The Star Malaysia

Does her size matter?

The question of genitalia and size is often assumed to be more relevant to men than women, though some women do have concerns about this issue.

- Datuk Dr Nor Ashikin Mokhtar starhealth@thestar.com.my

WORRYING about the size of one’s genitals is usually confined to men, but the truth is, women often ponder this question as well.

In particular, this is a question that plagues women after childbirth, as they come to terms with physical changes in their postbirth vagina and how it might affect intercours­e.

Others who have smaller ones worry that they might experience a difficult birthing.

These are valid concerns, and yet, not very many studies have been done on how vagina sizes affect reproducti­ve activities. Hence, in our discussion here, there is no measured way to determine if vagina size has any influence on sexual pleasure.

But if you examine the wide range of knowledge that we do have on female genitalia, you will find that science and research will more likely point to the fact that the size of the vagina does not necessaril­y impact pleasure in intercours­e.

Let’s take a closer look.

Anatomy of the vagina

We use the word “vagina” loosely to refer to the entirety of our lady parts, but in reality, the vagina is one smaller component in the whole of our lady parts.

As a refresher, the outer part that we can see is known as the vulva, and consists of the clitoris and the labia. The latter can be further divided into labia minora and labia majora.

The vagina itself is only the tube that connects your uterus to the world outside, which runs between the cervix and the vulva, that is your actual vagina. Naturally, it plays an important role in childbirth, and to accommodat­e the penis.

This vaginal tube varies in size from woman to woman, but has an incredible ability to expand, in order to fit a tampon, or a baby on its way out of its mother’s womb, ready to join the world.

Like the stomach, it contains folds that spread out when more space is needed, and tucks itself back in when not in use, not unlike those foldable grocery bags that you can crush and fold within itself, held together by a string tie.

Accommodat­ing and changeable

The vagina is a very elastic organ that is small enough to hold a tampon in place, but can expand enough to pass a child through.

The walls of the vagina are similar to those of the stomach – they have rugae, meaning they fold together to collapse when unused, then expand when necessary. It changes to accommodat­e whatever is going on at that time.

The most commonly used measuremen­ts regarding the size of vaginas come from Masters and Johnson’s work from the 1960s. They looked at 100 women who had never been pregnant and found that vagina lengths, unstimulat­ed, range from 2.75 inches to about 3¼ inches.

When a woman is aroused, it increased to 4.25 inches to 4.75 inches. Regardless of how long the vagina is, the area that is thought to be important for most women’s sexual response is the outer one-third.

So how does length relate to sexual satisfacti­on? No one seems to know for sure.

Pain during sex

Hence, with the exception of the first time, one should generally not experience pain during sex, even if her partner is slightly larger than average.

Any pain experience­d might point to insufficie­nt foreplay. Foreplay is a key part of intercours­e that couples should not skip, as it helps to better lubricate and expand the vaginal canal.

Of course, reasons for painful intercours­e could be completely unrelated to size. A condition such as vaginismus, where a woman experience­s involuntar­y muscle spasms, requires longterm treatment and additional doctor’s advice.

Women who have recently gone through childbirth and are adjusting to any changes, may experience prolapse, a condition where organs like the uterus or the bladder are slightly out of place.

It happens because the pelvic floor muscles are stretched and weakened, and the woman might also experience related issues like leaky urine or urinary incontinen­ce.

But don’t let this put you off natural childbirth! Younger, healthy individual­s generally won’t suffer from prolapse, though women who are close to menopause should be more cautious and seek a doctor’s help if they experience prolapse.

The good news is that it can be prevented. There are exercises to strengthen your pelvic floor muscles, even if it requires some effort.

Kegel exercises can help

Kegels is a form of exercise you may have heard of, but never thought to try – after all, it’s not as straightfo­rward as picking up a dumbbell to perform bicep curls. Done right, Kegel exercises will help improve pelvic floor muscles, reducing problems like incontinen­ce and the symptoms of prolapse.

Kegel exercises do not change the size of your pelvic floor. Rather, the aim is to reinforce the muscles in that area, which supports the bladder, womb and even bowels. It’s even said to improve sex by prolonging orgasms.

The initial challenge with performing Kegel exercises is identifyin­g the correct muscles you are trying to strengthen.

You can try the following three methods to find your pelvic floor muscles:

● Gently insert a (clean!) finger into the vaginal canal and squeeze, to get a sense of where your pelvic muscles are.

● When urinating, stop the flow, midway, by squeezing. Relax and contract several times to get familiar with how the muscles feel when performing this action. However, this method should only be for educationa­l purposes and is not advisable for regular exercises, as it can lead to urinary issues.

● For a more accurate way to train your pelvic floor muscles, you may be able to seek biofeedbac­k training from a licensed gynaecolog­ist. It involves inserting a probe that is connected to a computer that tracks pelvic muscle movement on a monitor.

From there, your doctor will be able to determine if you are contractin­g the proper way.

Now, there are even Kegel trainers that you can use at home. A Kegel trainer is like a vaginal fitness tracker, shaped like a slightly inflated tampon. When inserted, it helps you with squeezing the right muscles, while recording the activity and letting you know of your progress.

The exact features depend on individual products, with some tracking real-time exercises via an app, and others letting you know the results of your workout on the device itself.

Once you have a good grasp on where your pelvic floor muscles are and how to contract them, it will take several months of consistent training to see results, which are well worth it. So, be patient and keep squeezing!

What really matters

Our fears that vagina size affect sexual health are largely unfounded. Instead of size, we should look at other factors that might affect sexual pleasure, such as lack of desire, arousal, insufficie­nt lubricatio­n, or even other related health problems.

For overall pelvic health, women should focus on helping their bodies retain the elasticity of the pelvic floor muscles, which support the womb, bowel and bladder.

This is especially true for post pregnancy, and luckily, Kegel exercises are quite effective in helping to improve your pelvic floor muscles. But you must be patient and consistent.

All women, not just post-delivery women, should take up Kegel exercises, which not only improves pelvic health, but has been known to increase sexual pleasure as well.

However as an option for those women with vaginal laxity or experienci­ng dryness of the vagina, then laser vaginal rejuvenati­on (LVR) treatment could be considered.

LVR treatment is a safe, reliable, non-invasive treatment with no downtime which you can easily fit into your busy schedule.

However, for women experienci­ng vaginismus, it is best to consult your gynaecolog­ist for the appropriat­e treatment and whether Botox may be considered as an option.

In conclusion, it is not an exact physical fit that women are looking for in terms of sexual function that really matters, but it is more about the communicat­ion between the two partners and making sure both are getting what they need out of the experience and are comfortabl­e.

Datuk Dr Nor Ashikin Mokhtar is a consultant obstetrici­an and gynaecolog­ist and a functional medicine practition­er. For further informatio­n, visit www.primanora.com. The informatio­n provided is for educationa­l and communicat­ion purposes only and it should not be construed as personal medical advice. Informatio­n published in this article is not intended to replace, supplant or augment a consultati­on with a health profession­al regarding the reader’s own medical care. The Star does not give any warranty on accuracy, completene­ss, functional­ity, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibi­lity for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such informatio­n.

 ?? — TNS ?? Some women worry that childbirth could affect vaginal size.
— TNS Some women worry that childbirth could affect vaginal size.
 ?? — AFP ?? The walls of the vagina are similar to those of the stomach – they have rugae, meaning they fold together to collapse when unused, then expand when necessary.
— AFP The walls of the vagina are similar to those of the stomach – they have rugae, meaning they fold together to collapse when unused, then expand when necessary.
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