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  • Dr. Karyn Eilber

USE IT OR LOSE IT: Penile rehabilitation is a thing...why isn't there vag rehab?


For over two decades, the concept of penile rehabilitation to improve recovery of erectile function after prostatectomy (prostate removal) has been recognized. It's relatively standard in urologic practice that after a man has a prostatectomy he starts penile rehabilitation. Before you get funny images in your head of a certain man's body part lifting weights, penile rehabilitation is regular, usually daily, use of medications to increase penile blood flow during recovery from prostatectomy to promote nerve recovery and prevent penile scarring (fibrosis). Nerve damage that occurs with prostatectomy can result in decreased erections. The decreased erections can ultimately lead to fibrosis of the penis because of lack of blood flow (that carries oxygen to tissues) that is normally associated with erections. Over time, collagen increases which isn't desirable (no pun intended) because collagen isn't as elastic as normal penile tissue, and the penis can actually shrink in size. This doesn't happen under normal circumstances because most men have daily erections. It's not necessary to climax to benefit from penile rehabilitation, the blood flow just needs to be increased.


Guess what happens to the vagina after menopause without hormone placement? Blood vessels can become smaller and result in changes in the collagen composition that make the vaginal wall thinner and weaker. Increased collagen has also been associated with prolapse. Unfortunately women don't have daily erections to increase pelvic blood flow, so what's a woman to do? Sex can definitely increase pelvic blood flow, but most people can't or don't want to do this every day. Women can also take medications like men do, but because these medications are specifically for erectile dysfunction they are usually not covered by insurance.


Vaginal rehabilitation may be as simple as daily use of a vibrator. Like penile rehabilitation, using a vibrator doesn't have to result in climax (although that's certainly not a bad thing), it just has to increase blood flow. Although there isn't hard (no pun intended) scientific evidence to support this (yet), it makes sense to me as there are multiple medical conditions in which vibration is an accepted treatment. Regardless, if there's one thing you should take away from this blog it's use it and don't lose it.

LOVE. REPLENISH. REPEAT.

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