Old Big Vagina

Old Big Vagina

Medically Reviewed by Carol DerSarkissian, MD on March 06, 2022
The age-old question of whether or not size matters is typically directed at men. But although they might not talk about it, some women may worry about the size of their vagina and how it affects sexual pleasure, particularly after having a baby .
Not a lot of research has been done in this area. Because so many things affect women’s sexuality, it's hard for researchers to know if vagina size and sexual pleasure are linked.
“Our ability to understand size as it relates to sexual function is poorly understood,” says Christopher Tarnay, MD, director of the division of female pelvic medicine and reconstructive surgery at the UCLA Medical Center.
The vagina is a very “elastic” organ, says Christine O’Connor, MD, director of adolescent gynecology and well women care at Mercy Medical Center in Baltimore.
It's small enough to hold a tampon in place, but can expand enough to pass a baby through. This is because the walls of the vagina are similar to those of the stomach in that they have rugae, meaning they fold together to collapse when unused, then expand when necessary.
“It doesn’t stay one particular size,” O’Connor says. “It changes to accommodate whatever is going on at that time.”
The most commonly used measurements regarding the size of vaginas come from Masters and Johnson’s work from the 1960s. They looked at 100 women who had never been pregnant and found that vagina lengths, unstimulated, range from 2.75 inches to about 3¼ inches. When a woman is aroused, it increased to 4.25 inches to 4.75 inches. Regardless of how long the vagina is, the area that is thought to be important for most women’s sexual response is the outer one-third.
So how does length relate to sexual satisfaction? No one seems to know for sure.
Tarnay says the main issues women report is discomfort during sex. This typically happens if the vagina is too short or tight or if they have a prolapse. In prolapse, the uterus, bladder , or other organs fall out of place, typically after childbirth.
But in general, vaginal length "probably doesn’t matter,” Tarnay says. “There is such a wide range of normal. One can be completely assured that in the absence of prolapse, length has no impact on sexual satisfaction.”
What may make a difference, Tarnay says, is what he calls the genital hiatus -- the vaginal opening. If there's a problem, it typically happens after childbirth.
The vaginal opening likely changes only slightly after birth, Tarnay says. In 1996, doctors began using a measurement called the pelvic organ prolapse quantification system as a way of helping them see how well they were doing repairing that area after childbirth.
This was the first time there was a true before-and-after measurement, Tarnay says. Doctors have used the system to look at populations of women and found that there is a slight increase in the size of the opening after vaginal deliveries. The issue may be more related to muscular weakness or injury in that area, Tarnay says.
“Women who are able to contract the pelvic floor muscles can increase or decrease the size of the hiatus,” he says. “Increasing pelvic floor muscle tone can reduce looseness.”
Kegel exercises can be very effective at strengthening these muscles, Tamay says may generally improve sex .
A study published in the Australian & New Zealand Journal of Obstetrics and Gynaecology in 2008 found that women who regularly did Kegel exercises reported greater sexual satisfaction than women who didn’t do Kegels.
To find the muscles you use to do Kegels, you can either insert a finger into the vagina and squeeze the surrounding muscles or stop the flow when urinating. After you’ve found the muscles, practice contracting them for five to 10 seconds, and then relax. If you can’t hold for that long, work your way up. Repeat the process 10 to 20 times, three times a day. While doing these exercises, breathe normally and try not to use the muscles in your legs, stomach, or bottom.
Some women sustain nerve injury during birth and can’t feel these muscles. Tarnay says there arephysical therapists who specialize in helping women learn how to do Kegels.
Worrying about vagina size and whether or not it changes over time is the wrong concern, O’Connor says. She notes that other things -- like lubrication, arousal, and having and a good relationship with your partner -- have a much greater impact on sexual enjoyment for women.
A 2010 study published in the International Urogynecology Journal bears out her opinion. Researchers used medical records, an exam, and questionnaire of 500 gynecological patients aged 40 and older to see if there was a correlation between vaginal length and opening size and sexual satisfaction.
The researchers found that desire, arousal, orgasm, pain, and sexual satisfaction weren't linked to vagina size.
“It is not an exact physical fit you are looking for in terms of sexual function,” O’Connor says. “It is more about the communication between the two partners and making sure both are getting what they need out of the experience and are comfortable.”
Christopher Tarnay, MD, associate professor of obstetrics and gynecology; director, division of female pelvic medicine and reconstructive surgery, UCLA Medical Center.
Christine O’Connor, MD, director of adolescent gynecology and well women care, Mercy Medical Center, Baltimore.
Schimpf, M. “Does vaginal size impact sexual activity and function?” International Urogynecology Journal , April 2010.
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WebMD does not provide medical advice, diagnosis or treatment.

