Vagina – use or lose?

Edited on July 3, 2018

A 20-something patient arrived at the office today and told us that she has not been having intercourse for over 8 months now. One of her concerns was whether she will be able to have pain-free sex when she resumes having intercourse. In other words, does the vagina operate under the ‘use or lose’ premise?

• Fact: the vaginal canal is not a voluntary muscle that needs to be exercised to maintain its shape and function, but rather a structure that is built to expand with penetration, then go back to its smaller size — kind of like a tube-sock.  That is with the exception of the circular PC muscles that are found close to the vaginal opening.
• Fact: women can go years between intercourse without a problem.
• Fact: doing the Kegel exercises will strengthen the PC muscle, which support the pelvic floor (a good thing!), but will not stretch or tighten the vagina.
• Fact: certain life events will impact on vaginal elasticity and its tolerance for the ‘rubbing/chafing’ of penetration. Examples include estrogen decline (natural, surgical, or induced menopause), vaginal radiation, or scars from surgical procedures, causing dyspareunia and/or vaginismus and requiring medical intervention.

Because the vagina is an invisible part of the woman’s body that cannot be easily stretched/inspected, it is susceptible to all kinds of worries. This is in contrast to the penis, which is always available for ‘review.’

Bottom line: it is okay to take the vagina on vacation…