Feeling looser after childbirth or menopause is common, and it is nothing to be ashamed of. The best-supported first step is pelvic floor muscle training, ideally guided by a pelvic floor physical therapist. If you leak urine, feel a bulge or have pain, see a doctor. Cosmetic gels can change how things feel for a short time, but they do not treat the cause.
What is vaginal laxity?
Vaginal laxity is when the vaginal tissues lose tightness or feel loose. Cleveland Clinic notes it most often follows pregnancy and childbirth, or comes with aging and menopause. It also says treatment is not always needed (Cleveland Clinic).
Some people notice looseness during penetration. Others notice less sensation, lower confidence or less interest in sex.
Laxity is not the same as pelvic organ prolapse. Prolapse usually involves an organ, such as the bladder, pressing into the vagina. It often causes a bulge you can see or feel (Cleveland Clinic).
Common causes
Pregnancy and vaginal childbirth
Pregnancy and delivery stretch the vaginal tissues and the pelvic floor muscles. For many people, things recover a good deal over time. For others, some looseness or weakness remains.
Menopause and lower estrogen
Estrogen helps keep vaginal tissue thick and moist. As levels fall around menopause, tissue can become thinner and drier. The NHS notes that weaker pelvic floor muscles become more common with age, especially after menopause (NHS).
Aging and other strain
Muscles and connective tissue change with age. Other factors can add strain to the pelvic floor. The NHS lists being overweight, long-term constipation or straining, a persistent cough and pelvic surgery such as hysterectomy (NHS).
Pelvic floor muscle training (Kegels)
The pelvic floor is a group of muscles that supports the bladder, uterus and bowel. These muscles also surround the vagina. Training them is low cost, private and low risk.
How to find the right muscles
Mayo Clinic suggests squeezing the muscles you would use to stop passing gas. You can also imagine stopping urine midstream. You should feel a slight lift and pull inside (Mayo Clinic).
Another check is to place a clean finger in the vagina and squeeze. A feeling of tightness around the finger means you have found the pelvic floor.
How to do them
Mayo Clinic and MedlinePlus give slightly different routines. Both are reasonable starting points.
- Empty your bladder first. Then get comfortable. Lying down is often easiest at the start.
- Squeeze and lift. Mayo Clinic suggests holding for three seconds, then relaxing for three seconds. MedlinePlus suggests working toward a hold for a count of 10, with a full 10-count rest.
- Repeat. Mayo Clinic suggests at least three sets a day, working up to 10 to 15 per set. MedlinePlus suggests 10 repetitions, 3 to 5 times a day.
- Keep everything else relaxed. Do not tense your stomach, thighs or buttocks. Breathe normally.
Do not practice by stopping and starting your urine stream. Mayo Clinic warns this can keep the bladder from emptying fully. That raises the risk of a urinary tract infection (Mayo Clinic).
More is not always better. MedlinePlus notes that over-exercising can tire the muscles and increase leakage. It adds that discomfort in your belly or back may mean the technique is off (MedlinePlus).
How long it takes
Be patient. MedlinePlus says most people notice some improvement after 4 to 6 weeks. It may take as long as 3 months to see a major change (MedlinePlus).
Pelvic floor physical therapy
Many people are not sure they are doing Kegels correctly. That is very common. A pelvic floor physical therapist can check your technique and build a plan for you.
Cleveland Clinic describes pelvic floor physical therapy as usually the most effective option for vaginal laxity (Cleveland Clinic). Therapists may use biofeedback, which shows on a screen which muscles are working (MedlinePlus).
Ask your doctor or midwife for a referral.
When to see a doctor
Looseness alone is not dangerous. Still, some symptoms deserve a check-up. Make an appointment if you notice:
- Leaking urine when you cough, sneeze, laugh or exercise
- A bulge, lump, pressure or heaviness in or around the vagina, which can be a sign of prolapse
- Pain or discomfort during sex
- Trouble emptying your bladder or needing to urinate often
- Symptoms that affect your confidence, relationships or daily life
The NHS lists pressure, a bulge, small leaks and frequent urination among possible prolapse symptoms (NHS). These are treatable, and a doctor can help.
Medical options to discuss with a gynecologist
The right plan depends on your symptoms and health history. Options a gynecologist may discuss include:
- Vaginal estrogen or lubricants when menopause-related dryness or thinning is part of the picture (Cleveland Clinic)
- A vaginal pessary, a removable device that supports the pelvic organs if prolapse is present (NHS)
- Surgery, which is generally reserved for prolapse rather than laxity alone
You may also see ads for laser or radiofrequency "vaginal rejuvenation." On July 30, 2018, the FDA issued a safety communication about these energy-based devices. It said their safety and effectiveness for these uses had not been established. It also warned they may be linked to serious adverse events (IUGA summary of the FDA communication).
Cleveland Clinic adds that energy-based treatments are not effective for tightening vaginal muscles. It also says cosmetic vaginoplasty is not recommended, because it can cause pain during sex (Cleveland Clinic).
Where cosmetic products fit
Some people like the feel of an intimate gel as part of their routine. It helps to be clear about what these products can and cannot do.
Cosmetic gels act on the surface. They can create a temporary tighter or fresher feel. They do not strengthen muscles, reverse childbirth changes or treat laxity, prolapse or incontinence.
For example, V-Tight Gel is a water-based cosmetic intimate gel. It contains manjakani extract, a traditional Southeast Asian astringent, along with witch hazel and fruit extracts. It is applied once or twice daily for a temporary tighter feel.
If you try any intimate product, patch test first. Stop using it if you notice burning, itching or irritation. Ask your doctor before use if you are pregnant, breastfeeding or have vaginal symptoms. You can browse other options in our women's health collection.
Frequently asked questions
Is vaginal laxity normal after having a baby?
Yes, it is common. Cleveland Clinic says laxity most often follows pregnancy and childbirth. Pelvic floor training and time help many people.
Do Kegels really help?
They can strengthen the muscles that surround and support the vagina. MedlinePlus says most people notice some improvement after 4 to 6 weeks. A physical therapist can make sure your technique is right.
Is a loose feeling the same as prolapse?
No. Prolapse usually involves an organ pressing into the vagina, often with a bulge or heaviness. If you notice those signs, see a doctor.
Can a gel tighten the vagina permanently?
No. A cosmetic gel can only create a temporary tighter feel on the surface. It does not change muscle strength or treat any condition.
Are laser "vaginal rejuvenation" treatments safe?
The FDA warned in 2018 that their safety and effectiveness for these uses had not been established. Talk with a gynecologist before considering any procedure.
Sources
- Cleveland Clinic: Vaginal Laxity
- Mayo Clinic: Kegel exercises: A how-to guide for women
- MedlinePlus (NIH): Pelvic floor muscle training exercises
- NHS: Pelvic organ prolapse
- International Urogynecological Association: FDA warns against use of energy-based devices to perform vaginal rejuvenation or vaginal cosmetic procedures
This article is for general information and is not medical advice. Our products are not intended to diagnose, treat, cure or prevent any disease.