubricant. That’s because dry, fragile vulvovaginal tissues are susceptible to injury, tearing, and bleeding during intercourse or any penetration of the vagina. The resulting discomfort can be so great that the woman avoids intercourse and the condition worsens. Sometimes, even women who are not sexually active are bothered by vaginal dryness and the irritation that may accompany it.

Continuing to have regular vaginal sexual activity through menopause helps keep the vaginal tissues thick and moist and maintains the vagina’s length and width. This helps keep sexual activity pleasurable.


Do I need Vaginal Dilators?

Yes, dilators are devices to widen (dilate) the vagina to enable you to go back to having sex. Women often start with a narrow dilator and move on to larger sizes over time. This is done until the vagina is wide enough to fit a penis for sexual activity without pain. The best results are obtained when dilators are used in conjunction with local hormone therapy. Everyone who wants to engage in intercourse needs to be dilating. It only makes things better. 


What do the VuVa Magnetic Dilators do?

Vuva Neodymium magnetic dilators sets are used to regenerate vaginal capacity, expand the vaginal walls, add elasticity to the tissues, and to allow for comfortable sexual intercourse. The magnets also help with blood flow which in turn helps create natural lubrication. 


How do I know what size Dilators I need?

When shopping for dilators, it might be hard to know what size vaginal dilators you need. If you ask your physician or pelvic floor physical therapist, they should be able to tell you what size you need to start your pelvic floor therapy with. Some people do not need the entire set and some people do.

When it comes to our size vaginal dilators, there are seven to choose from. We have one of the smallest vaginal dilators on the market and one of the largest. 

The smallest dilator, the Size 1, is comparable to a pencil and the Size 2 is comparable to a women's pinky finger. If you can get a larger tampon applicator in with ease, you may want to start with a Size 3 or 4 dilator if your muscles are very tight, or you have a lot of atrophy pain.

If you are sexually active, you might not need the smaller dilators and starting with the Size 4 or 5 and moving up would be best for your home therapy plan. You can also purchase the size dilator that is comparable in circumference to your partner if you are sexually active.

As dilator therapy can be uncomfortable, you do not want to be in extreme pain when you are dilating. If you are, then you need to move down one dilator size. On a pain scale of 1-10, you do not want to go over a 3-4 pain level when dilating. Now, when you first put the dilator in, it can be very painful, but that pain should subside after a few minutes. You don't want to be in extreme pain the entire time during your dilator therapy. 

Here is a video to help you choose your size:

Click here to see VuVa Dilator size chart. 


How do I use the Vaginal Dilators?

Please visit our directions page here.


How long will it take for the Dilators to start working? 

It depends on the severity of your condition. Everyone is different. Some women it takes a month to move up in all sizes and some women take six months. Everyone is different physically and psychologically so dilator therapy can be different for everyone.  


What kind of Lubricant should I use?

Did you know some store bought lubricants can actually make the vaginal tissue burn more? That is why we recommended water based Slippery Stuff Lubricant that only has five ingredients. Slippery stuff is water based and one of the most popular choices used by Pelvic Floor Physical Therapists. Customers always ask if they can use coconut oil, please ask your doctor if you can use coconut oil first. Coconut oil will not harm dilators. 


What happens if I do not use Vaginal Dilators?

Vaginal Dilators are part of the two part process to help with vaginal atrophy. Part one is estrogen therapy and part two is pelvic floor therapy which includes dilators. If you do not use dilators, you are missing half of the treatment plan. The benefits of dilators are more than just physical, they also help mentally with the fear of penetration in order to help you engage in an intimate relationship again. Do not be scared of dilating, it only helps. 


Do I need to take estrogen as well?

It does help with Vaginal Atrophy. Estrogen in any form — oral, transdermal (via skin patch), or vaginal — can help restore normal vaginal pH and beneficial bacteria, thicken the epithelium, increase vaginal secretions, and decrease vaginal dryness. But it's best to apply the estrogen directly to the vagina. Compared with oral or transdermal estrogen, vaginal application requires a lower dose and involves less exposure of breast and endometrial tissues, where estrogen can increase the risk of cancer by stimulating the growth of cells. Low-dose estrogen products recommended specifically for the treatment of vaginal atrophy include vaginal creams (Estrace and Premarin), the vaginal tablet Vagifem, and Estring (an estradiol-infused silicone ring that sits around the cervix and releases a very low, steady dose of estrogen). Do you not want to take estrogen? Read the next question.


If I do not want to take estrogen, what else can I take or use?

Many of our customers, as well as myself love the company Neueve. NeuEve suppositories and cream help ease menopausal discomforts: vaginal odor, dryness, atrophy, itching, burning, painful sex and bacterial vaginosis. They use 100% all-natural food grade ingredients.

NeuEve is gluten-free, hormone-free and estrogen-free. Click this link to learn more about Neueve. 


Do I need to do Kegels?

Do not do kegels if you have a tight pelvic floor, always check with a Pelvic Floor Physical Therapist first. It is surprisingly easy to mistake a tight pelvic floor for a weak pelvic floor. It may be that your pelvic floor is already overactive, so if you start doing kegels regularly you’re going to end up with a hypertonic pelvic floor and make these worse. Although pelvic floor dysfunction can come about through childbirth, injury or muscular weakness, it’s not always the case. It is really important to understand the reason for your dysfunction before you start doing kegels, otherwise you may end up with even worse dysfunction. You would need to ask a Pelvic Floor Physical Therapist if you need to do kegels. 


Is there a specialist that I can see to help me with vaginal dilator therapy? Yes, a pelvic floor physical therapist. 

Pelvic Floor PT is a treatment approach that uses the principles of physical therapy to provide a structured, effective and safe reconditioning of pelvic floor muscles. The goal of the treatment is to improve the strength and function of pelvic floor muscles and alleviate pain, weakness and dysfunction in the muscles. During the treatment, a skilled physical therapist accesses the muscles through the rectum or vagina and makes manipulations on them to improve their strength and functioning. The therapist may either stretch the muscles if they are short and contracted or apply resistance to improve strength if they weak and dysfunctional. Pelvic Floor Physical Therapist will also help you with vaginal dilator therapy if you need. Do you need a pelvic floor physical therapist? Click here for our locator: PT Locator Links 


Do you ship discreetly? Where are the dilators made?

Your dilators will be shipped in a plain white or brown box depending on your order. There will be a secret business name on the box. For international orders we have to put "pelvic stretchers" on the customs form. 

Our dilators are made in Sarasota, FL. We are one of the only companies that safely makes plastic dilators in the USA. 


Ready to shop? Visit the VuVa Dilator Store here

How do I know what size dilators I need? Click here for our help page.