The Pelvic Floor

Human beings have evolved to walk upright, and while this has given us certain advantages over our four-legged friends, it’s also given one specific group of muscles – the pelvic floor – a fairly heavy burden: our pelvic organs! Bladder, rectum, reproductive organs, digestive tract, urinary tract, prostate (if you have one)…. it’s a lot to support. And unlike our other muscles, which follow periods of activity with periods of rest, the pelvic floor is active all the time (for example, maintaining continence even when we sleep). One might justifiably call it the “hidden hero” of our bodies.   

Anatomy

Before we get into pelvic floor health and (dys)function, it’s worth taking a more detailed look at this remarkable group of muscles.


The term “pelvic floor” describes a hammock-shaped group of muscles and connective tissue that cradles the pelvic area, sitting between the tailbone and the front pubic bone. The pelvic floor has three distinct layers (which we describe in more detail on our blog...coming soon!).

The pelvic floor muscles support the reproductive and digestive organs. It's the contraction and relaxation of the pelvic floor that allows our anal and urethral sphincters to work properly. These muscles are integral both to our ability to pee and poop when we want to (and not when we don't), and to our sexual functioning - regardless of what kind of genitals we have.

Symptoms and causes of pelvic floor dysfunction

While some symptoms suggest a too tight pelvic floor (hypertonic), other symptoms may point more towards a weak pelvic floor (hypotonic.) Many people experience a combination of tension and weakness. For those with a mixed diagnosis, it’s generally recommended to first address the pelvic floor tension with relaxation techniques, and then move on to strengthening exercises. For a list of symptoms relating to hypertonic and hypotonic pelvic floor dysfunction, read our blog... link coming soon!

There are varying causes of pelvic floor dysfunction. These can include relatively simple things like sitting for long periods of time every day or working out improperly or too much. Even chronic coughing can take its toll on the pelvic floor. Things like heavy and/or incorrect lifting, poor posture, straining during bowel movements, or not peeing or pooping when you need to can damage the pelvic floor, too. Problems can also occur as a result of spinal misalignement or tight hip flexors. Other potential causes include injury or invasive procedures, childbirth (both vaginally or by C-section), hysterectomy, or genital reconstruction surgery. There may not be an obvious reason for your pelvic floor dysfunction, but that doesn’t mean there’s nothing you can do about it...

Luckily, there are some small but important things we can do to keep our pelvic floor in good health, whether we’re addressing existing symptoms or  taking a preventative approach.

Locating your pelvic floor

Still not sure exactly which muscles we’re talking about here? It’s often hard to imagine and get connected with parts of our internal body.  

One way to locate your pelvic floor muscles is to imagine that you are peeing and then visualize stopping the flow of urine. The muscles you feel working are located in the pelvic floor.

(Note: some people recommend actually stopping the flow of urine to locate these muscles, but this is a bad idea: it could cause urine to go back up the urethra, leading to infection; and messing with your sphincters’ natural patterns like this can actually lead to incontinence.)

To find the muscles further back, gently squeeze your butt cheeks together and tilt your hips forward (like you’re pulling an imaginary tail through your legs!), or imagine that you need to pass wind and you’re trying to hold it in. Try not to tense your butt cheeks while you do this.

If you touch your perineum while you’re contracting your pelvic floor muscles, you should feel it move upwards and inwards.

If you have a penis, a mirror can also help: stand naked in front of a mirror and attempt to contract your pelvic floor. If you’re working the correct muscles, you should be able to see the base of the penis draw in, causing the penis to dip slightly downwards, and the scrotum to lift.


Contracting and relaxing; strong and supple

A happy, healthy pelvic floor can both contract (to keep you from peeing/pooping) and relax (to allow you to pee/poop). These two functions are equally important, and we need to care for both.

We've noticed that when vaginas and the pelvic floor are discussed in mainstream media,  there’s often a lot more emphasis on strength – and on tightness – than on relaxation. The focus on having a tight vagina is inevitably bound up in the heterosexist myth that providing sexual pleasure to a penis is what a vagina is for... and that the most penis-pleasing vagina is a tight vagina.

But in fact, vaginas aren’t designed to be tight like your neon-glitter leggings, nor are they built to lift weights. If “weight training” (e.g. using heavy Kegel balls or a Kegel barbell) is something you want to do to strengthen the pelvic floor, because it gets you off, or you simply find it interesting, feel free! You are, as ever, the boss of your own vagina. But don’t be misled into seeing that as the one and only way to pelvic floor health.

While Kegel exercises may be part of your pelvic floor care, they're not necessarily right for everyone or sufficient in isolation. Caring for and protecting these awesome muscles requires a more holistic approach. Let's turn our attention now to what that might involve...


Pelvic floor health: a holistic view

Taking care of all of the muscles  that surround and support your pelvic floor is more important and effective for long-term pelvic floor health than targeted “Kegel” exercises using Kegel balls or other tools designed for pelvic floor training. (see below)

Here are some simple daily habits you can develop to support your pelvic floor health:

•    keep your bowels and bowel movements healthy by eating a balanced diet that includes plenty of fiber and good oils, staying hydrated, and using a “squatty potty”

•    avoid unnecessary pressure on your pelvic floor by turning your head to the side when you sneeze or cough

•    develop a good posture – with a strong core, flat back and chin tucked slightly in – and a light, balanced gait

•    elongate the muscles that are connected to your pelvic floor through regular, daily stretching exercises.

