Using vaginal dilators after pelvic radiotherapy

What is this information about?

This information tells you about why you need to use vaginal dilators after your radiotherapy treatment, and how to use them.

It also lists sources of information, support and advice.

If you have any concerns, please feel free to contact your specialist nurse. You will find their telephone numbers listed below.

Why have I been given this information?

Radiotherapy can cause changes to the tissue in your vagina. To keep this area comfortable and functioning normally, we recommend using vaginal dilators.

Following the guidance here will help you to recover more quickly from your treatment and reduce pain and discomfort.

You may want to share this information with your partner: it may help to show them this leaflet.

What is a vaginal dilator?

A vaginal dilator is used to gently stretch and relax the tissue inside your vagina. It is a plastic cylinder specially shaped to be used inside the vagina.

Why do I need to use a vaginal dilator?

Using a dilator will:

Reduce the potential long-term discomfort that vaginal scarring can cause.
Allow your doctor or nurse to examine you internally, without causing you discomfort.
Help to prevent sex from being uncomfortable. If you are not currently in a sexually active relationship, using a dilator will still help to reduce any difficulties you may have with future sexual partners.

When should I start using a vaginal dilator?

We recommend that you start using the dilator about six weeks after your last treatment.

If you feel sore and uncomfortable then leave it longer. Sometimes this could be up to eight weeks.

Is there an alternative to using a vaginal dilator?

Yes. Sex and using a vibrator will also help with vaginal dilation. You can use either the dilators, a vibrator or have sex to keep your vaginal tissue healthy.

You may not need to use a dilator if you have sex at least once a week (if you want to).

How should I use the dilator?

Find a private and comfortable place where you can relax and use the dilator. This could be in the shower, the bathroom or the bedroom as long as it is private, and you feel relaxed. The more relaxed you feel, the easier it is to use the dilator.

If you want, you can involve your partner too.

To use your dilator:

Before you insert the dilator into your vagina, put some water-soluble lubricant on the dilator and around the entrance to your vagina. You can request repeat prescriptions for this lubricant from your GP free of charge. Please let your specialist nurse know if you do not have a prescription exemption certificate or card.

You can use the dilator in different positions:

Either lie down on your back with knees slightly apart or bent, or
Stand with a leg raised on the side of the bed or bath to insert the dilator as you would a tampon.

Gently insert the lubricated dilator into your vagina (without forcing it) as far as is comfortable.

Try to relax your muscles and do not force the dilator.

Once inserted to the top of the vagina or as far as is comfortable, gently rotate the dilator and then withdraw it. You may find it helpful to visualise the tip of the dilator as a piece of chalk drawing small circles, which gradually increase the size.

It is usual to start with the smallest size or a finger and progress to the larger size (three or four) in the days and weeks following treatment or as it is comfortable.

You may choose how long you use the dilator for each time. Guidelines suggest from three to ten minutes twice a week for the first six months.

After the first six months use the dilator once a week. If you are not experiencing any difficulty after a year, you can use it only occasionally.

Are there any signs I should look out for?

A small amount of bleeding or ‘spotting’ is not uncommon when using dilators.

If you experience heavy vaginal bleeding or pain then please seek advice from your GP, Practice Nurse or Clinical Nurse Specialist.

How should I clean my vagina after using a dilator?

You can use plain, unperfumed soaps to wash the area surrounding your vagina. Your vagina will clean itself with natural secretions.

Douching is not usually advised.

A douche flushes water up into the vagina, clearing out vaginal secretions. This means using a douche can disrupt the normal vaginal bacteria and may increase the risk of infections.

How should I look after my dilators?

Wash your dilators with hot soapy water after use, rinsing well.
Wipe dry or leave to air dry before storing in the provided case.
Please check the dilators for any cracks or damage before each use.
Do not use if there are signs of damage.
Contact your specialist nurse for a replacement.

Who can I contact for further information and advice?

If you have any questions or concerns regarding the use of the dilators or any symptoms following your radiotherapy treatment, please do not hesitate to contact your Clinical Nurse Specialist.