7 Physiotherapy Solutions that Reduce Vaginal Laxity and Internal Size

reduce vaginal laxity

Learn how to reduce vaginal laxity and overcome vaginal size concerns with this Physiotherapy video and information.

Laxity or looseness is a common problem experienced by many women after childbirth or menopause.

  • Reduce vaginal laxity
  • Improve sensation with intimacy
  • Cope with negative emotions and relationship difficulties
  • Measure vaginal size
  • Know average vaginal size

Please scroll below this video to learn:

  • How to measure vaginal size
  • Average vaginal size
  • Causes of vaginal laxity
  • Ways to improve sensation with intimacy

How to Reduce Vaginal Laxity and Increased Size (Video)

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Problems Caused by Pelvic Floor Injury During Childbirth

relationship difficultiesVaginal laxity is looseness or loss of elasticity in the vaginal walls and weakness in the surrounding pelvic floor muscles.

Damage to the pelvic floor muscles and tissues during natural childbirth is a major cause of vaginal laxity and increased vaginal size.

Increased vaginal laxity and size after natural childbirth can have a negative effect on a woman’s self esteem and self confidence.

Some couples experience relationship difficulties owing to perceived vaginal laxity concerns by either partner.

  • Decreased desire, sensation and satisfaction
  • Poor body image
  • Decreased self esteem
  • Relationship difficulties
  • Embarrassment 
  • Isolation
  • Anxiety
  • Depression

Average Vaginal Size 

Vaginal size can be measured using 1-2 fingers placed internally.

Vaginal length is measured from the entrance to the vagina to the cervix. Genital hiatus is the measurement of the width of the vaginal opening measured from the back to the front of the vagina.

  • Average vaginal length 9.6 cm or 3.7 “
  • Average genital hiatus (width) 2.9 cm or 1.1”¹

Causes of Increased Vaginal Laxity and Size

Main Causes of pelvic floor damage resulting in increased laxity and size include:

  • Forceps delivery
  • Prolonged pushing – 2nd stage labour²
  • Large birth weight baby (especially large head circumference)

There is no evidence to suggest that increased vaginal laxity is caused by the frequency of sexual intercourse.³

7 Physiotherapy Solutions to Reduce Vaginal Laxity and Size 

Kegel Exercise Technique 

Regular Kegel exercise can increase pelvic floor muscle thickness and strength, reduce vaginal laxity, size and improve sensation during intimacy. 

Step 1 – Puborectalis pelvic floor muscle activation

Place one or two fingers against the back wall of the vagina (closest to the anus). Puborectalis is a pelvic floor muscle that loops around the vagina and rectum from its origins at the pubic bone. You should feel the back wall of the vagina move slightly forwards against your fingers as you contract your pelvic floor muscles.

Step 2 – Clock face Kegels

Visualize the vagina as a round clock face with the front wall 12 o’clock and the back wall 6 o’clock. Try to bring the side walls (9 o’clock and 3 o’clock) together towards the midline as you squeeze and lift your pelvic floor muscles inwards.

1. Kegels for Strength 

Using maximal effort with your Kegel exercises can strengthen and thicken the pelvic floor muscles to reduce size, laxity and improve vaginal sensation. Use the Kegel exercise technique described above when performing Kegel exercises to reduce vaginal laxity.

  • Contract your pelvic floor muscles strongly
  • Perform up to 8-10 Kegels for 1 set of Kegels
  • Hold each exercise up to 10 seconds
  • Repeat 3 sets of kegels/day
  • Progress to standing Kegel exercises

2. Power Kegels

Strong fast kegel exercises improve pelvic floor muscle strength and speed of contraction.

  • Activate your pelvic floor muscles with a strong and brisk Kegel exercise
  • Repeat up to 10 strong fast Kegels
  • Perform1-3 sets/day

3. Functional Kegel Exercises

Try to incorporate Kegels into everyday activities for example before and during coughing, sneezing or heavy lifting. Some women find that performing Kegel exercises during intimacy improves sensation and arousal.

4. Positions for Intimacy

Different positions may improve sensation during intimacy. Side lying with back to partner or using a small pillow under the lower back are two positions that improve sensation during intimacy for some women.

5. Oestrogen Pessary (Ovestin)

Ovestin HRT cream acts locally on the vaginal tissues and the pelvic floor. This medication can improve internal vaginal wall thickness and lubrication. Speak with your doctor regarding your suitability for using Ovestin for nourishing the vaginal tissues and thickening the walls of the vagina.

Pjur water and silicone based lubricants6. Lubrication

Choose water based lubricants without additives during intimacy. Hybrid (water and silicone) based lubricants can improve sensation and personal comfort with intimacy and foreplay.

Poor lubrication may be a problem for breastfeeding mothers and women during or after menopause.

Water based lubricant Pjur Woman Nude (shown right)

Water and silicone hybrid lubricant Pjur Original (shown right)

7. Emotional Healing 

relaxationCoping with some of the emotions surrounding increased vaginal laxity and size is often a major challenge for women.

Some women feel self conscious and have negative body image issues related to vaginal laxity and increased size.

Strategies available to women and couples for coping with emotions include:

  • Counselling therapy (individual and couples)
  • Stress relieving techniques
  • Self compassion

Self compassion involves showing yourself the same kindness and understanding you would show a loved one who is experiencing emotional problems related to vaginal laxity and increased vaginal size.

Resources

References

1. Swift et al. Pelvic Organ Support Study (POSST): the distribution, clinical definition, and epidemiologic condition of pelvic organ support defects. Am J Obstet Gynecol. 2005;192:795–806 https://doi.org/10.1016/j.ajog.2004.1…

2. Shek, K. and Dietz, H. (2010), Intrapartum risk factors for levator trauma. BJOG: An International Journal of Obstetrics & Gynaecology, 117: 1485-1492. https://doi.org/10.1111/j.1471-0528.2… 

3. Schimpf, M.O., Harvie, H.S., Omotosho, T.B. et al. Does size impact activity and function?. Int Urogynecol J 21, 447–452 (2010). https://doi.org/10.1007/s00192-009-10…

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