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By Heather Rupe, DO Board-certified OB/GYN April 13, 2021

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As someone who sees about 35 vaginas a day, I can assure you that they come in all shapes and sizes. Life, childbirth, weight gain, sexual activity, gravity, and hormonal changes can have an effect on the contours of the vagina over time, but is this a problem?
The vagina is a muscular tube that is approximately 3-4 inches long and 2-3 inches wide. It expands for sexual activity and even more so for childbirth. Vaginal childbirth can affect the shape of the vagina. Think of the vagina as a tube sock. If an elastic tube sock has only ever had a foot in it, and then one day you put a cantaloupe in it, it is going to be a little stretched out initially. Vaginas are amazingly resilient, and they were made for childbirth. Most revert back to normal quite quickly. But when childbirth involves prolonged pushing, large babies, multiple births, or significant vaginal tears (especially if they don’t heal well or get infected), sometimes the pelvic floor can be damaged, permanently affecting the shape and function of the vagina.
It can take 6-12 weeks for the pelvic muscles to recover from childbirth. If after that time you have any of the following symptoms, then you might have pelvic floor damage and need to see your doctor.
If your vagina did not bounce back as well as you would have preferred from the adventures of childbirth, there are things you can do to get your vagina and pelvic floor back into shape. You can start with weight loss (if your BMI is more than 30), Kegels , and exercises that strengthen your core. If these don’t work, then there are specialized physical therapists who are trained to help women strengthen their pelvic floor.
If physical therapy doesn’t help, it may be time to see a doctor. Gynecologists or urogynecologists (a urologist or gynecologist who has had additional training in pelvic floor reconstruction) are the best types of doctors to see if you’re concerned there is something wrong with your vagina. Sometimes the perineal muscles (the muscles between your vagina and rectum) tear during childbirth and don’t heal as they should. Occasionally they need to be surgically repaired.

What you shouldn’t do to tighten your vagina

Do not use any type of over-the-counter vaginal “tightening sticks” or “herbal remedies” to try to tighten or shrink your vagina. These work by causing irritation to the vagina that induces swelling. I have seen patients with severe vaginal burns from these products requiring hospitalization. As a general rule, you should not put anything in your vagina that you buy on Etsy.
If you are concerned about the outside appearance of your labia, then seeing a plastic surgeon to reshape your vaginal lips is fine (though completely unnecessary in my professional gynecological opinion). If you are concerned about the structure or function of your vagina, then you should see a gynecologist or a urogynecologist. Surgery should always be the last resort, but if you need your pelvic muscles repaired, then you need to see a urogynecologist who is trained to reconstruct your pelvic floor.
Vaginal laser treatment is marketed as another option, but we don’t have enough data on it. It supposedly stimulates collagen growth and claims to improve vaginal dryness and some symptoms of vaginal laxity. Be aware: Laser treatment has not been approved by the FDA for this purpose, and there have been case reports of vagina burns. If you do choose to try vaginal laser therapy, make sure you have it done with a gynecologist who can assess your pelvic floor and not at a med spa.
A woman’s sexual satisfaction is not related to the size of the vagina. Stimulation to the clitoris and pressure to the inner front portion of the vagina enhance sexual response. Multiple studies have shown no difference in sexual function or satisfaction between women who have had cesarean sections versus those with vaginal deliveries, suggesting the normal stretching from a vaginal delivery does not make a difference.
Can a vagina be too big? If a woman hasn’t had an exceptionally difficult vaginal birth or any type of vaginal surgery, then no. If childbirth has damaged your pelvic floor and is causing structural problems, then consult your gynecologist or urogynecologist. Remember to be kind to your vagina, don’t rush into any surgery, and above all else, don’t put any herbal “tightening” remedies in there.
Heather Rupe, DO, is a board-certified OB/GYN in private practice in Franklin, TN, and serves as the vice chief of staff at Williamson Medical Center. She is the co-author of The Pregnancy Companion: A Faith-Filled Guide for Your Journey to Motherhood and The Baby Companion: A Faith-Filled Guide for Your Journey through Baby’s First Year.
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