Most people associate using a dilator to treat women experiencing pain with vaginal penetration, whether it is pain with intercourse, gynecological exams, and/or use of tampons. While this may be the case, there are so many other uses for a dilator program. To elaborate, a dilator is not only used vaginally and it is not only used for women. Some patients who seek pelvic floor physical therapy have issues with constipation and/or rectal pain. Often times these symptoms are a result of tension in the pelvic floor muscles. The tension is causing difficulty for the muscles to relax and thus difficulty with stool evacuation. The tension in the muscles can also produce spasms and result in rectal pain. Myofascial release and connective tissue manipulation in the external pelvic girdle such as the abdominals and inner thighs can help alleviate these symptoms but internal rectal release of the pelvic floor muscles has an even bigger impact on symptom relief. Often patients ask, “Is there anything else I can do at home aside from stretches to help me manage my symptoms?” If they are open to it and if they have found internal rectal release helpful, they can perform self trigger point release with a rectal dilator at home. A rectal dilator is used for the purposes of stretching the rectal tissue and also assisting with relaxation of the muscles.
A rectal dilator can also be used to help with re-training your muscle coordination. When the pelvic floor muscles contract, they are holding back urine, stool, and gas. When they relax, they are allowing for the initiation of flow of urine and the passing of gas or stool. If there is an issue with muscle coordination, patients may have difficulty emptying their bladder or bowels. Patients with constipation can practice inserting a rectal dilator and actively practice relaxing their pelvic floor muscles to “pass” the rectal dilator, similar to the passing of stool.
As I mentioned, rectal dilators are not only for women experiencing pain with vaginal penetration. If a person is engaging in anal intercourse and having pain, a rectal dilator can be appropriate for this person to use. The rectal dilator can be used to stretch tight muscles affecting a person’s ability to enjoy intercourse. A person can progress to a dilator size similar to the size of the object that is performing the penetration, whether it is a digit, toy, or phallus. While there are a number of purposes to use a dilator as a supplemental treatment for physical therapy, it is important to ask your medical provider whether it is appropriate to use and to learn proper instructions.