Original Paper

Gynecologic and
Obstetric lnvestig'a.tion Gynecol Obstet lnvest 1996;42: 178-182

Paula B. Pendergrass
Cornelia A. Reeves
The Shape and Dimensions of the
Meyer W Belovicz Human Vagina as Seen in
Darron J. M alter
Janet H. White Three-Dimensional
Women's Health Research Group,
Durham, N.C., and Dover, Ark., USA
Vinyl Polysiloxane Casts

..................................................................................................
KeyWords Abstract
Vagina, human Full vaginal casts of 39 caucasian women , 13 each nulliparous, uniparous and
Anatomy, vaginal multiparous, were made using vinyl polysiloxane impression material. Vagi-
Vinyl polysiloxane nal lengths were measured with polished acrylic rods inserted by the subjects,
and introital diameters were measured with conical polypropylene flasks. Par-
allel sided, conical, heart, and slug shapes were found. Lengths ranged from
6.86 to 14.8 l cm; widths ranged from 4.8 to 6.3 cm; introital diameters ranged
from 2.39 to 6.45 cm. No significant differences by parity or shape were
found.

lntroduction Materials and Methods

Although numerous, sometimes conflicting, reports of
vaginal length are available in the literature [ 1-4], de-
scriptions of actual vaginal shape are limited to two sets of
authors. Dickinson [ 1] described the vagina as gourd
shaped, and Masters and Johnson [5] characterized itas a
collapsed cylinder of varying length with a diameter
approximately equal to the introital opening.
Considering the increasing number ofwomen who use
one-size-fits-all contraceptive, feminine hygiene, and
menstrual protection products, it seems reasonable to ask
whether there are differences in vaginal dimensions and
shape and whether any differences are related to factors
such as parity or weight. The purpose of this paper is to
describe variations in adult vaginal anatomy in sexually
active nulliparous, uniparous, and multiparous caucasian
women based on full vaginal casts obtained with vinyl
polysiloxane dental impression material.
The protocol for this study was reviewed and approvcd by the St.
David's Human Research Revicw Board prior to study initiation. Ali
subjects gavc informed consent and completcd a reproductive histo-
ry questionnairc.
Thirty-nine adult caucasian womcn were assigned to nulliparous,
uniparous, and multiparous groups (13 each) based on a screening
questionnaire. Ali subjects were at least 18 years of age and had expe-
rienced sexual intercourse. Age, height and weight were obtained for
ali subjects.
Ful! vaginal casts were taken in lying, standing, and sitting posi-
tions following the mcthod of Pendergrass et al. [6] with slight modi-
fications. Subjects washed their perinea with warm, soapy water then
do uched with a commercial water douche prior to each cast to facili-
tate removal of the mold. Subjects assumed a supine position on an
examining table; a 2.5-cm square of surgical tape was placed over the
urethra, and vaseline or baby oil was applied to the pubic hair to
protect against adherence of any leaked molding material. Then each
subject inserted a warmed 15-cm iced tcaspoon as far back into her
vagina as possible to open the posterior fornix. Then one fourth of a
50-ml cartridge of medium body vinyl polysiloxane impression mate-
rial was injected into the posterior ofthe vagina. Thc spoon and cast-
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 a b
Fig. 1. Four vaginal shapcs found in the
study population. a Parallel sides. b Conical.
e Heart. d Slug. The anterior surface is fac-
ing forward in ali views. x 0.5.
e d
ing nozzle were removed, and the subject digitally inserted a junior
absorbency tampon to serve as a retriever. The remainder of thc car-
tridge was expressed as thc nozzle was gradually withdrawn from thc
vagina. The material was allowed to polymerize for 7 min. Once so-
lidilied. it was lubricated liberally with KyTM jelly and removed by
the subject who pulled on the string and pushed with her pelvic mus-
eles until the mold was extruded.
For the first mold, the subject simply remained in the supine posi-
tion on the table after the material had been injected into the vagina.
For the molds taken in the standing and sitting positions, the vinyl
polysiloxane was injected with the subject in the supine position;
then the subject either stood or sat on a chair for 5 min while the
mold set. After the third mold, the subject douched with a commer-
cial vinegar-and-water preparation to help ensure normal vaginal
pH.
In addition to the three molds, vaginal length and introital disten-
sibility were obtained. With the subject in the supine position. length
was taken by having the subject inserta 17 .5-cm polished acrylic rod
as far back into her vagina as possible without causing discomfort;
introital distensibility was determined by having the subject inserta
lubricated 125-ml polypropylene Erlenmeyer flask as far back as pos-
siblc into her vagina without causing discomfort. The circumfcrcncc
at the point of cntry was markcd and measured, and thc diameter was
calculatcd.
Grcatest width and greatest depth of each cast wcre measured
with calipers. Anterior length was measured from the edge of the
anterior fornix to the introitus with calipers and with a string placed
directly on the contours of the casts. Similarly, posterior length was
measured from the greatest height of the posterior fomix to the
in troitus with calipers and strings. Ali mcasurements were to thc
nearest cent imeter.
Shape and Dimensions of Human Vaginas
Results
Casts in general show posterior widening around and
behind the cervix, with posterior fornices being quite
deep in sorne subjects. Anterior to the cervix, casts narrow
and become constricted as they approach the introitus.
Rugae are distinct in alrnost ali subjects with the excep-
tion of sorne older, possibly perirnenopausal wornen.
Shapes
Visual exarnination of the casts reveals four discern-
able shapes as shown in figure 1. Each subject produces
