What is an expandable vaginal dilator? Meet Milli!

In Female Pelvic Pain by Stephanie PrendergastLeave a Comment

Author: Tracy MacNeal, Materna CEO

 

This week we are posting about the Milli, the first-ever gradually expanding dilator. Please note PHRC cofounder Stephanie Prendergast is a member of the Materna Scientific Advisory Board and PHRC is posting this blog on their behalf.

 

Vaginal dilators are often recommended in treatment plans for women suffering from vaginal stiffness and discomfort. Dilators can be used to improve scar tissue after childbirth, surgery, or radiotherapy. They can reduce vulvar and vaginal hypersensitivity. Dilators may help the pelvic muscles relax to a size that is functional for sexual activity, increasing the quality of sex life for women. 

 

In a recent series featuring Pelvic Health and Rehabilitation Center’s co-founder, Stephanie Prendergast (MPT), Stephanie provides insight on vaginal dilation  and why dilators are part of treatment plans for painful sex or vaginal tightness.

 

During this Peer & Pro Tips segment, Stephanie covers the differences between pelvic muscles and other muscles in the body. Unlike the hamstring, for example, pelvic muscles cannot simply be stretched through common exercises like yoga. Instead, manual techniques like pelvic floor physical therapy and vaginal dilation are often used. Dilators are able to apply stretch to the pelvic floor muscles reducing tightness and increasing relaxation over time. They are a way for women to help stretch their pelvic floor muscles on their own at home. 

 

Vaginal dilators are often recommended to women experiencing tightness or discomfort in their pelvic floor. For anyone suffering, routine vaginal dilation is a non-hormonal approach to loosening these muscles and reducing pain during sex.

 

Shelby Hadden of Tightly Wound speaks along with Stephanie. Shelby suffered from a condition called Vaginismus, which caused involuntary tightening of her vaginal muscles. Shelby refers to vaginal dilation as a technique to teach your muscles how to relax and ultimately stretch out. Women begin with the smallest diameter dilator in the set and when they have no issues inserting the dilator, they will progress to the next largest size and so on. To minimize discomfort and increase effectiveness, Shelby recommends women try Milli, a silicone vaginal trainer with adjustable sizing. Milli achieves and gives incremental sizing from 15 mm to 40 mm in diameter, with a total expansion of 25 mm. Unlike current vaginal dilators on the market (static dilators), the jumps in sizes can be intimidating for many women. Milli offers a less daunting experience due to its millimeter-by-millimeter incremental sizing that women control with a click of a button. Shelby’s favorite feature of the product is the vibration setting with low and high settings, which she says helps desensitize tissue in the muscles.

 

Click here to watch this 2-minute Peer & Pro Tip on  “What is Vaginal Dilation”.

 

For more information about the Milli and vaginal dilation please visit their website

 

FAQ

What are pelvic floor muscles?

The pelvic floor muscles are a group of muscles that run from the coccyx to the pubic bone. They are part of the core, helping to support our entire body as well as providing support for the bowel, bladder and uterus. These muscles help us maintain bowel and bladder control and are involved in sexual pleasure and orgasm. The technical name of the pelvic floor muscles is the Levator Ani muscle group. The pudendal nerve, the levator ani nerve, and branches from the S2 – S4 nerve roots innervate the pelvic floor muscles. They are under voluntary and autonomic control, which is a unique feature only they possess compared to other muscle groups.

What is pelvic floor physical therapy?

Pelvic floor physical therapy is a specialized area of physical therapy. Currently, physical therapists need advanced post-graduate education to be able to help people with pelvic floor dysfunction because pelvic floor disorders are not yet being taught in standard physical therapy curricula. The Pelvic Health and Rehabilitation Center provides extensive training for our staff because we recognize the limitations of physical therapy education in this unique area.

What happens at pelvic floor therapy?

