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. In today’s post, I want to pick that storyline back up. That is, I want to discuss my decision to start working with dilators again after having stopped for almost a year. This post will be part of a series on my journey with dilators. I will detail my experience each week, in a quasi-journal entry format. I am sharing my journey in the hopes that it will help you in your journey.
After I was diagnosed with Lichen Sclerosus, I was determined not to lose my sex life. Thus, I quickly found a 5-piece dilator set online, purchased it, and booked an appointment with a pelvic floor physiotherapist. While I experienced some success with them initially, I eventually decided to stop using them. Briefly, I had a lot of burning and stinging after using the dilators. Thus, I decided the time wasn’t right, and I set them aside. For the full story on why I stopped, read my blog entry here.
At this point, I had already told my husband we were going to stop having penetrative sex for an indefinite amount of time. Now, I was indefinitely setting my dilators aside. Instead, I decided to just focus on healing my vulvar tissue with my steroids. Furthermore, I focused on working through many of my mental health struggles associated with sex and LS with a sex therapist.
I spent about the first year after being diagnosed with Lichen Sclerosus completely alone. I didn’t know anyone with Lichen Sclerosus, and I had no community I could go to for advice or help.
After that year, I stumbled upon Lichen Sclerosus Podcast, hosted by Kathy. In one of her episodes, she spoke about a Lichen Sclerosus Support Virtual Meetup. Without much detail of what this meetup would entail, I signed up, eager to connect with others that also had LS. By this time, my LS was in remission, but I still hadn’t started back with dilators. Further, I did not have plans to try penetrative sex any time soon.
What stood out to me during that meeting was how many of us were unable to have penetrative sex. I realized, by conversing with these beautiful LS warriors through my computer screen, fear had been holding me back. I hadn't tried to work with dilators again because of fear.
Specifically, I was afraid working with dilators and/or having penetrative sex would knock me out of remission. I was also worried about tearing as I did in the past. Additionally, there were extra worries about pain as I had also been diagnosed with vaginismus and vestibulodynia.
Similarly, I was afraid of all of the unknowns that came with starting up dilators again. This one was particularly heavy, since, at that time, I didn’t have any support system to help guide me through the process. Except now I did. Through these meetups, and joining the LS Warriors, I found the most beautiful community of folks with LS cheering me on.
Thus, with their encouragement, I felt motivated and ready to start working with dilators.
Shortly after I joined the LS Warriors support group, Kathy posted about a book by pelvic floor physical therapist Dr. Heather Jeffcoat, called “Sex without Pain”. This book is designed for anyone with a vulva/vagina experiencing painful sex due to vaginismus, vestibulodynia, lichen sclerosus, etc. During my work lunch break, I devoured the book, metaphorically speaking. And that was it. The book provided an in-depth explanation of exactly how to work with dilators. Additionally, I now had a strong community behind me. I felt ready this time. Thus, I dusted off my dilators and got to work the next day.
In what follows, I will outline what my process looked like for the first two weeks.
Importantly, at this stage, my Lichen Sclerosus was in remission. I had healed my fissures and cuts and worked a lot on my mental health; I felt physically and mentally ready.
First, I worked through the self-assessment portion of the book. This is meant to help you establish your baseline so you can accurately track your progress. I worked through the various assessments, taking notes on the worksheets Dr. Jeffcoat provides at the end of her book. Throughout the assessment, my pain levels were between 0-4.
Once I had this baseline established by completing the self-assessments, I moved to her IRAS technique – insert, release, adjust, stretch – the following day. It looked like this:
The first day I did this with the smallest (size 1) and second-smallest (size 2) dilators, and gradually moved up through the week. My dilator set had 5 sizes, with what I'll refer to as size 1 being the smallest and size 5 being the largest, with the sizes in between being progressively larger than size 1.
I continued to do the IRAS technique for the majority of week one. Every morning, after brushing my teeth, I would take about 15-20 minutes to work on this. During this week, I was mainly focused on getting used to the feeling of the dilator in me. I tried to be mindful of how I felt physically and mentally through the process.
Overall, my physical pain stayed under a 4.
Mentally, I felt pretty good. I told myself when I decided to start working with dilators again I wouldn’t give myself any timelines. This freed me from the heaviness of expectations. I told myself that it would take the time that it would take. And if I experienced pain, I would take a day off, and try again with a smaller dilator the next day.
I essentially continued the same routine I did in week one. During each session, I would release any trigger points with the smallest dilator, then do the stretches with dilators 2, 3, and then 4. With the fourth dilator, I couldn’t get it in very far, so I mostly just inserted it and did some deep, diaphragmatic breathing. While I breathed, I worked on relaxing my pelvic floor and envisioning my vulva and vagina as a rose slowly blooming and opening up. I visualized the flower blooming, gently softening and opening, and imagined blood flowing through my tissues, encouraging healing. Thus, my process combined trigger point release, stretching, and visualization with deep breathing.
I would do this for 15-20 minutes each morning before I looked at my phone or got distracted by work and life demands. I saw this moment as an act of radical self-love. Because, for me, I often get swept up in the current of life demands, and I forget to stop and take time out for myself. Thus, dedicating this time strictly for me felt like an act of self-care and self-love. I would have soft-lighting and listen to relaxing spa music. Sometimes, I would do a body-scan meditation before or after dilating. I would also journal my pain levels and their locations, as well as how I felt and what came up for me emotionally afterward.