the same characteristic shape in ali positions. Group A,
parallel sides, is characterized by long, nearly parallel
sides which are only slightly more narrow than the poste-
rior fornix. Group B, conical, is decidedly conical with the
posterior fornix being noticeably wider than the anterior
canal. Group C, heart, has a flattened vagina character-
ized by a rnarkedly distended posterior fornix constricted
at rnidfornix to produce a scallop or heart shape. Group
D, slug, shows distension of the anterior and lateral walls
into a distinct bulge or balloon. Transitions between the
groups are sornetimes found, but ali casts have been clas-
sified into a discrete group for sirnplicity of data presenta-
tion.
The distribution of the four shapes by parity and
weight is shown in table 1. Conical vaginas were found
rnost often, followed by parallel-sided and heart-shaped
vaginas in the sarne proportions, with slugs being found
the least often. Interestingly, vaginas with parallel sides
were found predominantly in nulliparous subjects, while
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Gynecol Obstet lnvest 1996;42: 178-182 179
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 Table 1. Comparison of vaginal shapes by parity and subject Discussion
weight
The use of vinyl polysiloxane casting gives good repro-
Shape n % % % % Average
Total Null Uni Multi weight, lbs
duction of the inner contours of the human vagina.
Because the stratified squamous epithelium of the vagina
Parallel sides 9 23 31 15 23 186.4 is comparable to that of the oral cavity, dental casting
Conical 15 38 46 23 47 159.1 materia Is that are safe for the mouth are expected to be safe
Heart 9 23 15 39 15 152.6 for the vagina. Two important features of this molding
Slug 6 15 8 23 1S 127.7
material are that it is hydrophilic and therefore releases
Total,% 100 100 100 100 easily, and that it does not generate heat during polymer-
ization. It should be noted that this technique must be per-
formed only by trained medical personnel, and that ex-
treme caution should be taken to avo id injecting the mold-
ing material into either the cervical os or the urethra.
conical vaginas were found equally in nulliparous and T he highly detailed casts produced by our method
multiparous subjects; both heart- and slug-shaped vaginas have potential for use in several areas. The likely place-
were found most frequently in uniparous subjects. Note ment and correlated success of vaginal contraceptives,
that the average weight decreases with each respective vaginal medications, and tampons can be determined by
shape reflecting a predominance of parallel sides in heavi- having subjects insert them into the mold before it poly-
er women, and the predominance of the slug shape in merizes. T he depth of the posterior fornix can be deter-
lighter women. mined prior to hysterectomy and reconstructive surgery.
Dimensions and curvature of the vagina can give insight
Vaginal Dimensions into probable cause of painful intercourse. And examina-
Means, standard deviations and ranges for rod lengths tion ofthe rugae can give good information about the sub-
and introital distensibilities by parity are given in table 2. ject's hormonal profile.
T he overall range of rod length for the 3 parous groups An important finding from our study is the description
was 6.86-14.81 cm; the range for introital diameter was of four distinct shape groups among the subjects. Ali four
2.39- 6.45 cm. The greatest range in rod length was found shapes are wider at the posterior end and sharply nar-
in the nulliparous group, whereas the uniparous group rowed at the introitus with only the parallel-sides shape
had the greatest range in introital diameter. Means are not resembling the collapsed cylinder of Masters and Johnson
significantly different among the 3 groups for either mea- [5]. The conical and heart shapes could reasonably be
surement, although the upward shift in the introital d is- extrapolated to the gourd shape described by Dickinson
tensibility in the multiparous group should be noted. [ 1], but there is nothing in the literature comparable to the
Comparisons of posterior and anterior lengths of casts slug shape. The correlation of heavier body weights with
by parity in the standing position as measured by calipers parallel-sided vaginas suggests that pressure from intraab-
are presented in table 3. The range for posterior wall dominal fat may flatten otherwise conical vaginas. The
length for the 3 groups was 7 .23- 10.61 cm; for the anteri- absence of a clear correlation between shape and parity
or wall it was 5.8-9.3 cm. There were no significant differ- suggests that vaginal shape is retained throughout the life
ences among the means. of the subject even with multiple births.
Means, standard deviations and ranges for lengths of Vaginal lengths for adult women of 7.25 [2], 7.5-8.5
anterior and posterior walls by parity in the standing posi- [4], 11.0 [3], and 7.6-12.7 cm [1] have been reported, with
tion as measured by strings are given in table 4. T he range the composite range being 7.25-12.7 cm or 2.85- 5.0
for the posterior wall was 8.0-12.5 cm; for the anterior inches. Our total range as measured with a rod was 6.86-
wall, it was 6.6- 11.2 cm. 14.81 cm or 2.7-5 .83 inches with our subjects showing an
Comparison of the greatest widths and depths for the 3 average length of 11.51 cm or 4.52 inches. Our range
groups by parity in the standing position is pressented in exceeded both the h igh and low published figures with ou r
table 5. T he range for greatest width was 2. 1-5.0cm; for upper length being 2. 11 cm, or 0.83 inches, longer than
greatest depth it was 1.0-4.5 cm. There were no signifi- previously reported [ 1].
cant differences among the means for parity. P roduction of a 3-dimensional cast permits measure-
ment of anterior and posterior walls that can only be esti-
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180 Gynecol Obstet lnvest 1996;42: 178- 182 Pendergrass/Reeves/Belovicz/Molter/White

