Hey, beautiful soul. Last year, I began blogging about my journey with dilators for painful sex and Lichen Sclerosus. I left off on a bit of a cliffhanger, where I explained why I – rather abruptly – stopped using dilators and put them away for quite some time. Read about this here. Today, I want to share what motivated me to start working with them again.
However, before diving into my journey, I want to highlight a few points on how dilators can help with Lichen Sclerosus (and reasons you may want to consider them even if penetrative sex is not a goal of yours).
Folks that can benefit from using dilators may have one or more of the following conditions:
You may have one or more of these conditions. It is not uncommon to have lichen sclerosus plus another condition. For example, in addition to lichen sclerosus, I was also diagnosed with vaginismus and vestibulodynia.
Be sure to subscribe to my YouTube channel, as I plan on filming a Dilator Basics 101 where I will show the dilators I use, talk about the different types of dilators (and the pros and cons for each), etc.
The narrative we often hear with dilators centers around penetrative sex. However, while they certainly can help if this is a goal of yours, there are many other reasons you may want to work with them that do not involve penetrative sex. In this post, you will learn:
Vulvar Lichen Sclerosus is a chronic, inflammatory skin condition that is considered to be an autoimmune disease. The inflammation caused by LS can cause changes to the texture and color of the vulvar skin. For example, in some cases, folks with LS may have fusing (also known as adhesions or scarring).
*If you’re unfamiliar with these terms, check out the video I did on Lichen Sclerosus Terminology Fundamentals here.
Fusing can occur between the clitoral prepuce (i.e., the hood) and the clitoral glans, the labia (either labia majora or minora), around/over the urethra, and around the vaginal opening/introitus. For those with fusing around the vaginal opening, using dilators can help by slowly and gently stretching the skin.
Listen to Dr. Ashley Stump, pelvic floor physical therapist, explain how dilators can help with fusing on Lichen Sclerosus podcast here.
Thus, even if penetrative sex is not a goal for you, you may consider working with dilators and a physical therapist to work on the fusing.
Another one of the skin changes that can occur with Lichen Sclerosus is a thickening of the vulvar skin. Watch my video on how LS thickens the skin here. This thickening makes it harder for blood to flow through the vulvar tissue, which is important because blood flow is crucial for healing and healthy tissues. Specifically, oxygen plays a critical role in the creation of collagen and the growth of new capillaries, according to Whitney (1990). The movement of the dilator (and vibrations from a vibrator, if you use one), can enhance blood flow and circulation of oxygen to the vulvar and vaginal areas.
This is another reason to consider working with a pelvic floor physical therapist and dilators. Perhaps you aren’t even thinking of sex with others or with yourself, but you do want to improve your quality of life. This can be another tool in your toolbox to help improve Lichen Sclerosus symptoms.
Many of us with Lichen Sclerosus often feel disconnected from our bodies. For example, you may feel as if your body has betrayed you. You may feel as if you don’t even recognize your own self anymore. Perhaps you stopped touching your vulva because of feelings of self-hate and shame. I know I felt all of these. Body dysmorphia led to an intense feeling of self-disgust with respect to my vulva, and, accordingly, I couldn’t bring myself to touch myself down there. This lack of touch created a disconnect between my mind and my vulva; early on in my Lichen Sclerosus journey, I felt very disembodied.
Working with dilators played a role in healing those wounded parts of my soul that felt self-disgust and shame. And, by focusing on mindfulness while working with dilators, in time, I managed to re-learn and re-connect with my vulva and vagina. This was incredibly healing for me and also made me feel more empowered with my Lichen Sclerosus. This can be another reason to consider working with dilators.
On average, it takes folks with vulvar Lichen Sclerosus between 5-15 years to get diagnosed. Personally, it took me almost 11 years. And, for many of us, this means suffering from an array of vulvovaginal symptoms for years. A common symptom with Lichen Sclerosus is painful sex.
