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Medically Reviewed By:

Dr. Amanda Olson, DPT, PRPC
President & Chief Clinical Officer

Dilators for Endometriosis: How They Work

Vaginal dilators have been used to treat pelvic conditions for almost a century and are now widely recommended for relieving the uncomfortable symptoms of endometriosis.

If you’re looking to reduce pelvic pain, abdominal bloating & pain during sex, or reduce barriers to getting pregnant, read on to understand more about vaginal dilators for endometriosis, and how they work.  

What is Endometriosis?

Endometriosis is when tissue similar to the endometrium, which is the inner lining of the uterus, is found growing outside the uterus. Known as endometrial implants, this type of tissue growth can manifest as cysts on the ovaries, lesions on the bladder or bowel, and adhesions that join organs together which would otherwise remain separate.

According to the Office on Women’s Health, endometriosis affects 11% of American women during the reproductive years, with patients commonly aged 15-44.

What Are Dilators? 

Vaginal dilators are tube-shaped medical devices ranging from the size and diameter of a woman’s pinkie finger to an erect penis. Commonly prescribed by OG/GYNs and pelvic physical therapists to relax tight pelvic floor and vaginal muscles, dilators can help relieve pain during sex, vaginal dryness, and vaginismus, as well as alleviate the symptoms of endometriosis. 

Although originally made from glass, and then plastic, the most advanced versions of modern dilators are made from body-safe medical-grade silicone and are sold in sets of incrementally increasing sizes for long-term results. 

How Dilators Work for Endometriosis

Vaginal dilators are prescribed to alleviate symptoms of endometriosis due to their ability to reduce pelvic pain, relax vaginal muscles, relieve pain during sex, dispel the fear of penetration, and alleviate the bloating associated with an ‘endo belly’. 

Before using dilators, it is important to understand how to use them, which size to start with, and how long they should remain inside the body for each patient’s specific situation.

Ideally, it’s best to set up a consultation with a pelvic health physical therapist or OB/GYN for initial guidance. If this is not something you can achieve or feel comfortable with, brands such as Intimate Rose have informative instructions and videos about dilation therapy online. 

For best results in relieving the symptoms of endometriosis, dilation therapy is ideally practiced in the comfort of your own home for 10-15 minutes at least five times per week.  

How Dilators Reduce Pelvic Pain

Endometrial implants and scar tissue on pelvic organs often cause pain and a feeling of tightness in the pelvis and vaginal muscles. By starting with the smallest dilator in a set and steadily working upward in size, women with endometriosis will gradually feel vaginal muscles and pelvic floor muscles relax. Scar tissue from endometrial implants will also stretch and soften as dilation therapy progresses. 

Dilators Reduce Pain During Sex 

Dyspareunia (pain during sex) is often a symptom of endometriosis due to the presence of uncomfortable growths and lesions on pelvic organs. On top of that, one of the first medical treatments for endometriosis is often hormone therapy to reduce the production of estrogen.

While this can help reduce the growth of implants, low estrogen levels can also result in vaginal dryness (atrophy), which can worsen the discomfort felt during sex. 

This type of pain and discomfort is substantially relieved with the regular use of vaginal dilators along with a water-based personal lubricant. By gently stretching the pelvic floor muscles, blood flow to the area is improved, pain is reduced, and natural lubrication is increased. 

For young women suffering from painful sex due to endometriosis who are still hoping to get pregnant naturally, vaginal dilators can help to release the anxiety surrounding intercourse and allow them to start family planning without the fear of painful penetration.  

Dilators Relieve the Fear of Vaginal Penetration

The long-term pelvic pain associated with endometriosis can often manifest into a fear of vaginal penetration. Whether the pain is felt with a tampon in younger endometriosis patients, or during sex for older patients, the body’s response is usually physical as well as psychological. And this automatic tightening of the vaginal muscles in response to penetration inevitably leads to more pain.

Starting dilator therapy with the smallest dilator can help to psychologically and physically relax the automatic spasming of the vaginal muscles upon penetration. A steady progression through the set of dilators encourages muscle relaxation and inevitably the associated anxiety will diminish too.  

Dilators Reduce Endo Belly & Bloating 

The abdominal bloating felt by many women with endometriosis, referred to as ‘endo belly’, can be uncomfortable for some and excruciating for others. Although surgery for endometriosis is often recommended to relieve bloating by removing endometrial implants, regular dilation therapy can also be effective. 

It is not just the endometrial implants that cause bloating, after all, but an amalgamation of many factors. Primarily caused by the reaction of endometrial growths to estrogen surges during the menstrual cycle, overactive (tight) pelvic floor muscles can also contribute to bloating, as can constipation due to endometrial implants growing on the bowels. 

With the regular practice of dilation therapy to relax tight pelvic muscles and soften the build-up of endometrial tissue on pelvic organs, women with endometriosis can manage bloating and find relief from endo belly. 



Less invasive than surgery, with no side effects like hormone therapy, dilators are highly effective at treating debilitating endometriosis symptoms in the comfort of your own home. Proven to reduce pelvic pain, bloating, and discomfort during sex, as well as alleviate the fear of penetration, these easy-to-use medical tools are a game-changer for endometriosis patients of all ages. 

If you are suffering from endometriosis, speak with your healthcare provider about starting dilation therapy to reduce your symptoms, regain your quality of life, and manage the condition in the long term. 


Office on Women’s Health – Endometriosis -

Science Direct – Vaginal Dilator -

Cleveland Clinic – Vaginal Dilators -

National Library of Medicine - Low Dose, High-Frequency Movement Based Dilator Therapy for Dyspareunia: Retrospective Analysis of 26 Cases -