If you can comfortably insert any size tampon, you don't need much more space to allow for intercourse. I use two fingertips as a rule of thumb; that is, if I can insert index and middle fingers during an exam, I can assume intercourse is likely to be comfortable. The only time I've done surgery to enlarge the vaginal opening was when only a Q-Tip could be inserted--a definitive intact hymen.
What you might find helpful is vaginal dilators to help to extend the elasticity that you already have. The graduated sizes of dilators, regularly used, can gently stretch the tissue to assure comfortable penetration. I'd certainly try that before opting for surgery!
Dr. Barb DePree, M.D., has been a gynecologist and women’s health provider for almost 30 years and a menopause care specialist for the past ten.
2 comments
Since this blog deals with menopausal women, are you saying that after menopause a woman’s vaginal opening can become smaller and need to be dilated?
Does this have to do with prolapse of some organs into the vagina? You mentioned a definitive intact hymen00would that be only in a virgin? or can a woman’s hymen survive intercourse?
The reason the vagina ‘shrinks’ in menopause is because of the absence of estrogen. This absence of estrogen leads to loss of blood supply to the area and the tissue become more dry, and narrow, and fragile. It doesn’t have to do with prolapse (although that becomes more common in menopause too). The hymen undergoes the same general atrophic changes as the rest of the vulva and vagina in menopause. If a woman has had sex comfortably in the past, there isn’t going to be a hymen issue that needs to be addressed later in life.
Preserving vaginal function and comfort is best accomplished with regular use of vaginal moisturizers, or localized vaginal estrogen. For women on systemic estrogen, their vagina is getting the benefit.