Last updated 11/30/23
Whatever you call it, Vaginal Noise (VN) can be associated with a variety of challenges. This article will present the current scientific literature, along with a plan for treatment.
Why are there so Many Names for this?!
Queef (urban dictionary) – Audible release of air from the Vagina
Identified in 1995 by French researcher, Attapattu, as “Garrulitas Vulvae” (Chattering vulva)
2003 scientific research by Krissi, Medina and Stanton as “Vaginal Wind”
Vaginal Noise (VN) (2009) (scientific term identified by Sieker-ten Hove, et al.)
Also: Vaginal Flatulence, Vaginal Flatus, Vaginal Air, Vaginal Gas, Vart, Noisy Vagina, Fanny Fart
What is the most appropriate name for this “symptomatic vaginal air,”? Authors of a large 2009 Dutch study decided on Vaginal Noise “because the exact mechanism is unclear and ‘noise’ does not connote to anal flatus” which they thought was just a nicer way to say it. By understanding that the terminology isn’t even accurate, we can better understand why the potential preventions and treatments are so often inconsistent and confusing.
We are going to clear all of it up for you here, and provide you with some more concrete answers!
What Is Vaginal Flatulence?
Vaginal flatulence is the audible sound that can occur when trapped gas exits the vaginal canal. Yes, it is similar to passing gas from the anal canal, although caused by different provocations. “It is possible that air becomes trapped in the posterior fornix [of the vagina] and that during sudden movements it is released and produces the typical noise.”
Unfortunately, VN can cause social isolation, and lead to an overall decrease in one’s quality of life. Three accounts explain the varying levels of challenge with VN that women are dealing with:
- One woman’s challenge is that since having a vaginal birth, she now “suffers” from “vaginal wind or vaginal fart” and that “it’s really so embarrassing. I am feeling so sad…” She describes having friends over for dinner, sits down, and “suddenly this (vaginal fart) happens.” She asks for help to “treat this problem.”
- A second woman explains that when she is close to orgasm, “I feel my vaginal muscles tensing and my vagina actually pulls air in like a vacuum…vaginal muscles actually sucking air in.” Her challenge is that it interferes with sex. “Please help,” she requests, “How do I stop my muscles from doing this? How can I make it so it doesn’t interfere with [sex]?”
- A third woman demands, “There has to be an answer to this horrible unfair ‘disorder’…there are so many women having to put up with it and it is life-changing [and] can cause disability in later life.” She asks, “Is there any actual full research on this at all?”
Solving each of these scenarios, and the many others that exist requires a deeper understanding as to why they occur. If you are going to effectively prevent or treat this yourself, you will need to identify your unique health history.
What are the Potential Causes of Vaginal Gas?
Here are two umbrella causes of Vaginal Noise (VN), so you can begin assessing which causes may be applicable to you:
- ONE: Natural Causes – To some extent, air in the vagina is normal. Air can enter the vaginal canal when making postural changes in general, including things like: yoga, other physical exercise routines, and movements like crossing or uncrossing one’s legs, and having sex. Many people are unaware that the size and shape of internal organs vary wildly between individuals, including the vagina, so there is also a genetic component to VN.
- TWO: Pelvic Floor Dysfunction is when some portion of the muscles or connective tissues of the pelvic muscle areas are weakened or injured. Some of the wide ranging reasons include:
- Traumatic injuries to the pelvic muscles & area (ie. car accidents, physical abuse)
- Unmanaged downward pressures occurring during the 9 months of pregnancy (or possibly even from being overweight)
- Labor & Delivery – Hours upon hours of your child’s head pressing into your cervix, combined with well-intentioned birth attendants who may pull and push on you in various ways, are two reasons how giving birth may cause injury that leads to VN.
- Prior pelvic surgeries – It is common for tissues to be injured or remain damaged after a surgery in the pelvic muscle area.
- Advancing age – As collagen tissues weaken, and become more flaccid.
- Vaginal fistulas – Abnormal openings between the vagina and another organ. Openings like these are most often considered a severe circumstance, and in need of medical attention, like surgery.
