This leaflet answers common questions about using dilators after having a course of radiotherapy to your pelvis. If you would like further information, or have any worries, please do not hesitate to ask a member of your radiotherapy team, clinical nurse specialist or oncology doctor.

In all cases, a member of your team will talk to you and answer any questions you may have.

Why have I been given this leaflet?

One of the possible side effects of pelvic radiotherapy is the formation of scar tissue (fibrosis) within the vagina. This can cause the vagina to become shorter or narrower, dryer and less elastic. As a result, future examinations and sexual intercourse can be uncomfortable.

To help minimise these effects, you have been given a dilator kit to help with the stretching of the vagina. This can also be done by using a vibrator, fingers or by having penetrative vaginal intercourse.

What is a dilator kit?

You have been provided with a kit which consists of a range of plastic, cylinder-shaped dilators of gradual sizes and lengths. These have been designed to gently stretch the vagina, helping to relax the muscles and prevent scar tissue from developing.

How to use a vaginal dilator

You are advised to start with the smallest size dilator and increase the size gradually, if it feels comfortable to do so. We advise the use of a water-soluble lubricant to help keep the lining of your vagina moist.

  1. Place some lubricant on the rounded end of the dilator and around the entrance of the vagina.
  2. You can use the dilator in whichever way you find most comfortable. You may wish to lie on your back with your knees slightly bent or stand with one foot on the side of a bath or stool or use whilst in a shower/bath (avoiding perfumed products).
  3. Insert the dilator gently into the vagina as far as is comfortable. Try to relax your muscles and do not force the dilator.
  4. The dilator should be inserted and withdrawn in a forward and backward motion, then a left to right motion. If possible, you should then gently rotate the dilator in a small circular motion. Repeat this for approximately five minutes.
  5. After removing the dilator, clean with warm, soapy water, then rinse well and dry.
  6. Some people find that they experience discomfort after using the dilator for the first time. If you do, we suggest that you use any mild painkiller that you would normally take.

Benefits of a vaginal dilator

Using a dilator to maintain the form of the vaginal wall will:

  • Reduce the potential long-term discomfort which scarring can cause.
  • Enable easier and more comfortable medical internal examinations if they are required.
  • Help to reduce discomfort or difficulties during intercourse.

When should I start using dilators?

It is recommended that you start using the dilators three to four weeks after completing your radiotherapy treatment. If you still

feel sore, it could take up to six to eight weeks before you feel comfortable enough to start. You should use a dilator twice per week for six to 12 months after the end of your radiotherapy treatment.

If you are sexually active, you can alternate the use of the dilator with intercourse.

When to contact a member of the team

Slight bleeding or spotting may occur during or after using the dilators or when having intercourse, especially in the first few weeks. Please do not be alarmed, this is due to the breakdown of scar tissue.

If the bleeding persists or is heavy, please contact your clinical nurse specialist or GP.