Hi, my name is Tori and I am a doctor of physical therapy who specializes in pelvic dysfunction,
which means I treat things that can go wrong around the pelvis — including sexual
dysfunction. In fact, I treat women who are having painful sex every day, multiple times a day.
Today, I want to talk about what makes a vagina “tight,” because there is a lot of
misinformation both on the internet and, apparently, within the medical community.
I was inspired to make this video because of a surgical procedure that some of the women I
am treating have undergone called “the husband stitch.” The husband
stitch is essentially where a physician sews a woman’s vaginal opening—like the
actual vaginal entrance—“tighter/smaller” or closer together, than it was before the
procedure—said another way, the physician makes the circumference of the vaginal opening smaller.
The idea here is that making the vaginal opening smaller
will make the vagina “tighter” and make heterosexual sex better.
Now, there is a lot to break down here, but the main assumption is that the actual vaginal
opening, as in the entrance to the vagina, is what determines “tightness,” and that
line of thinking is fundamentally flawed. It is simply incorrect. That’s not how vaginas work.
My intention in making this video is to share how “tightness” in a vagina is actually achieved,
and to hopefully empower those listening with knowledge, so that if a physician
offers this procedure to you or to your partner—whether you just delivered a baby
vaginally, or maybe you are undergoing a different surgery where the surgeon works transvaginally, or
through the vagina, to achieve the outcome of the surgery, you can make a decision about your body
coming from a place of knowing and hopefully save yourself from potentially years of painful sex.
So first and foremost, let’s talk about what actually makes a vagina “tight.” We
have to zoom out a little bit and talk about vaginal anatomy and what happens
to the vagina when you are sexually excited.
So the first thing to know is that your vagina is kind of like a wine glass. The
actual vagina canal is like the stem, and it leads to the pelvic bowl, which is wear you’d
pour the wine. The vagina is essentially a tube, and above it you have your cervix,
which then leads into your uterus. This is why when women deliver a baby vaginally, the baby
moves from the uterus, through the cervix, through the vagina, and out into the world.
Now, a vagina that is not sexually aroused is about 3-4 inches long. Said another way,
the stem of the wine glass, with no sexual arousal, is like 3-4 inches long.
But, when you’re sexually excited, the vagina expands and elongates—it grows in length,
in width, releases a natural lubricant,
and your cervix and uterus actually move up towards your head to create more room
in the pelvic bowl so that the cervix isn’t hit by whatever is penetrating the vagina.
So then, onto vaginal “tightness.” There are muscles that surround the vaginal canal and
the pelvic bowl—these muscles are called the pelvic floor. If you want to deep dive into
pelvic floor anatomy and function, I have a different video up, actually one of the
first videos I made, all about generally, global pelvic floor anatomy that you can watch. But,
for our purposes, know that this group of muscles can become weak—they can lose strength, endurance,
and tone. Which, if you imagine them surrounding the vagina and pelvic bowl, that weakness,
that lose in strength, endurance, and tone, can feel like “looseness.”
Now, let’s revisit this procedure, “the husband stitch.” The visual examples I
am about to use are not meant to be crude or disrespectful to vaginas,
but they are a little exaggerated just to really drive home this point.
If we imagine that this toy is a vagina with a healthy, strong, well-tone pelvic floor,
you can imagine that something penetrating the vagina would
feel “tightness” through the entirety of the experience.
The canal would be “tight,” and there would be “tightness” in the pelvic bowl as well.
You can imagine that if we made the vaginal opening here smaller,
that wouldn’t change the “tightness” in the canal. Instead, it might prevent the
opening of the vagina—as part of the canal—from naturally expanding with sexual arousal,
and it might cause the woman pain with initial penetration, but it does nothing for “tightness.”
On the other end of the spectrum, if we are imagining a vagina with a weaker, lower
tone pelvic floor, with less muscle bulk through the canal or in the pelvic bowl
you can imagine that making the vaginal opening smaller, does nothing for the
actual “tightness.” Again— it might prevent the opening of the vagina—as part of the canal—from
naturally expanding with sexual arousal, and it might cause the woman pain with
initial penetration, but it does nothing for “tightness.”
Instead, the outcome that I see in my clinic, is painful sex. It hurts
when things are inserted because the vagina is meant to expand and elongate,
and now the opening is sensitive, painful, and stitched too tight.
A few things to say:
If you are a young woman who has never had a baby watching this video trying
to learn how to tighten your vagina, I want you to know that your pelvic
floor is probably strong already and you probably have higher tone, not lower tone.
There is such a thing as being “too tight,” and if you are already experiencing painful sex,
Kegels and other pelvic floor muscle exercises will probably make you worse,
not better. Imagine your pelvic floor is my bicep and this is a contract or a Kegel, this
is a relax, and this is a bear down/defecate/pass gas/have a baby. You want your pelvic floor to
move well through its full range of motion. (talk about normal, low and high resting tone, too).
If you already have higher resting tone, then walking around doing kegels all day
would be like flexing your bicep all day without letting your arm rest. Over
time, it might become difficult to relax your bicep, you might have arm pain, you
might have a hard time carrying objects or even typing at your computer—the same thing is true
of your pelvic floor. Over time, you might become “too tight,” and start to have symptoms of pelvic
dysfunction like painful sex, urinary urgency, frequency, or leakage, and even constipation.
If you are recognizing after watching this video that your painful sex experience may be related to
“the husband stitch,” find a pelvic physical therapist in your area. You can use
the directory linked in the description of this video to find a provider near you if you live in
the states. Hear me when I say—I treat this a lot, and it IS treatable. You can get better.
Lastly, I want to address the idea that the “husband stitch” is just a myth. It usually
isn’t sold to a woman with that title, in fact I can think of two women right of the
bat who were undergoing hysterectomies, or the removal of the uterus, for other reasons,
and the procedure was sold to them as a cherry on top, like “while I’m in the
vicinity I can also throw in something that will make sex better and make you tighter.”
Can you blame these women for saying yes? When I put myself in that position,
if I didn’t know any better, I feel like I might say yes, too. All of this to say,
the husband stitch is a very real procedure and it is happening to women as we speak—it being
sold under the guise of better, tighter sex when in reality that isn’t how vaginas work.
Imagine a world where we—women and men—understood such an important
part our bodies. Where these “taboo topics” were talked about widely because everyone
has a pelvis. That’s the world I want to live in. That’s the world I am trying to create.
Thank you all so much for watching! If you found this video helpful, please like it and share it,
let’s get this information out there and make it general, public knowledge! Feel free
to comment anything below including suggestions for future content—I am super open to requests.
Also, if you want to learn more about female anatomy, specially the clitoris, or the female
orgasm, I have videos up diving into both of those topics. I also have created The Female
Orgasm survey, it is 3 questions long, 2 yes or no, 1 open ended, that explores the female orgasm
experience. If you have female genitalia and want to participate, I would so appreciate it.
Finally, subscribe to my channel for more content surrounding pelvic health.
Thank you so much for watching, and I’ll see you in the next one. Bye!