One 2012 study found three primary sources for the onset of VN:
- 45% of VN is reported to begin after vaginal delivery
- 34% of VN starts spontaneously, for no apparent reason
- “Cesarean section and other pelvic operations”
How Prevalent is Vaginal Gas?
That 2009 study followed nearly 3000 Dutch women, aged 45-85, and found that about one in eight women experienced VN (12.8%). However, a 2017 literature review found this number to range from 1% to 69% in various studies.
A 2020 study of 570 women (nearly 90% had given birth) found 33% reporting VN. Of those that reported VN (185 women), the women who had given birth reported frequency as follows:
- 14% reported VN less than once per month
- 38% reported VN once per month
- 25% reported VN once per week
- 15% reported VN once per day
A small 2003 UK study that found “Vaginal wind causes significant distress and embarrassment to sufferers.” However, the larger 2009 study found that “the vast majority” were “bothered” by VN only a little, or not at all.
What Else Do I Need to Understand About the Potential Causes of Vaginal Gas?
The first question to ask yourself is:
- Did my VN start at an obvious time, or has it always been with me, even as a young child, etc?
If your VN started obviously after some event, like pregnancy, then you have much of the information you need to know for taking the next step toward treatment. With VN, identifying the cause is going to be helpful for knowing how to proceed.
But unfortunately, it gets a bit more challenging from here.
That’s because for the many of you who identify Pelvic Floor Dysfunction (PFD) as the category you fall into, these can be related to a large variety of other symptoms, both functional and mechanical. Functional means that the muscles may need to be trained, whereas mechanical means that deeper therapy and medical attention may be required. This makes it a bit more challenging to know exactly what to do first.
For example, a 2020 scientific paper attempted to capture the “broad constellation of symptoms” of PFD which corresponds to both an “increase[d] activity (hypertonicity)” in pelvic floor muscles (PFM) as well as “diminished activity (hypotonicity).” Yes, these are exactly the opposite problems, which require somewhat opposite treatment plans; one requires activation of the muscles, while the other requires more deactivation of the muscles. In addition, according to the same research, PFD could also be just “inappropriate coordination of the pelvic floor muscles” or something completely different, like pelvic organ prolapse (where the organ structure has led one organ to fall into another).
Can you see how convoluted this can become? Don’t worry we are going to help you sort it out! For now, it’s important for you to be gathering the right information for what your specific set of circumstances has been.
Are PFM the same as Kegel exercises?
Please note that in this article, we will frequently discuss Pelvic Floor Muscles (PFM). Yes, these are the same muscles as Dr. Arnold Kegel identified as important for childbirth long ago. However, it is incredibly important to know that although a kegel exercise is an activation of the PFM, you must also be able to relax and disengage the PFM! Therefore, Fit For Birth does not typically refer to our physical exercise routines as doing Kegels, but rather with a bit more specificity when directing you: either activating the PFM or relaxing the PFM, as well as bulging the PFM.
In general, scientific research has shown the following correlations:
- Having birthed a child makes it significantly more likely for the mother to have VN,, especially if an instrument like forceps or a vacuum is used during a delivery.,
- Urinary incontinence is a “known risk factor.” Essentially, the same mechanical damage that causes incontinence may also cause VN.
- Pelvic Organ Prolapse (particularly central and posterior compartments) is a precipitating factor. Again, similar damage causing various symptoms, including VN.
- Postural changes and physical exercises/activity are precipitating factors as moving about causes changes to the canal, with subsequent possibility to uptake or release gas.
- Inability to hold poop (solid stool anal incontinence) is also more highly correlated to VN., One reason for this is if damage to the Internal Anal Sphincter (IAS) forces the External Anal Sphincter (EAS) to overcompensate. This, in turn may over-activate the PFM, which might cause air to make a sound when it escapes the vaginal walls.
- Over-active PFM muscles may be a precipitating factor, because a levator muscle with “higher resting tone may confer a higher resistance against which trapped air is expelled during physical activities.” However, Pelvic Floor Muscles (PFM) have not been shown to have any significant difference in the strength and endurance of women with or without VN.