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 Table 2. Summary of rod length and
introital diamctcr by parity Parity Rod length, cm Introital diameter, cm
mean SD range mean SD range

Nulliparous 11.84 2.29 6.86-14.81 4.57 0.8 1 3.02-6. 15

Uniparous 11.23 1.98 8.0- 13.67 4.75 1.07 2.39-6.45
Multiparous 11.48 1.70 8.39-14.68 4.67 0.84 3.38-6.02
Total 11.51 1.96 6.86-14.81 4.67 0.89 2.39-6.45

Table 3. Summary of length of posterior

and anterior vaginal walls measured with Parity Posterior wall, cm Anterior wall, cm
calipers by parity mean SD range mean SD range

Nulliparous 8.93 0.92 7.5-10.4 7.74 0.67 6.82-9.08

Uniparous 8.80 0.88 7.7-10.61 7.49 0.71 6.2-8.95
Multiparous 8.80 0.73 7.2-10.05 7.48 0.94 5.8-9.3
Total 8.84 0.83 7.23- 10.61 7.57 0.77 5.8-9.3

Table 4 . Summary of length of anterior

and posterior vaginal walls measured with Parity Posterior wall, cm Anterior wall, cm
strings by parity mean SD range mean SD range

Nulliparous 10.52 1.55 8.0- 12.4 9.37 0.97 7.9-11.2

Uniparous 10.02 1.20 8.3-12.0 8.85 0.94 7.0-10.4
Multiparous 10.15 1.16 8.6-12.5 8.68 1.1 8 6.6-10.9
Total 10.23 1.30 8.0-12.5 8.97 1.05 6.6-11.2

Table 5. Summary of maximum widths

and depths of vaginal casts by parity Parity Width,cm Depth,cm
mean SD range mean SD range