While doing the IRAS technique the second week, I started to become more aware of and in tune with my body. I became more mindful of ‘quieter’ sensations. For example, a loud sensation would be a very sharp and obvious pain sensation. Conversely, the quieter sensations I would notice were tension in my hip flexors, clenching of my adductors, and slight feelings of discomfort in certain areas.
For instance, I noticed I felt slight discomfort when I would stretch in the 6 o’clock direction. I suspect this may have to do with stored trauma in the body, as I used to often tear from penetration in that area. Perhaps there was a residual stored memory there of the pain that was causing the discomfort and sense of unease in my mind and body.
Thus, when stretching in the 6 o’clock area, I stretched very mindfully and gently. I focused on breathing slowly and deeply into the area, and with each inhale, I imagined the area softening and melting, becoming more elastic and fluid. I’m a very visual person, so when I work with dilators, I often conjure up imagery to go along with my breathing to encourage relaxation. This also helps to remind me that I am safe and in control.
Another thing I noticed was my 4 o’clock (my left side) felt tighter than the 8 o’clock (my right side). Interestingly, I do have chronic low back, glute, and hip pain from degenerative disk disease, and historically this pain always presented much more intensely on the left side. Perhaps this is connected and explains why the left side felt tighter than the right during my stretches.
This was important for me to be aware of, as this helped me give more love, patience, and compassion to the left side as I worked to slowly stretch it out.
An important piece of working with dilators is being clear on your goals. As I noted in my last blog post, there are many goals you may have when working with dilators. For example, you may want to use them to help increase space at the vaginal opening, to help gently stretch out scarring, to increase blood flow to the area in order to promote feeling or to be able to have penetrative sex.
I had a mix of goals, but one of my goals was to be able to have penetrative sex again and to reclaim myself as a sexual being. Thus, it was important to me to incorporate pleasure into my use of dilators. Working with dilators can feel rather clinical and can sometimes be a harsh reminder of our LS. This is why I like to add in some relaxation elements such as lighting, music, and scent to help create a space that feels warm and inviting. Additionally, some mornings I would also masturbate while using the dilators.
I was very nervous to masturbate. I hadn’t masturbated in about a year at this point. In large part, battling body dysmorphia with my vulva made me feel a lot of shame and disgust towards my vulva. Therefore, I didn’t want to touch it at all. Further, early in my LS journey, I lost myself as a sexual being. It was as if all the sensuality and sexuality were drained from me. Because I hadn’t masturbated in a relatively long time, and because I still had remnants of the false narrative that my sex life was doomed because of LS, I was afraid that it “wouldn’t work”. Nonetheless, I tried, and, to my surprise, I was able to orgasm.
I cried afterward, feeling immense gratitude. I added masturbating into the mix 6 out of the 14 days I used my dilators. Sometimes I orgasmed, and a couple of times I got too tired and gave up. Somedays I would masturbate with a dilator inside me to kind of train my brain to associate penetration with pleasure. Other days I would do it before the dilators as a “warm-up” so to speak.
At this point, I was simply using my fingers around my clitoris to masturbate. On the days where I couldn’t reach orgasm, I still felt gratitude. I didn’t let it bring me down because I know as we go through life on this planet, the one thing that is guaranteed is change. Our orgasms – the intensity, duration, etc. – will ebb and flow throughout our lives. Thus, for me, I saw the fact that sometimes I could orgasm and other days not, as a representation of the normal ebb and flow of change that is part of being a human.
To conclude, my first two weeks of using dilators were quite positive. I believe the experience was positive because this time I was truly ready. Physically and mentally, I was ready. Physically, my LS was in remission. Mentally, I worked through the mental hurdles I had concerning fear, anxiety, body dysmorphia, etc., with my sex therapist. The fact that I came into this with curiosity instead of timelines and hard expectations on my body and the process helped me soften into the journey instead of going full speed ahead.
Additionally, having a beautiful network and community of fellow LS warriors cheering me on, whom I could lean on for advice or support when I needed it made me feel very empowered. In my journal, I wrote that while I had no idea if I could have penetrative sex again, and that if I did, when it would happen, I felt hopeful and grateful for my body. This was enough for me.
In my next post, I will discuss weeks three and four of working with dilators, the obstacles I encountered, and the new things I tried.
Whether you want to contribute to The Grief Project or you want to chat with me personally, you can contact me in the following ways:
Instagram: @thelostlabiachronicles
Facebook: @TheLostLabiaChronicles
Email: lostlabiachronicles@gmail.com
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!
Dr. Jeffcoat’s website, where you can buy her book “Sex Without Pain: A Self-Treatment Guide To The Sex Life You Deserve”.
A trigger point is defined as “[…] discrete, focal, hyperirritable spots located in a taut band of skeletal muscle. They produce pain locally and in a referred pattern and often accompany chronic musculoskeletal disorders.” (Alvarez and Rockwell, 2002, American Family Physician). Trigger points can be released by applying gentle but firm pressure to the area until the pain reduces or releases. I have had trigger points before in my glutes which I released with a lacrosse ball.
*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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