During an evaluation for pelvic floor dysfunction the physical therapist will take a detailed history. Following the history the physical therapist will leave the room to allow the patient to change and drape themselves. The physical therapist will return to the room and using gloved hands will perform an external and internal manual assessment of the pelvic floor and girdle muscles. The physical therapist will once again leave the room and allow the patient to dress. Following the manual examination there may also be an examination of strength, motor control, and overall biomechanics and neuromuscular control. The physical therapist will then communicate the findings to the patient and together with their patient they establish an assessment, short term and long term goals and a treatment plan. Typically people with pelvic floor dysfunction are seen one time per week for one hour for varying amounts of time based on the severity and chronicity of the disease. A home exercise program will be established and the physical therapist will help coordinate other providers on the treatment team. Typically patients are seen for 3 months to a year.

What is pudendal neuralgia and how is it treated?

Pudendal Neuralgia is a clinical diagnosis that means pain in the sensory distribution of the pudendal nerve. The pudendal nerve is a mixed nerve that exits the S2 – S4 sacral nerve roots, we have a right and left pudendal nerve and each side has three main trunks: the dorsal branch, the perineal branch, and the inferior rectal branch. The branches supply sensation to the clitoris/penis, labia/scrotum, perineum, anus, the distal ⅓ of the urethra and rectum, and the vulva and vestibule. The nerve branches also control the pelvic floor muscles. The pudendal nerve follows a tortuous path through the pelvic floor and girdle, leaving it vulnerable to compression and tension injuries at various points along its path.

Pudendal Neuralgia occurs when the nerve is unable to slide, glide and move normally and as a result, people experience pain in some or all of the above-mentioned areas. Pelvic floor physical therapy plays a crucial role in identifying the mechanical impairments that are affecting the nerve. The physical therapy treatment plan is designed to restore normal neural function. Patients with pudendal neuralgia require pelvic floor physical therapy and may also benefit from medical management that includes pharmaceuticals and procedures such as pudendal nerve blocks or botox injections.

What is interstitial cystitis and how is it treated?

Interstitial Cystitis is a clinical diagnosis characterized by irritative bladder symptoms such as urinary urgency, frequency, and hesitancy in the absence of infection. Research has shown the majority of patients who meet the clinical definition have pelvic floor dysfunction and myalgia. Therefore, the American Urologic Association recommends pelvic floor physical therapy as first-line treatment for Interstitial Cystitis. Patients will benefit from pelvic floor physical therapy and may also benefit from pharmacologic management or medical procedures such as bladder instillations.

Who is the Pelvic Health and Rehabilitation Team?

The Pelvic Health and Rehabilitation Center was founded by Elizabeth Akincilar and Stephanie Prendergast in 2006, they have been treating people with pelvic floor disorders since 2001. They were trained and mentored by a medical doctor and quickly became experts in treating pelvic floor disorders. They began creating courses and sharing their knowledge around the world. They expanded to 11 locations in the United States and developed a residency style training program for their employees with ongoing weekly mentoring. The physical therapists who work at PHRC have undergone more training than the majority of pelvic floor physical therapists and as a result offer efficient and high quality care.

How many years of experience do we have?

Stephanie and Liz have 24 years of experience and help each and every team member become an expert in the field through their training and mentoring program.

Why PHRC versus anyone else?

PHRC is unique because of the specific focus on pelvic floor disorders and the leadership at our company. We are constantly lecturing, teaching, and staying ahead of the curve with our connections to medical experts and emerging experts. As a result, we are able to efficiently and effectively help our patients restore their pelvic health.

Do we treat men for pelvic floor therapy?

The Pelvic Health and Rehabilitation Center is unique in that the Cofounders have always treated people of all genders and therefore have trained the team members and staff the same way. Many pelvic floor physical therapists focus solely on people with vulvas, this is not the case here.

Do I need pelvic floor therapy forever?

The majority of people with pelvic floor dysfunction will undergo pelvic floor physical therapy for a set amount of time based on their goals. Every 6 -8 weeks goals will be re-established based on the physical improvements and remaining physical impairments. Most patients will achieve their goals in 3 – 6 months. If there are complicating medical or untreated comorbidities some patients will be in therapy longer.

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