Having the impression that one’s vulva is permanently open, that the vaginal mucosa is rubbing against underwear, suffering from gas incontinence in this region of our anatomy… It’s entirely possible, and this has a name: vaginal gaping, which often goes hand in hand with vulvar gaping. The obstetrician-gynecologist, specializing in urogynecology and intimate functional disorders, Hichem Bensmail, explains where it comes from, and how to manage it.
What are the symptoms of vaginal gaping?
“We speak of vulvovaginal gaping when a patient has the impression of feeling a relaxation in this place, and that her vulva remains permanently open. Sensations of discomfort and irritation on a daily basis are often described,” begins the doctor. “It is complicated to have statistics on the issue because many women suffer from it without talking about it,” he notes. As for the symptoms, he specifies that the vulvovaginal gap does not generally cause pain strictly speaking. “But as the mucosal area is more exposed, due to the larger opening, discomfort sets in,” he notes. That said, the extent of the disorder from an anatomical point of view is not correlated with the patient’s feelings : “some patients have relaxation but no daily repercussions, others have moderate anatomical damage but significant discomfort…”
For those who consult because they suffer from it, in addition to the unpleasant aspect of friction, diminished sensations during sexual intercourse, with a reduction in pleasure, due to the loss of elasticity of the vagina, are frequently mentioned. The other manifestation during the reports is a feeling of gas coming outdue to penetration, but also outside of these moments of intimacy.
In the list of symptoms, he notes that the hydration of the vagina is modified by this disorder: “The vagina is an elastic mucosa which folds like an accordion. With the relaxation linked to the gape, the mucous fold is relaxed, it does not “There is no longer this accordion effect. And the secretions flow. Patients often report a feeling of permanent humidity.” At the same time, hydration of the vagina is less. During menstruation, tampons may not fit in the vagina due to distension.
According to the Aubagne obstetrics and gynecology center, “on examination we can see an exaggerated vulvar opening and laxity of the walls of the vagina. There is often an insufficiency of the muscles of the perineum (levator muscles of the anus) and sometimes the beginning of genital prolapse (descent of the organ ).” The gynecologist also notes that vaginal distension can be correlated with prolapse, which tends to accentuate it.
What causes gas incontinence?
Several causes can lead to a vulvovaginal gap, starting with hereditary factors. “Some people have more or less elastic tissues,” recalls the doctor. Having a mother or grandmother who suffered from prolapse may be a risk factor. Other cause of this disorder: age, which affects the elasticity of tissues.
The event that can cause it, even in young women, is pregnancy and more particularly childbirth. “The more a woman has experienced it, the more the risk increases. A difficult birth is also one of the factors which increase the risk,” comments the gynecologist. The baby’s weight, if it is greater than normal, can have an impact on the development of a vaginal gap. He also specifies that a tear or an episiotomy are not normally linked to gas incontinence. Unless the repair is poorly done, or if “the suture has deteriorated, the stitches have jumped”, in this case, it may happen that a vulvovaginal gap results, without being able to really predict at what point in time. postpartum.
How to combat gas incontinence?
First of all, Hichem Bensmail points out that vaginal gaping can be prevented, particularly after childbirth, or between two pregnancies, by re-educating the perineum. “This helps slow down the relaxation phenomenon,” he explains. Rehabilitation with a physiotherapist and self-rehabilitation are also the preferred ways to treat a vaginal gap. We can also rely on “heat treatments”, i.e. techniques that restore elasticity to tissues, via radio frequency or laser. Because it is important to resolve the underlying problem, he insists, explaining that these tools make it possible to stimulate the manufacture of elastic fibers. In general, he advises combining approaches.
There is also a surgical option, vaginoplasty. “If there is associated organ descent, we can correct the gap surgically. But if there is only a vulvovaginal gap and we only treat the skin, there is a strong risk of recurrence, because the tissue will continue to deteriorate. It must be treated in depth.”
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