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.
Vaginal changes after childbirth
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.
- Leaking of urine
- Trouble controlling passing gas or holding in stool
- Pain with intercourse
- Tampons or menstrual cups fall out
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.
Sexual function
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.
