Alright, I admit it: I’m a slightly smug Kegel-er.
Over the course of my working day, I like to give my pelvic floor muscles a good ol’ flex as often as I remember. Which is sometimes lots of times, and sometimes not at all. Not to worry. Despite my scattergun approach, they seem to be pretty good. For example, they did not fail me when I was required to empty half my bladder during a recent ultrasound.
The benefits of a strong pelvic floor are well known. Better bladder and bowel control, improved posture, reduced back pain, and of course, enhanced sexual pleasure. I started my daily flexes during the year of Seductions, mainly because I thought H would notice. I was genuinely surprised when my body’s response changed too: the whole length of my vagina now feels much more sensitive and ‘alive’, and orgasms almost tumble out of me.
But it turns out that my Kegel-ing efforts might have been in vain. A growing number of experts now argue that Kegels can do more harm than good – especially as few of us are doing them properly. It may be better to pay attention to our core muscles in general, rather than the specific muscles in our lower abdomen.
This all gets very complicated, very quickly, so I’ve compiled a handy guide.
1. What muscles are we talking about here?
Good starting point, imaginary questioner. The pelvic floor is a group of muscles that stretch from your pubic bone to the base of your spine. They support your bladder, uterus and bowel, and help these to open and close effectively. We often use the term ‘PC muscles’ when we’re talking about a strong pelvic floor, but this actually only refers to one of the muscles (the pubococcygeus). It’s better to talk about whole lot together.
Pregnancy and childbirth are renowned for damaging these muscles, but apparently they only tend to exacerbate existing problems. We’re suffering a epidemic of pelvic floor problems because of – you guessed it – our modern habits.
This is only half relevant, but I find this Betty Dodson video enlightening. In it, she draws the internal structure of the clitoris and vulva, which helps to illustrate why strong PF muscles can lead to orgasmic fireworks.
2. What’s a Kegel?
A Kegel is the classic exercise recommended to strengthen the pelvic floor. It simply involves drawing the PF muscles upwards, and holding for a while. I say ‘simply’ but it can take a bit of learning so that you’re not tensing every muscle in your body, holding your breath, or generally making yourself dizzy in other ways. But once learned, it’s simple and convenient. There’s a good factsheet of how to Kegel from Guy’s and St Thomas’ Hospital here.
3. But you said that Kegels might not be the answer.
Well, yes and no. As this post on Mama Sweat shows, Kegels can make the PF muscles too short and tense, causing a knock-on effect to other parts of your pelvis. Your vagina may feel tight, but you’re not getting the support you need. This is particularly a problem for pregnant women, for whom Kegels can make it difficult for the pelvis to open up fully during childbirth.
Far better, says biomechanical scientist Katy Bowman, to do regular squats (not the gym sort, the ‘peeing in the woods’ sort), something that our ancestors would have naturally done all the time. She suggests you start squatting in your bath every time you pee, but if that’s not your bag, she offers a great squatting programme here, and a basic guide here.
As with all things, it’s essential to do these exercises with a correct posture. This video from Hold It Sister shows good practice.
4. So it’s goodbye Kegels, hello squats?
Well, no. Alyce Adams, the self-dubbed Kegel Queen, argues that there’s nothing wrong with Kegels if they’re done properly. Her guide to the Five Biggest Kegel Mistakes shows how many of us are misinformed about how to Kegel correctly. The most important point is this: to avoid over-shortening the PC muscle, you should make sure you fully relax (not push out) after every Kegel. And there’s absolutely no need to do hundreds every day.
It’s all about balance. The squats are great for overall pelvic health, particularly for pregnant women, but (properly done) Kegels have their place too – they’re convenient, discreet and really target sexual pleasure for those interested in that sort of thing. The Kegel Queen has something to say about that, too.
5. Okay, so it’s really a case of squatting a few times a day, and Kegelling a few times a day.
Probably, yes. Let’s be honest, integrating both or either into your everyday life is your best chance of sticking with it.
6. What about all those PF exercisers that are on sale? Worth it?
Jury’s out. Studies seem to suggest that exercising alone is more effective than gadgets, including those that use electric currents. And pregnant women are at a higher risk of infection, so shouldn’t use anything that’s inserted into the vagina.
On the other hand, PF exercising gizmos may add an extra element of motivation, because they’re pleasurable, and you can sometimes leave them in place while you get on with your life, without having to remember to keep squeezing or squatting. Given the concerns about shortening muscles, though, it’s probably a good idea not to leave them in for too long, so that you make sure your vagina gets some r’n’r between sessions.
