Does vaginal size impact sexual activity and function?

Introduction and hypothesis This study seeks to determine if total vaginal length (TVL) or genital hiatus (GH) impact sexual activity and function. Methods Heterosexual women≥40 years were recruited from urogynecology and gynecology offices. TVL and GH were assessed using the Pelvic Organ Prolapse Quantification exam. Women completed the Female Sexual Function Index (FSFI) and were dichotomized into either normal function (FSFI total>26) or sexual dysfunction (FSFI≤26). Results Five hundred five women were enrolled; 333 (67%) reported sexual activity. While sexually active women had longer vaginas than women who were not active (9.1 cm±1.2 versus 8.9 cm±1.3, p=0.04), significance was explained by age differences. GH measurements did not differ (3.2 cm±1.1 versus 3.1 cm±1.1, p=0.58). In sexually active women, TVL was weakly correlated with FSFI total score, but GH was not. TVL and GH did not differ between women with normal FSFI scores and those with sexual dysfunction. Conclusions Vaginal size did not affect sexual activity or function.