Vaginal Tightening: Myths and Facts

Vaginal Tightening: Is my vagina too loose ? This is a question that haunts many women, and they often have no way of being sure. It is usually her man who raises this and complains of being dissatisfied. Women can feel the lack of friction too. A lot of ignorance and myths prevail about this highly sensitive and private matter. I see a a lot of women in my plastic surgery practise who suffer from this issue and who are desperate to improve their sex lives and satisfy their partner. But there are a lot more out there who suffer in silence. On google search, there are a lot of natural remedies, gels and pills on offer. There are lasers available to tighten the vagina, and then there is vaginal tightening surgery. Which one should the woman choose ? Do these things work? Are they safe? Let’s explore the facts and bust some myths .

What is normal vagina?

 Normal Vagina

Vagina is a tube like connection between uterus and external genitalia. Vagina opens into female external genitalia close to the opening of urethra and anus. A lot of women refer to whole external genital area as vagina. But in fact vagina is just one part of it. Female external genitalia include – Labia majora (outer vaginal lips), Labia minora (inner vaginal lips), clitoris, urethral opening and vaginal opening.

Vagina Tube Connection

Vagina is a tube of 3-4 inches length with elastic walls. Inner lining of the tube is vaginal mucosa and outer one is layer of smooth muscle. There are strong voluntary muscles called pelvic diaphragm and supporting structures called ligaments common to urethra, vagina and rectum that keep them supported. Normal vaginal mucosa lining the vaginal tube is not smooth, but has longitudinal folds called rugae. Vaginal mucosa is naturally lubricated and also has a mechanism to keep the ph at 4.5 . Lubrication and acidic ph together protect the vagina from injury and infections. In virgins there is usually (but not always) a structure called hymen at the entrance of vagina , which is a fold or diaphragm of vaginal mucosa, with an opening to allow menstrual blood flow .

 vaginal mucosa

Does Vagina become loose after sexual intercourse?

It’s a common myth, that vagina is never the same after virginity is lost. But nothing can be farther from truth.

Imagine vagina to be like a brand new sport sock. At rest normal vaginal length is 3-4 inches and width about 1 inch. But like a sock, vagina relaxes and stretches both width and lengthwise during sexual intercourse to accommodate the penis and to grip it. And springs back to normal resting stage soon after intercourse. Vagina does not get loose by having sex once or having sex for years even. Hymen is just a flimsy fold on way into vagina that gets torn first sexual intercourse. Think of hymen as a paper label on the sock, which is of no use per se, and which is discarded during first use.

What causes vagina laxity?

1. Childbirth: Studies done with MRI scan reveal that vagina gets larger after vaginal delivery.

Episiotomy, or cutting the muscle at the narrowest entry point of vagina is often needed during vaginal delivery. The cut is stitched back as soon as the baby is out, but wrongly performed episiotomy or vaginal tears during childbirth can damage the vagina and pelvic muscles permanently.

Damage during traumatic childbirth when baby is too big or when the head was stuck at vagina for too long or required forceps delivery, can lead to symptoms of looseness of vagina afterwards. In more severe cases of vaginal trauma during childbirth there can be additional symptoms of urine leak during coughing (stress urinary incontinence) and other urinary symptoms like need to run to washroom (urge incontinence ), prolapse or bulge of urinary bladder into vagina. Vaginal tears can extend into rectum or urinary bladder and can cause urine leakage into vagina (vesicovaginal fistula) or feces leaking into vagina (rectovaginal fistula). These complications are fortunately uncommon, and most couples do not have sexual issues after vaginal deliveries.

2. Age: With age there is loss of tone of muscles all over the body. Same happens to vagina too. Age factor comes into play after 30s and varies from woman to woman.

3. Injury: Trauma to vagina during forced intercourse and insertion of large objects can cause vaginal muscle injury and laxity.

4. Menopause is a common cause vaginal muscle laxity and dry vaginal mucosa.

Is my vagina loose?

A lot of women want to know, if their vagina is too loose . This question comes up in following scenarios:

  1. Husband or long time partner who was satisfied earlier, is complaining .
  2. You don’t feel the penis in your vagina
  3. You are starting a new relationship, and you are apprehensive that your vagina may be loose

This is a simple test you can do at home. Insert 2 fingers into vagina and try to grip it, If you can feel the grip, and maintain it for 3 minutes, your vagina is not loose. If you can hold a tampon inside vagina and walk around, you are normal. If you are young and healthy and have had normal vaginal intercourse once or many times even but have not had vaginal delivery and you can do all of the above , you can be rest assured that your vagina is not loose.

You may be loose if:

  1.  You don’t feel the fingers
  2.  You can not grip them
  3. You can introduce much more than 2-3 fingers inside
  4.  You have symptoms urine leakage when coughing or lifting weight
  5. You have vaginal fart like sounds during intercourse due to air getting in, beside penis.

In case of doubt, you should see a gynaecologist or plastic surgeon who specializes in vaginal rejuvenation, to confirm the diagnosis . We diagnose it clinically by doing vaginal exam. No specific tests are required to diagnose vaginal laxity.

A common scenario is when woman has a normal vagina on examination, but sexual intercourse is not satisfactory due to mismatch of sizes of vagina and penis of the partner. Sometimes it is the male who has weak erection or smaller penis. This sexual mismatch should be diagnosed and addressed for best result.

