Pain during intercourse after 60

Ilonka L, 25.03.21: I’m 64 years old. Due to low oestrogen levels, I have thin, dry mucous membranes around the vulva and at the entrance to the vagina. I also have a scar from an episiotomy and another from a biopsy. These factors have led to pain during intercourse and mild incontinence.
My goals are to improve tissue flexibility and to strengthen my pelvic floor.
Here are my questions:

  • How many times a week should I use the dilators
  • How long should each session last?
  • I’m unsure about the right size: D28 works quite well, but D32 feels uncomfortable. Should I increase size in 2 mm or 4 mm steps? And for pelvic floor training – is a smaller or a larger size more suitable?

Answer: I recommend using the dilators daily or every other day. What matters most is that you feel unhurried and undisturbed – pelvic floor work done in a rush is rarely effective. Depending on how well you’re able to focus and relax, 10 to 15 minutes per session is usually enough.
Start with a size that you can insert without pain, and be gentle and caring with yourself throughout. The attitude should feel more like an act of self-love than strict “training”. As for size: I would recommend increasing in 2 mm steps, as it’s simply more gradual and gentle.
In your case, that means trying a D30 next.You can find further guidance here: https://theros.de/en/pages/use-of-dilators-for-vaginismus … or in the official instructions for use that come with your set.

Hera Schulte Westenberg
About the Author

Hera Schulte Westenberg

I trained as a midwife and am a pelvic floor therapist, a licensed practitioner of psychotherapy under German law, and the founder of Theros®.

For decades, I have worked directly with people from a wide range of backgrounds, with diverse health concerns and personal needs. In my guides, I combine this practical experience with solid professional expertise and a holistic view of the pelvic floor, intimate health, psychological well-being, sexuality and relationships.

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