What's to know about vaginal gas?

By Jennifer Huizen

Reviewed by Stacy Sampson, DO

Vaginal gas occurs when air becomes trapped in the vagina. It is a common condition and is not usually associated with any health risks.

In rare cases, however, it can be a sign of more serious conditions that require medical treatment, such as vaginal fistulas, which are caused by an abnormal connection between two organs.

What is vaginal gas?

There is usually some air in the vagina, but vaginal gas may occur when larger pockets or bubbles become stuck and slowly squeak out, or when the air is released suddenly.

Vaginal gas usually causes a noticeable sound as the trapped air vibrates through the vaginal canal. This may sound similar to flatulence.

Common natural causes

Anytime something is inserted into the vagina, air can enter and become trapped inside.

In most cases, vaginal gas is not considered a health risk. Some common natural causes of vaginal gas include:

Pelvic floor dysfunctions or conditions

There is very little research on vaginal gas, probably because it is not harmful and may only cause occasional embarrassment. However, some pelvic floor conditions have been linked in some way to an increased risk of vaginal gas.

Common conditions and factors linked to vaginal gas include:

•    urinary incontinence

•    pelvic organ prolapse

•    fecal incontinence

•    weak pelvic floor muscles caused by childbirth, being overweight, age, or excessive bowel strain

Sexual activity

During sexual activity, air can easily become trapped inside the vagina. The vagina expands and contracts when it is aroused, allowing more air to enter.

Each time the penis or another object enters the vagina, there is a risk of this excess air becoming trapped. When this air is released, it may cause the sensation and noise of air bubbles.

In some rare cases, air bubbles can become trapped under the diaphragm, which can cause upper abdominal pain and chest pain.

Feminine hygiene products

Products that are inserted into the vagina, such as tampons and menstrual cups, can allow air bubbles to become trapped inside the body.

This air can escape when the product is removed, or during physical activity or stretching.

Tense muscles

Certain activities, such as sexual activity or gynecological exams, may cause the pelvic muscles to tense. This can trap pockets or bubbles of air in the vagina.

Coughing and exercise can also cause the pelvic muscles to tense, pushing air downward and out of the vagina.

Stretching exercises

Certain exercises that involve stretching the pelvic region, such as yoga, often encourage the vagina to open or relax, allowing more air to enter.

During a change in pose or position, air trapped in these pockets can suddenly be released.

Gynecological exams or procedures

Physical examination and the insertion of a speculum during gynecological exams and other procedures can cause air to become trapped in the vagina.

This air may be released when a doctor removes the speculum and finishes the physical examination.

Prevention

In many cases, there is no real way to prevent vaginal gas, but there is also no need to. Usually, the only symptoms of vaginal gas are the noise and sensation of trapped air leaving the vagina, which is typically painless.

If vaginal gas does not go away naturally, squatting down, especially while urinating, can help trapped air escape. If vaginal gas is the result of tension, trying to relax and practicing deep breathing may help.

If vaginal gas is problematic, a person can avoid the sexual activities and physical exercises that cause it. Avoiding the use of internal female hygiene products, such as tampons, may also help reduce the risk.

Although cesarean delivery and pelvic surgeries are associated with an increased risk of vaginal gas, a 2012 study found that most cases of vaginal gas began after vaginal delivery.

While unsupported by direct research, a limited study found that the use of a pessary, a circular device that sits inside the vagina to help support tissue affected by pelvic organ prolapse, decreased vaginal gas symptoms.

Kegel exercises, known to improve the strength of pelvic floor muscles, may also reduce the likelihood of vaginal gas.

Fistulas

Fistulas occur when an abnormal, hollow chamber develops between two otherwise normally unconnected organs. They can occur when scar tissue forms or breaks down. Vaginal fistulas can cause vaginal gas.

Fistulas can develop between the vagina and several other pelvic organs. The symptoms associated with vaginal fistulas are dependent on the size and location of the fistula and organs involved.

Possible types of vaginal fistula include:

Vesicovaginal fistula

A vesicovaginal fistula (VVF) occurs when a connection develops between the vagina and the urinary bladder.

At least three million women in developing nations have unrepaired VVFs. The condition is typically associated with obstructed labor and gynecological surgical injury.

In developed nations, VVF is far less common, although linked to an estimated 3 to 5 percent of cancers involving the vagina, cervix, and uterus (endometrial lining).

The most common symptom of VVF is abnormal watery discharge and continuous urine leakage. Large fistulas may cause pain and discomfort.

Ureterovaginal fistula

This occurs when a connection develops between the vagina and a ureter, the tube-like structure (normally one on each side of the body) that transfers urine from the kidneys to the bladder for removal.

A majority of ureterovaginal fistulas occur as the result of injury during a gynecological surgery, such as a hysterectomy.

The most common symptom of the condition is continual urine leakage from the vagina and abdominal discomfort.

Urethrovaginal fistula

A urethrovaginal fistula is the result of a connection between the vagina and the urethra, the tube-like structure that connects the bladder to the outside of the body.

The most common symptoms of urethrovaginal fistulas are continual urine leakage from the vagina that worsens with increased abdominal pressure.

Enterovaginal fistula

An enterovaginal fistula develops when an abnormal opening forms between the vagina and the small intestine.

The condition may result from abdominopelvic surgery or an inflammatory bowel disease, such as Crohn's disease. Symptoms include the passage of gas from the vagina and abdominal pain.

Rectovaginal fistula

This type of fistula happens when an abnormal connection develops between the vagina and the rectum.

Common causes include:

•    inflammatory bowel diseases, such as Crohn's disease or ulcerative colitis

•    prolonged or obstructed labor

•    injury during surgery or post-surgery complications, such as infection

•    radiation therapy involving the pelvis

•    cancerous tumors

The most common symptoms of rectovaginal fistulas include inflammation, the passage of gas or feces through the vagina, and a foul odor.

Colovaginal fistula

This fistula forms when an abnormal opening develops between the vagina and the colon.

The condition is considered rare and potentially a complication of pelvic surgeries, including hysterectomies. It can also be caused by gastrointestinal conditions, such as colon diverticulitis, Crohn's disease, or ulcerative colitis.

The most common symptoms of colovaginal fistulas include:

•    passage or leakage of feces or gas from vagina

•    foul-smelling vaginal discharge that may be discolored

•    multiple or recurrent urinary tract or vaginal infections

•    pain and inflammation in the area between the vagina, colon, and external vaginal tissues

•    pain during sexual activities

When to see a doctor

In rare cases, vaginal gas can be a sign of a more serious condition that requires medical attention. A fistula between the vagina and another abdominopelvic organ is a condition associated with vaginal gas that needs medical attention.

A person should speak to a doctor if vaginal gas follows or is accompanied by:

•    childbirth, especially after a recent or complicated delivery

•    radiation therapy involving the pelvis

•    gynecological, pelvic, or abdominal surgeries

•    pain or discomfort

•    urine leakage or increased discharge

•    feces or other waste

•    a foul smelling odor

•    blood

•    inflammation or swelling of vaginal tissues

A person may also wish to speak to a doctor if vaginal gas develops throughout the day and is unrelated to activities known to cause the condition, such as sexual activity or stretching.

SOURCE: MEDICAL NEWS TODAY