Also, for the love of all that’s holy please don’t use PF trainers with horrible chemicals in them. Just think: these things are sitting in your vagina for extended periods, thereby offering plenty of time for you to leach the nasties out of them. The lovely Amy of Pomegranate Boutique explains all here.
If you’re interested in a PF exerciser, Pomegrante offer a great, safe range, and I’m personally a fan of Coco de Mer’s breathtakingly expensive stone love eggs.
7. Shouldn’t you issue a disclaimer for all of this?
Yeah, probably. Take responsibility for your own pelvic floor, kids. If you’ve got any doubts at all, check with your doctor. And bear in mind that I have no medical training whatsoever, except a Girl Guide First Aid badge, and that really didn’t cover pelvic floors.
Ha! I’ve not seen my video for a year or so and my tummy went all Whoosh as I remembered the nerves! I really ought to be using it to spread the message.
See you in Bristol next week B!
That’s interesting, re kegels and squatting and general pelvic health. I have had long term physiotherapy, twice now, for damage post childbirth. I am advised to do kegels at the moment by the team at UCLH. There’s some fascinating research going on at the moment though, especially relating to significant risk factors for the kind of damage I wound up with – eg women who are hypermobile (‘double jointed’, I am) or who can do ‘party tricks’ eg bending fingers back (again, I can) and whether being stretchy/flexible in the first place can be a significant risk in serious damage to those muscles long term (I had my first pregnancy aged 29, and the damage to the pelvic floor from the pregnancy, labour and delivery was severe and the sort of damage you may expect from a far older mother or someone who had had several babies/a multiple birth).
Sorry, also in the section on gadgets, the not inserting things during pregnancy is really very important. You really shouldn’t use things, even if they motivate you. Or certainly that was the advice I had during my second pregnancy when I was in physiotherapy and had consultant care relating to birth injury, incontinence and, later, spd.
Ohhh I’m the poster child for screwing up kegels. I am quite the over-achiever, which meant that I nearly threw my back out trying to make my man feel my muscles during sex. So that sex toy the NJoy pure wand that’s heavy but not the eleven heavy?? I was practising Kegels with that, trying to induce an orgasm … when suddenly, I had a PAINFUL orgasm. I don’t think I’ve kegeled since then, which was at least 3 years ago.
I’m in the middle of pelvic floor physical therapy sessions trying to undo all my heavy lifting. Heh.
Wow, Jess, that’s quite an impressive effort! It just goes to show though – we shouldn’t thoughtlessly push Kegels without giving proper information about how to do them. I’ve definitely been working on the ‘tighten’ rather than the ‘relax’ too.
Oh yeah, because I was pretty smug too until that whole painful orgasm thing. Then I wanted answers, immediately.
Props to you for talking about this!
I’d like to offer my 2 cents on kegel devices: please don’t waste your precious time and money on them!
1. Holy cow, what a pain. Why deal with some cumbersome thingy you have to put in, take out, wash, and store when you can do super-effective kegels with your pants on? The only way to get results with kegels is to do them consistently. Convenience is a major influence on women’s success in sticking with kegels, and putting some gizmo in your vagina every day is not convenient!
2. If you go on an overnight trip, you may have to explain your kegel device to the airport security people. If you’re the unusual type who enjoys this type of interaction, bring an interesting sex toy to show them instead.
3. As you mention, Betty, devices — especially the ones that are basically weights you hold in by squeezing your pelvic floor — don’t let you practice relaxing the pelvic floor muscles, which is critical if you don’t want to end up having pain with sex like poor Jess.
4. One of the major reasons I’ve devoted my professional life to kegels is because of the awesome power women feel when they heal themselves (especially the women who cancel surgery) and/or radically juice up their sex life. I experienced this for myself when I started doing real kegels, and I hear it all the time from the women I work with: “I DID IT!” With a device, “I did it because of this thingy I bought and can’t live without” cannot compare to the amazing feeling of “I did it on my own with just me and my own body.” Fundamentally, better pelvic health is all about more power, more meaning, and more fun — and doing kegels without a device you definitely get more of all three.
Thanks for posting, Betty!
Thanks Alyce – it’s brilliant to have the benefit of your Kegel wisdom!
yeah – and don’t forget it’s not your FAULT if you end up with post-partum prolapse. A lot of the emphasis on doing Kegels during pregnancy is phrased along the lines of “do them or else you’ll end up incontinent/prolapsed”. It can happen anyway – even if your job entails lots of squatting and you do your kegels regularly and correctly!