pelvic health Archives - Revitalize Physical Therapy

The Key to Kegels

What are Kegels? Put simply, Kegels are to the pelvic floor what yoga is to the body, mind and spirit. They are an accessible form of low-impact exercise that has the potential to dramatically improve your life.

To get even more granular, “Kegel pelvic floor exercises are used to strengthen the muscles that support your uterus, bladder, bowel, and rectum,” according to WebMD. Kegels have enjoyed some publicity as of late, being touted as a way to treat erectile dysfunction and achieve pelvic floors of steel.

So how do you do them?

Many of us are not aware of where our pelvic floor muscles even are, so engaging them can be a challenge.

There are several ways, per Healthline. One is to simply replicate the experience of holding in gas. If you attempt that and then feel it in your vagina or back end, you’re doing it right! You can also locate these muscles by stopping urine while on the seat or putting a finger inside yourself while doing the exercise to feel the pull. Although please do not get in the habit of doing this routinely, as it sends mixed messages to your pelvic floor! You get one shot at it, for educational purposes only!

If you are of a certain age, think back to those claw arcade machines you played with as a child. The Cleveland Clinic compares the motion of a Kegel to the claw opening and closing around a prize.

You then will tighten your muscles for a count of five, and relax for the same count. For optimal help, perform these endurance contractions 20x, three times per week. You can also perform Quick Flicks, or “fast exhale squeeze, fast inhale release” 50x, three times per week.

Your physical therapy appointment is another great time to check your Kegel form. You shouldn’t be embarrassed or feel like you are bothering your therapist. That’s what they are there for!

Now, let’s take a closer look at what they’re for.

Pelvic Organ Prolapse

As I explain in my book The Inside Story, “POP is associated with the excessive descent of one or more of the pelvic organs or the vaginal wall.” It can happen after childbirth, and there are several different types of prolapse. These include uterine or cervix prolapse, cystocele/anterior prolapse, rectocele/posterior prolapse, and rectal prolapse. I also talk about prolapse in this blog post – well worth the read! Pelvic organ prolapse has a number of treatments, ranging from a pessary to surgery, but Kegels can make pelvic floor muscles stronger and those are the muscles that keep those organs stable.

Incontinence

Pelvic floor muscles affect how much control we have over our urination and defecation, which is why it may be recommended to strengthen them to treat urinary, urge and fecal incontinence.

Better Sex

Now I’ve got your attention! Yes, Kegels can even help in this department. According to WebMD, there is scientific evidence that Kegels can “enhance female sexual arousal by relaxing the vagina, improving lubrication and allowing more blood flow to the genitals.” In men, they may heighten the pleasure of orgasm and provide “greater control over ejaculation.” (Pelvic floor muscles really are the center to so much that goes on in our bodies!)

Who Shouldn’t Do Kegels

Kegels can be a problem for people with a hypertonic pelvic floor. This means the pelvic floor muscles are unable to fully relax. Nebraska Medicine states, “While these exercises may benefit both men and women, performing too many ─ or performing them incorrectly ─ may increase muscle tension and pain, or worsen your symptoms.” One journalist received a hypertonic pelvic floor diagnosis simply from doing Kegels alone, so you have to be careful. They also provide very limited benefit for overflow incontinence.

As usual, it is best to speak with a healthcare provider.

Also, have patience: Don’t expect overnight success as they can take up to a few months to work. Try adding Kegels to your Google calendar or doing them first thing in the morning. You can even pair them with your favorite podcast to help make the habit automatic. And the result is not only a stronger pelvic floor but stronger relationships, less embarrassment, less pain, more pleasure – overall, a pretty big impact for such a really tiny movement!

Introduction

Being in a relationship is something to celebrate! But having sex after you’ve been abstinent (for example, because it’s your first time, because you’ve just had a baby, or because you had a medical procedure) can feel scary. This anxiety is perfectly valid because it’s based in reality. Yes, real psychological and physical challenges can arise when you have sex again. But you don’t have to be scared. You just have to be prepared!

Why Sex Might Feel Painful After a Break

Similar to the nerves many first timers feel, you might worry that sex will hurt when you resume it after a break. A lack of lubrication and increased anxiety—which is completely expected—can make sex feel physically painful, according to Romper. Fixing lubrication is pretty self-explanatory, but anxiety can feel more complicated.

We all reduce stress in different ways, but some general recommendations include mindfulness, yoga, and exercise. You may also want to tell your partner that it has been awhile. They should know how to make the experience less stressful. And if they don’t, don’t be afraid to tell them.

Returning to Sex After Pain or Diagnosis

Returning to sex after a pain diagnosis can feel even more complicated. First, ask yourself: are you even ready to return? It’s ok if you’re not.

Chronic pain does not erase your libido on its own, but pushing through pain can create negative associations with something that should feel fun and enjoyable. Fear and anxiety can also cause your muscles to tighten instinctively. This is your body’s way of trying to protect you. That tightening can make sex even more painful, and the cycle continues.

And THAT can be a real libido buster, because who wants to participate in an activity that hurts? (My blog post on dyspareunia is particularly helpful here.) You should talk to your medical team and pelvic floor physical therapist about exercises that can help you prepare, such as dilator work and hip stretches.

In addition, if a hormonal component contributes to your pain (for example, as some women on prolonged birth control may experience), or if you are postmenopausal, you may benefit from estrogen or estrogen/testosterone creams.

Bleeding with Sex: What It Can Mean

Believe it or not, bleeding with sex is not limited to only the first time. Many things can cause postcoital vaginal bleeding in sexually active folks, including more serious conditions like cancer and pelvic inflammatory disease, according to the Mayo Clinic.

However, you may simply need more lube, more foreplay, or a different type of birth control that isn’t hormonal. There may also be no clear reason! Although it can feel embarrassing to talk about, you should always tell your doctor if it’s happening so you don’t miss an important diagnosis.

When Desire, Identity, or Emotions Shift

At any point in your sexual life, you may notice less desire than you used to. You may also experience challenges related to trauma, shame, orientation, identity, or addiction. The person you were when you were having sex at 25 may not be the person you are when you return to it in your late thirties.

This is where a psychologist or sex therapist can help. Sex therapists are real healthcare professionals trained to support people with a wide range of concerns, from lowered desire to difficulty maintaining an erection.

Final Thoughts

Sex is one of the most beautiful parts of being human, but it should never cause pain. It may feel silly to prepare for it, but remember: you can’t fully engage in loving someone else before you love and care for yourself first!

Tag: pelvic health

What are Kegels?