Your Big vagina

Written by Dr David Delvin, GP and family planning specialist
Worries about vaginal and vulval size are extremely common among women.

The vulva

The vulva is the visible part of the female genitals. It includes the clitoris, the labia, and the urinary opening.

This is scarcely surprising, because a woman's feelings about her own vagina and vulva are central to her sexuality.
If you are concerned about your own vagina or vulva, please don't hesitate to consult a doctor and get yourself examined.
Quite a few women who write to us say that they're not happy to consult their own GPs about this subject.
In the UK, a very useful alternative is your local family planning clinic. These clinics are staffed by (mainly) female doctors who are skilled in vaginal examination - and who carry out dozens of such examinations each week. They are also used to dealing with worries about ‘dimensions'. So they can rapidly give you an expert opinion about the size of your vagina or vulva.

Are you too big?

If you've never had children, it's almost unthinkable that your vagina or vulva is too big.
Unfortunately, there's a very common myth in some parts of Britain - a myth to the effect that a woman who has lots of sex will get a large vagina. This is just nonsense! No matter how much sex you have, it won't affect your vaginal or vulval size.
But what does affect your dimensions is childbirth. Unfortunately, the more babies you have, the more likely your vagina is to become widened. This is due to damage to the muscles and other supporting tissues of the vaginal walls. It's more common after difficult and prolonged labours. It can often be prevented by very determined use of the postnatal exercises that midwives and physiotherapists teach.

What happens if your vagina or vulva really is too big?

Let’s look at the vagina (ie the interior) first.
If your vaginal 'barrel' is excessively big, so that you are 'slack', this can have the following effects:

• intercourse may be less satisfactory for you.
• intercourse may be less satisfying for your partner.
• you may be more liable to experience the phenomenon of air getting into (and out of) the vagina - a phenomenon known in some parts of the country as 'fanny farting'.
• bath water may get into your vagina - though this isn't likely to be a health problem.
• much more seriously, lax muscles and ligaments around the vagina may lead to prolapse (descent of the womb and other organs) in middle age or later life.

What can be done about a slack vagina?

If your vagina is overly large and slack, the possible courses of action are as follows.

• Urgently set about tightening up your vagina by doing pelvic floor muscle exercises. Any midwife, nurse, physiotherapist, or doctor can teach you to do them. However, you'll need to do them intensively for six months in order to get much improvement. To get you started, try this:
  1. tighten up the muscles at the front of the lower part of your body - as if you were trying hard to stop yourself peeing.
  2. hold this contraction for 10 seconds.
  3. relax for 10 seconds.
  4. contract again for 10 seconds.
  5. continue to contract and relax like this for a full five minutes.
  6. repeat four times daily.
• You could also buy a vaginal muscle developer. However, these are expensive - about £75 to £200 - and you do have to work at them for quite a while to get any improvement. They’re now readily available through sex shops and the new mail-order organisations which sell sexual devices to women.
• Go to a gynaecologist (in the UK you'll usually need a GP's referral letter first) to discuss the possibility of a 'repair' operation. This draws the weakened pelvic tissues together and firms everything up.
• Finally, please note that as a temporary expedient, a woman whose vagina has become too big can improve the quality of intercourse (for herself and her partner) by simply popping a small vibrator inside during intercourse. This may sound surprising, but in fact, if you have had several children and become quite loose, there may well be plenty of room for both a small vibrator and a penis inside you - thus giving a much snugger fit.

What if you feel your vulva is too large?

A lot of women are desperately worried about the appearance of their vulvas – feeling that they are ‘too large’ or that the labia are ‘too long', or that bits of it protrude unequally. (Sometimes they are influenced in these views by having seen misleading pornographic magazines or videos – in which the ‘heroine’s’ vulva appears impossibly neat and tidy!)
If that applies to you, my advice is to go to a Family Planning Clinic – because the women doctors there are dealing with this sort of worry all the time.
Very often, they’ll be able to reassure you that you are in fact normal.
But if there really is an abnormality, it can be corrected by surgery – carried out by either a gynaecologist or a plastic surgeon. Since the beginning of this century, such operations have become increasingly common; however, a high proportion of them are performed privately, rather than on the NHS. However, some National Health gynaecologists are willing to shorten the labia of women who are distressed by an irregular appearance.

What if you think that you're too small?

Alternatively, do you think that you are 'built' too small?
I have to tell you that statistically this is most unlikely. Vast numbers of patients think that they are excessively small, but only once in a blue moon are they actually right.
The symptoms that make them feel that they are unusually small include:

• pain on intercourse
• inability to have sex at all
• inability to insert a tampon.