- Getting older and carrying more body fat may reduce your incidence of VN.
- Being sexually active may or may not have a significant difference between those with and without VN.
- Vaginal & Urinary Infections: Urinary Tract Infections (UTIs) are typically caused by bacteria affecting the bladder and urethra, while yeast infections are caused by Candida fungus in the vagina. Although an odor can be associated with a UTI, this is not the same as gas. UTI’s and vaginal flatulence are two distinct medical issues, and there doesn’t appear to be correlation or causal relationship between them in scientific research studies. Regarding vaginal infections gynecologists commonly (and mistakenly) believe that vaginal infection causes vaginal wind. This is also not a cause of VN.
What are the Preventions and Treatments for Vaginal Gas?
| Potential Cause | Potential Treatment |
| Natural state of having a Vagina | Consider using a tampon or pessary, both of which prevent a vagina from fully collapsing at rest. “While this doesn’t prevent the air from entering, it may prevent the noise as the air leaves the vagina” A pessary is a “device that can be inserted into the vagina to support its internal structure. It’s often used in the case of urinary incontinence and a vaginal or pelvic organ prolapse.” Also consider that since “the size, shape and colour of internal organs can vary,” some vagina’s may naturally be more prone to VN than others. |
| Having Sex | Find the positions that allow less air to enter the vaginal canal [“Certain sex positions such as doggy style and inverted missionary (aka, woman on top) seem to increase the queefing effect”] |
| Youth | Patience as you grow older, since increased age correlates with less Vaginal Noise. Practice having compassionate conversations with your sexual partner, or others in your circle of family and friends. |
| Low BMI | If you are underweight, seek ways to permit your BMI (body fat) to increase, since low BMI associates with more VN. |
| Pelvic Operations | Avoid unnecessary pelvic operations. |
| Parity (having given birth) | Avoid labor complications. Remember, giving birth itself is a high correlative for VN. |
| Exercise or Postural Changes | Identify whether or not your pelvic floor muscles (PFM) are overactive or underactive. (This can be done both with an internal examination with a Woman’s Physical Therapist and/or via a neuromuscular self-awareness assessment which can be guided by a Fit For Birth certified Pre & Postnatal Diastasis and Core Consultant). Practice activating or deactivating your Pelvic Floor Muscles (PFM) in the exact positions or exercises that tend to cause the VN. For example, if VN occurs for you commonly when you uncross your legs, perform that motion while (a) activating your PFM several times, and then (b) relaxing (possibly even bulging) your PFM several times. One of these may prevent the release of sound. If so, you have a wonderful neuromuscular practice that will give control back to you. |
| Anal Incontinence | Internal exam with a woman’s physical therapist to heal (or activate) your Internal Anal Sphincter (IAS), and to possibly to relax your External Anal Sphincter (EAS). Continued work with a Fit For Birth PPDCC or other pelvic floor therapist to integrate proper sphincter control into your daily life and movements. |
| Urinary Incontinence | Identify if your urinary incontinence is functional (related to the muscle function), stemming from an underactive PF or an overactive PF. This can be determined with an internal exam with a woman’s physical therapist, or a self-awareness assessment with a Fit For Birth PPDCC. For those with an underactive PF, see Solving Postpartum Incontinence in One Session – A Case Study for Fitness Professionals.Depending the findings of your assessment, practice either activating or relaxing your PF. If PFM function does not make improvement, visit a provider to help determine if your issue is the mechanical dysfunction of internal components. If you do not have access to health insurance, or hiring a professional is not an option, spend several minutes per day “closing and lifting” and then relaxing your PFM at a ratio of: 10 seconds ON and 10 seconds OFF. This 10:10 ratio is a balance of both ends of the spectrum, and may provide you intuitively with the answer to whether or not you are over or underactive.If you do discover with high certainty that you are overactive, you need to start to relax more than you activate the PFM. Conversely, if you discover that you are underactive, you would start to activate for a longer timeframe than you rest. This can be a bit tricky, as many overactive PFM’s feel weak, which is why asking a professional is a useful way to start. |