Understandably, when you experience pain with sex for a long period of time, your will start to associate sex or penetrative sex as dangerous. It is dangerous insofar as it is causing you harm and pain, which your brain will try to protect you from. Thus, in addition to the pain that comes from fissures and tearing from sex, you can also experience more pain when your pelvic and vaginal muscles tighten up upon penetration. This muscular tightening is your body’s defense mechanism against a perceived threat.
When you work with dilators, however, you do so in a safe and controlled environment, either with a pelvic floor physical therapist or on your own. As you learn to relax your pelvic floor muscles and work gently with dilators, you desensitize your brain from coding any form of penetration as danger.
Consequently, in time, your muscles will relax, allowing for more vaginal space and a reduction in pain.
This can be important regardless of if vaginal sexual penetration is a goal for you because there are times in which something may need to be inserted into your vagina, such as tampons, menstrual cups, or a speculum at the gynecologist’s office. Thus, dilators can be beneficial in reducing pain and discomfort in these instances.
Living with Lichen Sclerous can be disheartening and distressing. You may feel as if you’ve lost all control over your life. You may feel as if Lichen Sclerosus is taking away so much from your life. Working with dilators is a great way to counteract those feelings of helplessness and make you feel as if you are taking back your life (and you are, even if it doesn't feel like it initially)! Thus, working with dilators can cultivate a sense of empowerment, which can do wonders for your mental health.
Finally, if achieving pain-free penetrative sex is a goal for you, dilators can be helpful. Essentially, they help reduce pain with sex by combining all of the points above. Increasing blood flow and oxygen helps encourage tissue healing. By working with dilators, you can help introduce more flexibility and elasticity to scarring around the vaginal opening. Desensitizing the brain from coding penetration is another big one. If your brain perceives a threat, it will defend the body accordingly. In the case of vulvovaginal pain, this can look like your pelvic floor muscles contracting tightly, which only increases pain. In time, if you re-train the brain to see penetration as safe, you will have less of the contracting mechanism, and therefore less pain. Feeling empowered and connected to your body also has great mental health benefits. This can help bump up your confidence with respect to having penetrative sex again.
In sum, working with dilators is about way more than just being able to have penetrative sex. While it certainly can help with this, there are a great number of benefits to dilators including but not limited to increasing blood flow to the vulva, helping with scarring/fusing, desensitizing the brain from coding penetration as danger, feeling more connected with your body, and feeling more empowered. Thus, there are many physical and mental health benefits to using dilators.
In my next few posts, I will be sharing my journey with dilators and how I went from excruciating pain with sex, to be able to have pain-free, pleasurable sex. If you’re interested in working with dilators – regardless of your goal – and want to hear about how I used them and what my process looked like, be sure to sign up for The Lost Labia Chronicles Newsletter so you don’t miss these posts.
If you have questions about dilators or want to message me, I can be contacted through:
Instagram: @thelostlabiachronicles
Facebook: @TheLostLabiaChronicles
Email: jaclyn@lostlabia.com
I am planning on filming multiple videos on dilator basics (e.g., types of dilators, what lube to use, how I use them, etc.) and my experience with dilators. If you aren't already, please take a minute to head on over to my YouTube and subscribe to my channel – it helps me out more than you know.
Dr. Heather Jeffcoat – @theladypartspt
Jane Bai – @pelvicpro
Do you want more support in your journey with Lichen Sclerosus? Consider joining our Lichen Sclerosus Support Virtual Meetups. We meet bi-weekly, every other Saturday from 2-4 and 7-9 pm EST. These meetups are a safe space for you to share your story, cry, celebrate, vent, ask questions, and be a part of a community of support. Click the button below to sign up!
Resources
Whitney JD. The influence of tissue oxygen and perfusion on wound healing. AACN Clin Issues Crit Care Nurs. 1990 Nov;1(3):578-84. doi: 10.4037/15597768-1990-3013. PMID: 2223323.
*The Lost Labia Chronicles does not provide medical advice or engage in the practice of medicine. The information provided by The Lost Labia Chronicles is for education and entertainment purposes only and does not under any circumstances constitute medical advice. Please consult with your healthcare provider before making any changes to your healthcare plan.
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