Nulliparous 3.55 0.72 2.1-4.9 2.50 1.19 1.0-4.2

Uniparous 3.45 0.48 2.6-4.4 2.56 0.96 1.2-4.5
Multiparous 3.35 0.77 2.1-5.0 2.22 0.76 1.4-4.0
Total 3.44 0.66 2.1-5.0 2.43 0.97 1.0-4.5

mated if measurements are made with a speculum in
place. The posterior range with calipers was 7.23-
10.61 cm or 2.85-4.1 8 inches with a mean of 8.84 cm or
3.48 inches. The anterior range was 5.8-9.3 cm or 2.28-
3.66 inches with a mean of 7.57 cm or 2.98 inches. The
posterior range with strings was 8.0- 12.5 cm or 3. 15- 4.92
inches with a mean of 10.23 cm or 4.03 inches. The ante-
rior range was 6.6-11.2 cm or 2.59-4.41 inches with a
mean of 8.97 cm or 3.53 inches.
The difference in mean length between the posterior
and anterior fornices as measured with both calipers and
strings of about 1.25 cm or 0.5 inch is expected and is par-
tially accounted for by the width of the cervix. However,
mean posterior lengths which represent the greatest
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Shape and Dimensions ofHuman Vaginas Gynecol Obste! lnvest 1996;42: 178-182 181
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lengths of the vaginas as measured with calipers (8.84 cm)
and strings (10.23 cm) are consistently shorter than the
mean length as measured with rods ( 11.5 1 cm). lt is
unclear whether the discrepancy of about 1.25 cm or 0.5
inch is caused by failure to introduce molding material
completely into the posterior fomix or by distension of
the posterior wall with the rodas it is inserted.
The lateral width of the vagina as measured by adduc-
tion of the fingers has been reported to expand up to
l l cm [ 1]. The mean width from this study was only
5.01 cm; however, we were not attempting to measure
maximum lateral dimensions and did not extend the lat-
eral walls fully; consequently our figures are understanda-
bly lower. Nevertheless, neither the width nor the length
measurements from this study support the commonly
held idea that multiparous women have larger vaginas
than other women.
Introital diameters as measured by Dickinson [ 1] were
2.5 cm for the virgin, 4.4 cm for the sexually active nulli-
para, and 5.1 cm for the parous woman. Since ali our sub-
jects had experienced intercourse, we do not have a direct
comparison with the virgin. In the sexually active, nullip-
arous subjects, the mean diameter was 4.57 cm which cor-
responds very closely to Dickinson's findings. In unipa-
rous women, the mean introital diameter was 4.75 cm,
and in multiparous women, it was 4.67 cm; neither diam-
eter was as great as that reported by Dickinson [l]. The
greatest range (2.39-6.45 cm) was found in the nullipa-
rous group. However, the upward shift in the minimal
measurement (3.38-6.02 cm) of the multiparous group
indicates a real trend toward greater distensibility of
introital openings in this group. T his fi nding supports the
idea that repeated stretching of the vagina during child-
birth results in smooth muscle beds that do not fully
regain original tone.
Our description of four distinct vaginal shapes with a
range in length of 6.8- 14.81 cm and a range in introital
diameter of 2.39-6.45 cm indicates that adult women
show considerable variation in the shapes and dimensions
of their vaginas. Although sorne tendencies toward group
differences are identifiable, individual differences are the
dominant characteristic. Furthermore, these differences
are largely independent of parity. Our results q uestion the
wisdom of one-size-fits-all vaginal product designs and
suggest an anatomical basis for customer preference for
particular products. Additional studies are underway to
correlate menstrual product use with vaginal shape and to
collect data about possible racial differences.
Acknowledgement
Financia! support for this study was provided by Tambrands
!ne.

References 1 Dickinson R: Human Sex Anatomy. Balti-
more, Williams & Wilkins, 1933.
2 Jones H, Hellcr R: Pcdiatric Adolescent Gyne-
cology. Baltimore, WiUiams & Wilkins. 1966.
3 Hafcz E, Evans T: The Human Vagina. De-
lroil, Wayne Slale University. 1976.
4 Kaufman R, Frcidrich E, Gardner H: Bcnign
Diseases oflhc Vulva and Vagina, ed. 3. Chica-
go, Year Book Medica!. 1989.
5 Maslers W. Johnson V: Human Sexual Re-
sponse. Boslon, Lillle, Brown, 1966.
6 Pendergrass P. Reeves C, Belovicz M: A 1ech-
nique for vaginal casting ulilizing vinyl polysi-
loxane denla! impression material. Gynecol
Obstel lnvesl 1991 ;32: 12 1-122.

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182 Gynecol Obstet lnvesl 1996;42: 178-1 82 Pendergrass/Reeves/Belovicz/Molter/White

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