But the vast majority of women who complain of these problems do eventually turn out to be normal-sized. Nearly always, they are suffering from a degree of vaginismus - the common condition that makes the vaginal muscles contract whenever any approach is made to the genitals.
To find out if your vagina really is too small, you should have an internal examination by an experienced doctor who is good at putting patients at their ease.

Apparent 'smallness'

There are rare cases in which the apparent ‘smallness’ is due to the fact that the vagina has a ‘wall’ (a septum) down the middle, or has developed as a ‘double’ barrel. Happily, these women can be cured surgically.

The obvious place to go for this is a Family Planning Clinic - especially as the staff are mainly female. Indeed, many of the doctors and nurses have been specifically trained in dealing with this particular problem.
In the unlikely event that your vagina really does turn out to be too small, it is possible for a skilled gynaecologist to enlarge it surgically for you.
However, I must stress that in 30 years of practising sexual medicine, I have yet to see a patient who actually needed this operation.

Healthy Vaginas

A healthy vagina is as clean and pure as a carton of yoghurt...
Now there's a statement to combat some of the negative messages we have received about our nether regions. We are often taught that our vaginas are dirty and germ filled - generally not a nice place to go. But in fact as Dr Hillier from the Magee-Womans hospital in Pittsburgh states a "healthy vagina is as clean and pure as a carton of yoghurt". from Woman An Intimate Geography by Natalie Angier.
A healthy vagina is a self regulating system and is cleaner than our mouths and much much cleaner than our rectums. The vaginal ecosystem is a mutually advantageous relationship between the vagina itself and the micro-organisms that inhabit it.
Your vagina is full of life in the form of bacteria but these are good bacteria fighting the good battle to keep bad bacteria out of your reproductive system. These good bacteria are called lactobacilli which are the same organisms found in yoghurt. In a healthy vagina these lactobacilli maintain a acidic environment - around 3.8 - 4.5 pH ( a little bit more acidic than black coffee which has a pH of 5).
Vaginal mucus is "made up of the same things found in blood serum, the clear, thin, sticky liquid that remains behind when the solid components of blood, like clotting factors, are separated away. Vaginal discharge consists of water, albumin - the most abundant protein in the body - a few stray white blood cells, and mucin, the oily substance that gives the vagina and cervix their slippery sheen. Discharge is not dirt, certainly, and it is not a toxic waste product of the body in the sense of urine and faeces. No, no, no,. It is the same substance as what is inside the vagina, neither better nor worse, pulled down because we're bipedal and gravity exists, and because on occasion the cup runneth over."page 53 - 4 Woman, an intimate Geography by Natalie Angier
What about smell?? We have all heard the jokes that compare our private parts to fish. A healthy vagina has a slightly sweet pungent odour. If it smells anymore pungent than this or takes on a fishy odour then this is usually a sign that the delicate balance has been upset and the Lactobacilli (good bacteria) are losing the battle.
There are numerous things that can upset the balance in the vagina and lead to the smelly condition called bacterial vaginosis.

• Poor hygiene - if you haven't bathed for a week - things will start getting aromatic. It is not necessary to scrub or use heavily perfumed soaps or sprays on your genital area. Clean water is best, as lots of perfumed products used here can cause thrush.
  
  
• Illness - Pelvic Infections can lead to vaginosis. Candida is a condition where the vagina becomes too alkaline (due to diet, oral contraceptives, stress) causing some of the not so good bacteria to flourish. More info on thrush here

Pregnancy and the resultant change in your hormone levels can cause thrush.

• Drugs like Oral contraceptives and antibiotics can contribute to vaginosis.
  
  
• Low levels of lactobacilli - some women have less robust lactobacilli leaving them open to infections.
  
  
• Douching is really bad for the vagina. It kills off the lactobacilli leaving your vagina open to attack from the bad guys.
  
  
• Sperm are highly alkaline, so when they arrive in the vagina, the vagina needs to work extra hard to return itself to its acidic status quo, this can cause a brief increase in odour. If a woman has many sexual partners and does not use condoms, that is, is subjected to may different kinds of sperm, she may be more prone to vaginosis as her body tries to adjust.

The basics of maintaining a healthy Vagina

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  Do not douche. The only exception to this rule which may be acceptable is if you are trying to conceive and are trying to alter your vaginas pH for a greater good. Do it as little as you can and increase the number of lactobacilli in your diet through upping your intake of yoghurt or taking acidophilus tablets
  
  
  
  
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  Use condoms if you have multiple partners - which you should be using anyway to avoid STD's.
  
  
  
  
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  Eat a good healthy diet, minimising sugar intake (sugar helps the bad guys grow). Include good yoghurt or acidophilus every day.
  
  
  
  
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  Wear cotton underwear - this stops things getting too steamy down there, allowing good air flow.
  
  
  
  
• Do not use perfumes/spray on the genital area. 
  
  http://www.menstruation.com.au