Vaginal Flatus: Messages from the front

You are feeling strong at the yoga studio or in the bedroom, and suddenly a sound comes from your vagina. What was that? Queef, vaginal wind, vaginal gas, vaginal flatus, fanny fart, garrulitas vulvae, and other terms all describe the involuntary release of odorless gas from the vagina.

Occasional vaginal noise from trapped air is natural and normal. While vaginal gas is common, it can still feel embarrassing, isolating, or impact quality of life. Unless vaginal wind has an odor, it does not usually require medical attention. You should, however, mention it to your healthcare provider if it is frequent, bothersome, or causes concern. Persistent vaginal wind may reflect challenges in regulating pressure within the vaginal pelvic cavity, which can sometimes be improved by addressing contributing factors. Vaginal delivery and pelvic floor dysfunction increase the likelihood of vaginal flatus. In one study of women with pelvic floor disorders, 35 percent reported vaginal gas, especially those who were younger, more sexually active, had decreased sexual function, experienced urinary or stool leakage, or were pre-menopausal (Lau et al., 2021).

What Makes That Sound?

Vaginal sounds occur when air moves rapidly through the vaginal opening due to pressure changes from the top, around, within, or bottom of the vagina. The vaginal canal connects the vulvar opening to the uterine cervix. Its walls move with pelvic and abdominal organs, as well as with changes in abdominal pressure. When abdominal and vaginal pressures are balanced and pelvic floor closure is strong, air moves in and out of the vagina silently. Vaginal muscles do not close as tightly as anal muscles, so sounds can be harder to control.

Common situations for vaginal noise include:

• Penetration: sexual activity, gynecological exams, tampon or menstrual cup insertion

• Pelvic elevation: positions where the pelvis is higher than the abdomen, such as in yoga or other exercises

• Abdominal pressure changes: breathing, posture shifts, or movements where the diaphragm and pelvic floor move in opposite directions

  
  

When hips are higher than the ribs, abdominal organs shift away from the pelvic floor, pulling air into the vagina. When the pelvis lowers, the pressure of the organs pushes air out. The vagina is lined with folded, expandable tissue, allowing for penetration, childbirth, blood flow, and air movement. Air can become trapped in these folds, especially when pressure changes within the vagina are exaggerated. Rigid vaginal walls from surgery, radiation, or disease may also increase vaginal noise.

Lubrication and vaginal moisture influence vaginal sounds. Adequate moisture helps seal the vaginal opening, limiting excessive airflow, while increasing noise if air does move. Age-related changes in vaginal tissue and moisture may partly explain why vaginal sounds become less frequent over time.

Pelvic organ position and uterine variations can further alter vaginal pressure. Hormonal fluctuations, childbirth, and menopause can impact vaginal air movement. In patients with pelvic organ prolapse, 47-66 percent report vaginal flatus compared to 27 percent in those with stress urinary incontinence (Miranne et al., 2015). Retroverted uteri or post-hysterectomy changes may also affect vaginal pressure.

When the diaphragm and pelvic floor move in opposite directions, air can be pulled into or pushed out of the vagina. Breathing patterns that are not synchronized with pelvic floor movement or difficult physical tasks can increase vaginal noise.

Managing Vaginal Flatus

While vaginal noises are a normal part of anatomy, many people seek ways to minimize them. Strategies to reduce trapped air and limit rapid pressure changes include:

• Using a tampon or pessary to limit air movement and pelvic organ descent into the vagina

• Improving vaginal closure through pelvic floor physical therapy and exercises

  • Contractions, relaxations, and coordination of the pelvic floor muscles, ideally as part of a comprehensive, individualized plan

  • General guideline: 3 sets of 8 near-maximum pelvic floor contractions held for 8 seconds daily

  • Cue: close and lift the vaginal opening as if stopping urine midstream, without actually doing this during urination

  • Ensure full relaxation between contractions and avoid breath-holding

• Vaginal moisturizers or hormonal creams to improve closure of the vaginal opening and reduce air movement

• Coordinating abdominal pressure during movements when hips are above ribs

  • Overactive pelvic floor: inhale to maintain space, then move

  • Underactive pelvic floor: inhale to open, exhale to engage pelvic floor and abdominals for stability

• During penetration: decrease speed and depth of initial entry

• Functional activity training: adjust breath patterns, posture, and muscle engagement to manage downward pressure. Clinician Julie Wiebe suggests the cue “blow before you go” to encourage pelvic floor support

  
  

Vaginas are remarkable. They adapt through life, allow and prevent entry and exit, support sensation, self-clean, and yes, make noise. For most people, vaginal flatus is not a medical concern. For others, pelvic floor physical therapy can help address underlying factors and improve control. At Beyond Basics Physical Therapy, we specialize in diagnosing and treating pelvic floor dysfunction to support your comfort and confidence in vaginal health.

Looking for pelvic health physical therapy in Philadelphia?

If you want more individualized treatment including education, exercise, and manual therapy, we would love to help you continue your favorite activites. This personalized care can make a meaningful difference.  At Hazel Physical Therapy, we provide pelvic floor physical therapy, prenatal physical therapy, and postpartum care in Philadelphia to help you move with less pain and more confidence. Let's connect to see how pelvic health physical therapy might help you in your recovery.

References

• Lau HH, Su TH, Chen YY, Huang WC. The Prevalence of Vaginal Flatus in Women With Pelvic Floor Disorders and Its Impact on Sexual Function. The Journal of Sexual Medicine. 2021 Mar 1;18(3):487-92.

• Miranne JM, Marek TM, Mete M, Iglesia CB. Prevalence and resolution of auditory passage of vaginal air in women with pelvic floor disorders. Obstetrics & Gynecology. 2015 Jul 1;126(1):136-43.

• Neels H, Mortiers X, de Graaf S, Tjalma WA, De Wachter S, Vermandel A. Vaginal wind: A literature review. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2017 Jul 1;214:97-103.

• Neels H, Pacquée S, Shek KL, Gillor M, Caudwell-Hall J, Dietz HP. Is vaginal flatus related to pelvic floor functional anatomy? International Urogynecology Journal. 2020 Dec;31(12):2551-5.

• Pool-Goudzwaard AL, Eijkemans MJ, Steegers-Theunissen RP, Burger CW, Vierhout ME. Vaginal noise: prevalence, bother and risk factors in a general female population aged 45–85 years. International Urogynecology Journal. 2009 Aug;20(8):905-11.

• Sahar T, Fatemeh M, Parvin B, Reza SM. The Comparison of the Effects of Pessary, Pelvic Floor Physiotherapy, and Corrective Surgery Methods in Correction of Vaginal Sound in Patients with Pelvic Floor Disorders.

• Schorno-Pitsch A. Vaginal farting or queefing: tips to decrease your personal symphony. Core Exercise Solutions. April 11, 2019. Accessed May 1, 2022.