| Pelvic Organ Prolapse (POP) | Identify if you have pelvic organ prolapse by visiting your doctor or woman’s physical therapist; possibly using MRI/ultrasound. There are MANY kinds of prolapse, and each may carry different solutions, but general symptoms include:Feeling of pressure or fullness in the pelvisLower back achePainful intercourseFeeling of something falling out of the vaginaUrinary incontinenceConstipationBlood spotting from the vaginaStrengthen (activate) your PFM! “Close & Lift” your PF muscles at various intervals, frequently throughout the day. (Relaxed PF muscles are one kind of pelvic floor disorder that includes pelvic organ prolapse.) |
| Hypertonic (Overactive) Pelvic Floor (PF) muscles | First identify if you have overactive PF muscles, via either a manual internal exam with a woman’s physical therapist, or with a Fit For Birth PPDCC self-awareness PFM assessment. Symptoms can include: “pain and problems with defecation, urination, and sexual function…difficulty evacuating stool or straining with bowel movements…a sense of incomplete evacuation, bloating, and constipation…dysfunctional voiding”…and conditions resulting in painful intercourse. Practice relaxing or deactivating your PFM. There are two main ways to practice this: Mentally feeling for these muscles (much as you might feel any other muscle after a workout at the gym) and practicing mentally relaxing them. This will likely benefit greatly from de-stressing activities, and a low-stress lifestyle. Remember there are about 16 waking hours of the day, and it’s likely that you are “posturally” holding your PFM hypertonic for most of them. This is an “all day long” and “moment by moment” practice.Physically relaxing these muscles, via not activating them and/or manual relaxation with internal massage from a woman’s physical therapist (or possibly with a sexual partner or internal device at home.) When practicing physical relaxation of your PFM, you will have to simultaneously practice mentally relaxing them as well; all muscle activation comes from neurological (mental) stimulation of some sort. Physical relaxation can also be practiced as part of your exercise session, perhaps using ratios of PFM activation similar to: 3 seconds ON and 10 seconds OFF (3:10). The key point here is to spend much more time relaxing than engaging these overactive muscles. (The reason to activate them at all in the initial stages of your program design is to provide contrast for the subsequent relaxation periods.) |
What Action Can I Take Right Now & When is a Healthcare Provider Needed?
VN has a vast array of potential causes, and by now, you know causes are more likely to be yours. For most of you, your first step is to learn how to use your PFM, both activating the muscles and—possibly more importantly—deeply and truly relaxing those muscles.
It’s important to remember Kegel exercises.
- Step 1: Try identifying yourself whether or not you are hyper or hypoactive in your PFM. One way to give you insight into this is by using a stopwatch to give you feedback on your ability to activate and deactivate your PFM. Activate your PFM for 10 seconds, and write down your perceived activation strength on a 0-10 scale. Then completely relax/deactivate your PFM and rank your perceived ability to relax (ie. are you able to drop back down to 0, or only to 2 or 3? Are you able to drop down immediately, or does it take you several seconds. You want to be able to drop down to 0 immediately.) Once you confidently identify whether or not you are hyper or hypoactive (this process will likely take multiple self-awareness sessions over a couple of weeks), you can practice what you need! (Overactive people need to relax, while underactive people need to activate more frequently and for longer periods of time.)
- Step 2: If you don’t feel confident doing this yourself, or if at any point along the way, you want feedback or a PFM core exercise program, contact a Woman’s Physical Therapist for a manual internal exam or contact a Fit For Birth Pre & Postnatal Diastasis and Core Consultant for a professional assessment.
- Step 3: If you have spent three months performing some sort of PFM functional training and have not made progress, or if at any point you find yourself in pain, ask your doctor for some sort of MRI or ultrasound look to find out if something larger is at play inside your body.
If you want a personal assessment and fitness coaching to help you feel settled once and for all regarding Vaginal Noise, please view Fit For Birth personal training packages here.