Natural way of tightening vagina:

Vaginal Tightening exercises are the best and the first option for vaginal tightening. Vaginal tightening Kegel exercises are simple and they strengthen and maintain the tone of vaginal muscles. Kegel vaginal exercise involves pulling in your vaginal muscles like when you are tightening your muscles to stop urine. You should hold this to the count of 10 and then relax. You can do this exercise in bed or even at your desk, without anyone knowing. Do this for 5 minutes 3 times a day and you will see the result in a couple of weeks. You can do more and continue it all your life to maintain the tone of vaginaObesity is associated with lack of tone of body muscles. Exercising regularly and maintaining healthy weight can further help you.

What about vaginal tightening gels and creams ?

Vaginal tightening creams may work on mucosa but not on muscles that are deep inside. Vaginal tightening requires tighter muscles, which are outside the reach of gels and creams. Vaginal creams claiming to tighten vagina contain some herbal ingredients that may produce tingling sensation or temporary increase in blood supply. At best, it can improve the sensation of sex mildly and temporarily.

Are vaginal tightening creams safe? Vagina maintains a healthy ph of 5.5 and a normal flora of harmless organism that keep it healthy and infection free. Introducing untested drugs into vagina can alter the ph and introduce infections. Unknown ingredients of creams can cause

Vaginal Tightening Lasers: 

Vaginal Tightening Laser Treatment

Laser devises are used for non-surgical vaginal rejuvenation. There two types of vaginal devices for nonsurgical vaginal rejuvenation – Laser based like Femilift and Radiofrequency based like ThermiVa. These are similar to the machines that are used to tighten and resurface the skin, by dermatologists and plastic surgeons. These machines have probes that are gently inserted into vagina and laser or RF energy is delivered all around the vaginal walls. Laser energy penetrates the vaginal mucosa and creates microinjury upto few mm depth. This microinjury heals in 4-5 days and causes new collagen generation that leads to vaginal tightening. RF based devices heat the tissues and produce result similar to laser devices.

Laser vaginal rejuvenation is painless . There is no bleeding ,no need for rest and no restriction on activity , except that penetrative sexual intercourse should be avoided for 4-5 days . For best result in 3 sittings of laser vaginal rejuvenation are required at monthly intervals . Results of Laser vaginal tightening last upto one year.

But the flip side is that Laser vaginal rejuvenation works only for mild cases of vaginal laxity. Laser vaginal rejuvenation works best women after menopause who suffer from dryness and pain during intercourse.

Vaginal Tightening Surgery (Vaginoplasty): Vaginal tightening surgery is the most effective way of tightening loose vagina. Vaginoplasty surgery is done under local or general anaesthesia depending on the severity of the problem. During surgery muscles of vagina and pelvic diaphragm are tightened with sutures. Vaginal mucosal folds are recreated and external vaginal opening is narrowed. Vaginoplasty surgery can be combined with other surgeries if needed -like hymen reconstruction, labia surgery and fat injections. There are fine absorbable stitches in vagina which dissolve in 2 weeks leaving a virtually scarless and rejuvenated vagina. Absteinance from sex for 1 month following the surgery is advised. Results of surgery are permanent, and can be maintained by vaginal exercises.

What is the best option for me – laser vaginal rejuvenation or vaginoplasty surgery?

This can be best determined by the doctor who has experience of both the technologies. Natural choice of women is to opt for less invasive method like laser because it has advantages of no rest, no pain and no surgery. Laser vaginal tightening is useful in cases where on examination vagina seems normal but still woman or her partner are not satisfied. In such cases Laser is a good option , as mild improvement may suffice. Laser is also the first choice for women who have not had any injury or vaginal deliveries.

Vaginoplasty surgery is the best option when there when vaginal laxity is moderate to severe. Advantages of surgery are – one time treatment and permanent results. Vaginoplasty surgery is safe when performed by experienced plastic surgeon or gynaecologist. Excess tightening can cause problems and should be avoided.

PRP (platelet rich plasma) therapy, fat injections and Filler injections for vaginal rejuvenation:

All of the above are helpful in nonsurgical vaginal rejuvenation. Platelet rich plasma is prepared from 10 cc of your own blood , and it contains platelet-derived growth factors. PRP can be injected into vaginal mucosa , at G spot in vagina (G shot) and into external genitalia to facilitate antiageing and health of mucosa.

Fat injection technique is useful in cases where external genitalia and vagina are shrunken and atrophic. Fat is sucked out in syringes from any other fatly body part and injected into the vaginal walls and labia. Fat makes labia plump and adipose stem cells found in fat contribute to collagen and vascular regeneration in vagina.

Hyaluronic acid fillers like Juvederm and  Restylene can also be used instead of fat, to plump the vagina. All these can be combined with laser vaginal rejuvenation or vaginoplasty to enhance vaginal look and feel.

Pregnancy and childbirth need not be the end of sexually satisfied life. With the right treatment vagina can be restored to its original condition. Once again though, a word of caution. Its sometimes the man who may be having the problem. So in case of sexual dissatisfaction its best if both the partners get themselves checked.


DR. Priti Shukla

Dr. Priti Shukla is the best female cosmetic surgeons in Hyderabad. She has 18 years of experience in cosmetic plastic surgery and thousands of satisfied patients. Ambrosia Clinic is leading skin plastic surgery clinic of Hyderabad since 2009. Our team of dermatologist and Plastic surgeons at Ambrosia clinic offer services like hair transplantation, laser, skin care and plastic surgery.

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