What Is Dilating and Why Is It Important?
Transitioning comes with many exciting changes, but some aspects of it can feel like navigating uncharted territory. If you’ve recently undergone surgery to create a vagina, two key things you’ll likely be told to do—by your surgeon and your healthcare team—are dilating and douching. These might sound like intimidating words, but they’re essential for maintaining vaginal health and comfort after surgery. Let’s break it down so that you can understand what these terms really mean and how they fit into your journey.
Dilating involves using a medical device, a tapered, smooth dilator, to stretch the vaginal canal to maintain its depth and width. For many transitioned women, dilating is a part of their daily routine in the months following surgery. This helps to ensure that the vaginal tissue remains supple, healthy, and functional.
The goal of dilation is to keep the vagina from closing up or becoming too tight, which can happen as the tissue heals and scar tissue forms. Think of it like taking care of a garden—if you don’t regularly tend to it, things can start to overgrow. Likewise, keeping up with your dilation schedule is crucial for your long-term health.
Dilating is especially important in preventing vaginal stenosis, which refers to the narrowing or tightening of the vaginal canal. If left untreated, stenosis can make sexual activity painful or even impossible. While stenosis is less of a concern once your vagina has fully healed, it can still occur after infection, radiotherapy, or if dilation isn’t maintained. It’s another reason why following your initial dilation schedule is crucial for long-term comfort and functionality.
The Role of Douching
Douching is the process of rinsing the inside of the vagina with a solution to cleanse it. It’s a practice some transitioned women follow to maintain vaginal health. Douching can help keep things fresh and clean, particularly after dilation or penetrative sex.
While douching is associated with inflammation and negative health outcomes for a natal vagina, some healthcare providers recommend it for neovaginal care. Some recommend douching every other day, while others suggest it only after dilation or penetrative sex. The solutions recommended vary too—some professionals recommend douching with water, while others suggest alternative solutions. The important thing is that you’re following the advice of your healthcare provider, who knows your unique situation.
Just remember to be gentle with your body, and avoid overdoing both dilating or douching. If your vagina is still healing, excessive douching can sometimes lead to irritation or an imbalance in the vaginal flora. It’s important to be cautious and mindful about the products you use, opting for ones that are gentle and recommended by your surgeon.
The Different Types of Dilators: From Plastic to Silicone
When it comes to dilators, there’s a range of options available. At first, you might receive a set of clear, hard plastic dilators. These are standard, but not the most comfortable. Over time, you’ll likely want to switch to silicone dilators, which are softer, more flexible, and gentler on the vaginal tissue. The transition to silicone dilators can make the process much more comfortable, and many transitioned women find them a lot easier to use.
It's essential to gradually size up with your dilators to ensure that the vagina maintains its shape and is able to accommodate larger sizes comfortably. Sizing up gradually can also make penetrative sex more enjoyable and less uncomfortable in the future. Don’t rush it; allow your body to adjust to each new size at its own pace. It’s totally normal to feel a little nervous about sex at first, but the more you dilate, the better prepared your body will be when you’re ready for it!
Sensitivity and Healing: Embracing Your New Anatomy
Transitioned women often experience better vaginal sensitivity, which can actually be an advantage, compared to some cisgender women. Many cis women report that they don’t always enjoy penetrative sex due to reduced sensitivity, but for transitioned women, increased sensitivity can make sex much more pleasurable. However, it’s important to remember that the healing process takes time, and sensitivity may fluctuate as your body adjusts. Some women find that their sensitivity increases over time—sometimes it takes years—but rest assured, it’s part of the body’s healing process.
It’s very normal to feel a bit uncertain about your new anatomy at first. You’re learning how to connect with it, and that can be a little intimidating. But here’s the good news: your body is amazing at healing, and it will only get better with time, especially if you take care of it.
During the healing period, take things slow and gently explore your new body. It’s not just about vaginal penetration—explore other erogenous zones like your breasts, thighs, tummy, or wherever else you find pleasure. Feeling relaxed, comfortable, and connected to your body will help you reconnect with your sexual self. Give yourself time, and trust that, as you heal, your experiences will get more comfortable and enjoyable.
Dilating: The Process and its Flexibility
In the early stages after surgery, dilating can feel like a really time-consuming process. When you begin, you’ll likely need to dilate three times a day. During the first few weeks after surgery, it's usually suggested that you dilate three times a day for at least 20 minutes. It is important that you continue dilating during your immediate postoperative period, to prevent losing vaginal depth and width.
At first, this involves using pads to help you comfortably dilate while lying on your back. This positioning is important for creating the proper space for dilation. Over time, as your vagina heals and your schedule allows, you will dilate less frequently. Eventually, you’ll find a routine that fits more seamlessly into your life. For some women, dilation becomes part of their regular hygiene routine—for example, dilating while standing in the shower, which helps save time and feels more natural.
