SEXUAL HEALTH: A blast from the wrong part

Dr Joachim Osur discusses a problem that affects many women post-delivery, but that few will ever confess to having. PHOTO| FILE| NATION MEDIA GROUP

What you need to know:

  • “What causes laxity of the pelvic muscles? Could there have been a problem with my delivery?” Joyce asked.
  • Vaginal delivery can cause laxity of the muscles. Beyond delivery, however, the muscles are affected by hormones as well as trauma as a result of sports activities.
  • Once the pelvic floor muscle laxity happens, vaginal farts can happen. Worse is the possibility of the prolapse of pelvic organs.
  • This is when the internal organs sag into the pelvis, causing a variety of symptoms.

Joyce walked into my clinic after her 90-day maternity leave was over to ask if I could write her a chit for more off days. She said her condition did not allow her to be at work. I wondered what the condition was. She claimed she was farting loudly through the vagina. “I am serious,” she said. “It is embarrassing and I am not going to expose myself to my colleagues with this kind of a problem.”

Joyce was 30 and married with two children. The first one was three years old and the second one, three months old. Both deliveries were vaginal and without complications. She told me that her uncontrollable vaginal farts were so loud sometimes that they woke her husband from his sleep in the deep of the night. “We have not attempted sex since I delivered because I do not understand what is going on in my body,” she said.

I examined Joyce, and both her tummy and reproductive systems were perfectly healed and normal. I wanted to be sure that she did not have a fistula. It is a complication that happens during complicated and prolonged labours. A fistula is an abnormal connection between the vagina and the lower part of the intestines or the urinary system. In such cases, vaginal farting will be accompanied by smelly wind and uncontrolled passage of faeces or urine.  “Mine has no smell and there is no discharge from my vagina,” Joyce explained.

My diagnosis was vaginal flatulence. This is the uncontrollable passage of odourless wind through the vagina and can be accompanied by a loud sound. It is an embarrassing condition because it is hard to differentiate from the usual anal farting which is controllable but smelly.

Vaginal flatulence happens to many ladies. It can start after delivery, although sometimes it starts spontaneously. It happens during exertions such as coughing, exercising, lifting loads or even during sex. It can happen without exerting in severe cases.

The origin of this problem is laxity of the pelvic floor muscles. These are the muscles that tighten up the vagina, keeping its walls closed with no air spaces inside. When the muscles are lax, the vaginal walls become flabby and suck in air. When the person then changes position, coughs, has sex, exercises or exerts in other ways, the air is pushed out, causing a loud farting sound.

THE CAUSE OF THE DISTRESS

“What causes laxity of the pelvic muscles? Could there have been a problem with my delivery?” Joyce asked.

Vaginal delivery can cause laxity of the muscles. Beyond delivery, however, the muscles are affected by hormones as well as trauma as a result of sports activities. Once the pelvic floor muscle laxity happens, vaginal farts can happen. Worse is the possibility of the prolapse of pelvic organs. This is when the internal organs sag into the pelvis, causing a variety of symptoms.

Treatment of vaginal flatulence is simple but takes time. It involves exercising the pelvic floor muscles, also called Kegel exercises. When you are passing urine, tighten up to stop the flow of urine. That act of tightening up to stop the flow is what is called a Kegel exercise. Do it at least 10 times a day and each time, tighten up the muscles for about five seconds, release and repeat eight to 10 times.

“So I can even do it while cooking or driving?” Joyce asked. I nodded.

The results of these exercises may not be apparent until eight to 10 weeks later if done correctly and consistently. Patience is therefore very important. “But then that would mean that I do not go to work for all those weeks!” Joyce exclaimed anxiously. “Is there no faster treatment? My employer will never allow this.”

Unfortunately Kegel exercises remain the best way to treat vaginal farting. It is only in very rare and severe cases that surgery may be necessary to correct the problem.

Joyce discussed her predicament with her employer. She was allowed to work from home during her treatment. Fortunately she responded to treatment very well and by the seventh week of treatment, she was ready to mingle with her colleagues. She has kept up with the Kegel exercises and a year later, she reports that it has also made sex more pleasurable for her husband who says that she is once again as tight as she was when they got married. She was a virgin then.