Pressing on Your Vagina to Poop: What Splinting Means and What Helps

Some women learn a private workaround: when a bowel movement feels stuck, pressing on the back wall of the vagina, or on the skin between the vagina and the anus, helps it pass. Clinicians call this splinting, and it isn’t an odd habit they’ve never heard of.

What splinting can point to

	Rectocele	Muscles that won’t relax (dyssynergia)
What it is	The wall between the rectum and vagina weakens, so the rectum bulges onto the back wall of the vagina2	The pelvic floor muscles tighten, or fail to relax, when they should let go3
How splinting helps	Pressing against the bulge nudges stool out2	Usually alongside straining and a sense of blockage3
First treatments	Nonsurgical care first: fiber, water, a stool softener, a pessary2	Biofeedback with a specialist34

You can have both. A specialist exam and testing sort out which.

Rectocele: what the numbers show

At a pelvic floor center at Massachusetts General Hospital, researchers reviewed 106 women with constipation whose rectocele showed up on imaging.⁵

• 63.8% of the women whose back vaginal wall sagged on exam splinted, compared with 27.3% of those without that sag.⁵
• Their rectoceles were a little larger, 3.4 cm on average compared with 3.0 cm.⁵
• Cause and effect run both ways, the authors note: it’s unclear whether constipation makes prolapse worse or prolapse makes emptying worse.⁵ The study came from one specialty center.⁵

Cleveland Clinic² lists the common contributors: vaginal childbirth (especially with forceps, vacuum, tears or an episiotomy), menopause, which can lower pelvic muscle tone, and years of straining. Surgery, most often a posterior colporrhaphy, comes after nonsurgical care.² See what pelvic organ prolapse is and five questions about pessaries.

Dyssynergia: retraining works better than laxatives

• In an Italian trial, people whose pelvic floor wouldn’t relax had either 5 weekly biofeedback sessions or a laxative with counseling. At 6 months, 80% of the biofeedback group reported major improvement, compared with 22% on the laxative. The gains held at 24 months.³
• In an Iowa trial, biofeedback beat sham feedback and standard care, increased complete bowel movements, and cut how often people needed to help things along by hand.⁴

See what to expect from bowel biofeedback and why you’re constipated so often.

In the meantime

• Splinting is fine to do. Cleveland Clinic² advises a clean finger, washed with mild soap and water, and talking to your provider if you need your fingers to go.
• Stop adding force. Straining is one of the contributors to a rectocele.² Get your feet up with our toilet posture guide.
• Mild prolapse doesn’t always worsen: see does mild prolapse get worse?

Try: “To finish a bowel movement, I sometimes have to press on the back wall of my vagina. Could this be a rectocele or a muscle coordination problem, and which tests would tell?”

Bloated by Dinner explains splinting in Chapter 8, “Can’t Quite Finish.” For two weeks, next to each bowel movement in your Belly Clock, note whether you strained, whether it felt finished and whether you needed to press, and circle any day you went back a second time. Bring that page to the appointment. See the book.