Vaginal Laxity Issues, Answers and Implications for Female Sexual Function

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Introduction

Vaginal laxity and tissue architecture have often been overlooked as contributing etiologic factors to female sexual dysfunction. Vaginal laxity can lead to decreased physical sensation during intercourse. This decrease in sensation is often coupled with a decrease in sexual satisfaction, which can affect a woman's sense of sexual self-esteem and her relationship with her sexual partner. Indeed, physiologically, introital vaginal laxity is the key facet when discussing sexual function associated with vaginal laxity based on the positioning of the clitoral matrix. Subjective report of vaginal laxity, or looseness, might be suboptimal for defining the medical condition. However, vaginal laxity remains a patient self-reported condition, and thus far no objective measurement exists to quantify its severity or uniquely separate it from overall pelvic floor dysfunction.

In this article, vaginal laxity is defined as “looseness” of the vaginal introitus. The simplest definition of vaginal laxity as it relates to intercourse can be found in a pilot study published by Millheiser et al.¹ Women were asked, “How would you rate your current level of vaginal laxity/looseness during intercourse?” and responses were assessed using a seven-point Likert scale ranging from “very loose” (1) to “very tight” (7). A woman was defined as having laxity if she scored no higher than 3 on this self-reported scale.