Hello Scarleteen readers! It’s Caitlyn, the pelvic health physiotherapist here, talking this time about all things stretching. You may have heard of dilators—also known as vaginal trainers—before, but weren’t sure where to learn more about them. Maybe you’ve never heard of them, but you’re looking for ways to manage pelvic pain. Maybe you’ve already tried using dilators but haven’t had much success. Either way, you’re in the right place!
“Avaginal dilator” is the most commonly used medical term for these devices, although many clinicians and researchers refer to the term “vaginal trainer.” Many pelvic PTs—myself included!—prefer the term instructor. Not only does “training” sound less aggressive than “expansion,” it also conveys a key concept of using a trainer: it should be an active, participatory process in which the user is in control, rather than an experience that happens to them as a passive recipient.
I also generally refer to these devices simply as “trainers”. This terminology includes everyone with genitalia that allows the use of these devices. For these reasons, I will use the term “educator” for the rest of this article.
What exactly are these trainers?
The trainers we discuss here are medical devices used to reduce pain and improve flexibility in the tissues of the vaginal and neovaginal canals. (Neovagina is the medical term for a vagina that is surgically created for people who were not born with a vagina. When I use “vagina” for the rest of this article, you can assume that includes newborns.) Trainers also come in variations made specifically for rectal usealthough these types of trainers are beyond the scope of this article.
Trainers can be made from a variety of materials. They are usually cylindrical in shape. At first glance, they may look a bit like sex toys, but that is not their intended use. The trainers are designed to provide therapeutic stretching and pain relief to the tissues of the vaginal canal. Let’s learn more about the many situations in which trainers can be useful!
What are trainers for?
Flexibility and comfort are important for overall vaginal health. Here are some common reasons people choose to use trainers:
- To reduce excessive volume (hypertonicity) in the pelvic floor muscles
- To reduce pain/sensitivity in the vaginal canal
- To reduce discomfort during gynecological pelvic exams
- To improve comfort when using internal menstrual products such as tampons or cups
- For healing after neo-angioplasty surgery (also known as penile reversal colpoplasty or ‘down procedure’)
- To reduce the formation of scar tissue after treatment for certain cancers
This list of reasons is not exhaustive, but covers many common motivations for using a trainer. People with the following medical diagnoses can often benefit from trainers:
Trainers can be a useful tool in the management of many pelvic health conditions.
How do I know what type of trainers to get?
Since every person and their body is unique, different types of trainers work best for different people. However, trainers are usually made of silicone or hard plastic there are glass versions. Let’s break down the pros and cons of some common options:
| Trainer brand | Advantages | Disadvantages |
| Familiar Rose | Silicone is flexible and comfortable to insert
It can warm the trainer in your hands before insertion Available in 8 progressive sizes Can be purchased individually or in a package Extension handle available* |
More expensive than the plastic versions
Cannot be used with silicone or oil based lubricants (must use water based) |
| VuVa Tech | Cheaper than silicone options
Can be used with any lubricant. lubricant supplied to order |
Hard plastic can be more difficult to insert
It may feel a little cold at first No grip/extension option Usually you have to buy full set |
| Source of soul | Available in silicone and plastic options
The plastic version can be chilled for a cooling/pain-relieving effect Can be purchased individually or in a package It offers an option specifically for use after gender confirmation surgery |
Quite expensive
No grip/extension option |
| She-ology | Made of medical grade silicone
Shorter overall length (3 in) reduces intimidation Slightly curved shape with significant taper for easier insertion Large sizes can accommodate a bullet vibrator for further muscle relaxation |
Can only be purchased in sets of 3 or 5
Cannot be used with silicone or oil based lubricants (must be used water based) |
| Milli | A single rechargeable device that expands incrementally, 1 mm at a time
Soft silicone cover for comfort Optional vibration settings for further muscle relaxation |
Very expensive
Cannot be used with silicone or oil based lubricants (must be used water based) |
*Extension handles can help improve reach for less flexible and larger-bodied people.
Medical device vendors are constantly releasing improvements to the trainers they offer. Many offer deals to reduce the cost of trainers. If you are in the United States and have health insurance with an HSA (health savings account), you can use the money in your HSA to buy trainers.
If a full set of progressive trainers is a bit too steep for your budget, it’s worth starting with 1-2 individual trainers. You can make great progress with just a few sizes.
How do I choose the right size?
In general, it’s best to start with a smaller size than you think you could tolerate: this increases the chances that fitting your trainer will be virtually pain-free. You can always size up later when your body is ready.
Most websites that sell trainers will label each size with its height and width. For reference, the average “regular flow” tampon is less than half an inch wide. If inserting a tampon or a single finger is difficult for you, you’ll want to start with the smaller trainers that are less than half an inch wide.
If tampon/finger insertion is painless for you, but vaginal sex (with a penis or toy) is uncomfortable, you can start with a medium sized trainer. This is why buying at least two trainers can help: if one is too big, you can easily switch to the smaller size and vice versa.
Ok… now what??
You’ve decided you want to try trainers and have purchased some for home use…but now, you’re not sure what to do next! Never fear: in the second part of this short series, we’ll discuss the ins and outs of wearing your trainers, from hygiene and safety to practical tips to make working out more comfortable. Check it out here!
