Sex is pleasurable to most people but not for H’s husband. H was 39 and her husband 41 years of age. They had been married for 4 months and were trying to conceive. During her honeymoon period, sexual intimacy was frequent and enjoyable. One day, she was taken aback when she released “wind” from her vagina after sex. She suddenly remembered what her mother had said about “bad air" or “wind” entering her body through sex. The “wind” would migrate to the head and would cause a severe headache and ill health. She told her husband about her fear and insisted that all the windows be closed and the air-conditioner and fan be switched off during sex.
“Doc, every time I have sex, I feel like having a workout in a furnace. My whole body sweats and it becomes very uncomfortable,” H’s husband complained. “Sex becomes a chore. It is no longer pleasurable. I fail to convince her that her concept of “wind” going into her vagina is false. We always have heated arguments on this matter. I finally gave up and hardly have sex with her now.”
Gas passing out from the vagina is quite a common and normal occurrence during sex. Air can get into the vagina and get trapped during sexual activity due to the movement of the penis in and out of the vagina. When the muscles surrounding the vagina get tense from an orgasm or when the penis is removed, the gas will then be released. This can cause a sound similar to common flatulence from the anus.
Insertion of feminine hygiene products such as tampon can also allow air to get trapped inside the body. This air can escape when the product is removed, or during physical activity or stretching. Severe coughing can also cause the pelvic muscles to tense, pushing air downwards and out of the vagina. Certain exercises involving stretching of the pelvic region, such as yoga, often allow the vagina to open or relax, allowing air to enter. During a change in pose or position, air trapped in the vagina can suddenly be released. Occasionally, release of vaginal gas can also be a symptom of malfunction of the pelvic floor muscles.
Very rarely, gas escapes from the vagina due to the presence of a fistula, an abnormal hollow tract between the vagina and the large intestine. The gas is mixed with scanty faecal material and they pass from the rectum to the vagina regardless of whether there is sexual activity or not. There is usually a past history of trauma or injuries to the vagina e.g. following childbirth.
I examined H and found that her vagina was normal with no sign of injury or fistula. I then explained to her the various ways air can get trapped in her vagina and told her that her mother’s “bad air” theory was an old wives’ tale.
H appeared to be convinced when she left my clinic. A few weeks later, I received a call from her husband who told me that the situation had returned to normal and that H was well on her way to motherhood.