Dilation typically shouldn't be very painful, but it might cause soreness for some, particularly in the beginning. If you experience intense pain during dilation, it's important to stop, and consider adjusting the dilator, and repositioning your body for greater comfort. Additionally, using more lubricant may help minimize friction and facilitate a smoother process.
Dilation practices vary from person to person. Some women find they don’t need to dilate as frequently, if at all, once they’re having regular penetrative sex. Penetrative sexual activity itself serves a similar function by keeping the vaginal canal open. That said, douching afterwards is still recommended.
Dilation should not feel like an overwhelming chore—it’s a vital step in your recovery, but it won’t occupy your entire life forever. Find what works best for your body, and remember, dilation isn’t always necessary for everyone. The most important thing is that you listen to your body and adjust your routine accordingly.
Let’s Dive Into Real Experiences
Every transitioned woman’s experience with dilating and douching is unique. So, let’s hear from a few who have navigated these steps themselves.
“Dilating is actually… pleasurable?”
One transitioned woman, who had surgery with Dr. Supporn, shared an unexpected revelation: dilating was pleasurable for her! This might sound unusual, but for some women, the process of dilation can actually be quite enjoyable. She was pleased with her results and found the experience of dilation to be a positive part of her recovery.
Her favourite lubricant for the process wasn’t a typical medical-grade one, but instead, she loved using Durex Massage Lube Aloe Vera. While some women swear by medical lubricants like Acquacell or Optilube, others find success with more mainstream products. The key is to choose a lube that feels comfortable for you. Just remember, when you’re still healing, make sure to follow your surgeon’s advice. Stick with lubricants that are non-irritating and, when possible, consult your healthcare provider on whether sterile or non-sterile options are best for you. Generally, sterile lubricants are recommended early on, as they reduce the risk of infection.
“I'm struggling to dilate”
Another transitioned woman spoke candidly about her difficulties with dilation. Despite following her regimen, she struggled with the entrance to her vagina being covered by her labia. It wasn’t just that her vagina didn’t stay open—she needed surgical intervention.
Sometimes, dilating can only do so much. If there are issues like scarring or anatomical barriers, more intensive treatments might be necessary. In this case, the woman required a type of surgical correction (similar to an episiotomy) before she could even attempt penetrative sex. This experience highlights that dilation, while helpful, can’t solve everything, and some issues require more specialized attention.
She also shared a frustrating experience with a GP who suggested using steroid cream to address the problem. This can cause red, friable (fragile) skin, which, as you can imagine, is a bad approach for delicate vaginal tissue. Unfortunately, in some instances, healthcare providers might not be fully equipped with the knowledge of post-surgical care for transitioned women, which is why it’s so important to advocate for yourself. If your healthcare provider doesn’t understand your needs, don’t hesitate to seek out a more knowledgeable one.
Additionally, this woman discovered that not douching after dilation led to soreness in her vagina. She had been using Optilube, which can sometimes leave behind residues, especially if not properly rinsed. The soreness likely stemmed from a combination of lubricant residue and lack of cleansing, which might have contributed to irritation or discomfort. So, make sure you’re following a hygiene routine that works for you—and always clean up properly!
“I Tried a Few Douches, But Some Are Painful!”
Another common issue comes from the type of douche nozzle used. One woman shared her experience with different douches, mentioning that the ones with very small holes at the end caused her pain. This is actually a fairly common problem, and it may be a result of pressure build-up or irritation due to the narrow nozzle.
If you’re using a douche, choose one with a larger, more comfortable opening. You want a gentle flow that won’t feel like it’s forcing anything. Always listen to your body; if something doesn’t feel right, try a different approach.
Final Thoughts: Keep It Fun, Keep It Safe
Douching and dilating might seem like a chore, but when done correctly, they are crucial steps to ensure your vagina stays in the best shape possible. Self-care is a big part of this journey, and it’s totally okay to take things slow and make adjustments along the way. Everybody is different, and while some women find dilation pleasurable, others might find it painful at first, or a bit of a chore. And that’s perfectly okay!
If you’re struggling, don’t be afraid to reach out to your surgeon, a trusted healthcare provider, or a support group. Remember: you’re in control of your journey, and there’s no shame in seeking the help you need.
If you have any experiences or tips to share, please feel free to leave a comment, or suggest an improvement or correction on Bluesky!
References:
"Gynecological concerns and vaginal practices and exposures among transfeminine individuals who have undergone vaginoplasty" https://academic.oup.com/jsm/article/20/11/1344/7268932
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