•    avoid crunches or other exercises that increase intra-abdominal pressure

•    don't wait to go to the bathroom! Respect your sphincters and listen to your body's signals.

•    avoid pushing or straining when peeing or pooping

•    masturbate regularly! This keeps blood flowing in the pelvic region, which is great for pelvic floor health.


For specific exercises, depending on whether you have an overly tense or weak pelvic floor, check out ... drum roll please... our pelvic floor blog post (coming soon)!


Sex and the pelvic floor

The good news is, a healthy pelvic floor is good for your sex life, and your sex life is good for your pelvic floor! The muscular contractions experienced during orgasm are an automatic workout for your pelvic floor, and orgasming is also one of the most effective ways to relax and let go of tension in the body.

But you may experience difficulty with orgasm if your pelvic floor muscles are very weak or very tense. Pelvic floor weakness or tightness can even result in an inability to orgasm. Bigger, better orgasms can be a motivating force when it comes to getting acquainted with your pelvic floor. Just remember that it’s NOT ABOUT HAVING A TIGHT VAGINA, and doing a bazillion Kegel exercises isn’t going to guarantee you the orgasm of your life. Rather, a pelvic floor that is both strong (able to properly contract) AND supple (able to properly relax) will most likely result in increased sexual sensation.

Because relaxing these muscles helps them to stretch and elongate (which is a good thing!), any kind of sexual penetration that you enjoy can support optimal pelvic floor health and function. If you’re a fan of getting fisted, or using relatively large toys, (which both encourage relaxation) consider balancing your sexy good times out with some strength exercises.

While Kegel balls have definite pros and cons (see below), it can sometimes be fun to incorporate them into your sex play. Here are some sexy tips for those Kegel balls that are sitting around in your drawer collecting dust (just wash the dust off first):

  • If you’re wearing a dildo-harness, you can wear your Kegel balls at the same time. Use the Kegel balls with the metal internal balls, so that you can feel them rolling around inside you whenever you move your hips.

  • Wear your Kegel balls while receiving cunnilingus. Ooh...aah!

  • Wear them while you masturbate!

For many folks, pelvic floor issues only arrive on their radar because of pregnancy and childbirth, creating a clear connection between the pelvic floor and vaginas. But what about butts, you ask? Is all that anal sex you’ve been having or want to be having good for your pelvic floor? It definitely can be!
 
Anal play, both internal and external, can be extremely relaxing for the pelvic floor muscles and can have the same benefits as enjoyable vaginal penetration. This is also a great way for folks who have penises to support their pelvic floor health. Again, the aim of the game is to have both strong and supple muscles, so if you’re doing a lot of anal penetration, you’ll want to do some pelvic floor strength exercises, too. So wear your favourite butt plug for 10 minutes, and call your exercise done for the day!

If you experience pain during any kind of penetration, it could be that you have an overly tense pelvic floor. Don’t force penetration in this case, as you risk putting more strain on these muscles. Get your doctor to refer you to a pelvic floor specialist, and in the meantime, try some relaxation techniques (see our blog post coming soon).

Finally, bringing fresh oxygenated blood to any body part has health benefits, and that's exactly what arousal and pleasurable touch does. So every time we get off, we can pat ourselves on the back for taking such good care of our pelvic floor.

Kegel exercises

“Kegel” exercises (named after gynecologist Arnold Kegel) are one way of engaging with your pelvic floor. These exercises can be helpful as part of a holistic approach to pelvic floor health , and are particularly effective, when combined with relaxation exercises, for those who experience urinary incontinence. 

However, using Kegel balls only targets the outermost layer of the pelvic floor; if practiced in isolation, they can contribute to an imbalance in the area. Kegel exercises in general are not recommended for people with tense pelvic floors, as they can make the tension worse. They should also be avoided by those with vaginal scar tissue.

To do Kegel exercises, identify the correct muscles (see “Locating Your Pelvic Floor” above), contract them, hold for 3-10 seconds, then consciously relax for at least as long as the contraction.

Try to contract on your exhale, and relax on your inhale: this will help you to avoid tensing other parts of the body, such as your buttocks or shoulders. Breathe normally as you do the exercises; don’t hold your breath.

The number of repetitions in a session, and the number of sessions per week, that make sense for your body (and are a realistic goal) will vary from person to person, but 8-12 repetitions, 1-3 times a day is a common suggestion.

Most people find that doing these exercises lying down is the easiest option, with sitting, standing and moving around progressively more challenging. As with any other kind of exercise, build up your strength gradually.

Kegel Balls

Kegel balls (or Ben Wa balls) are special tools designed to help vagina-havers strengthen their pelvic floor. These balls fit inside the vagina, giving the pelvic muscles something to squeeze against, which can help to strengthen the muscles. Some people also find that they produce enjoyable stimulation.

Many models contain smaller, weighted balls inside, which bounce around as you move your body normally while wearing the Kegel balls vaginally. The sensation this creates activates different muscles within the pelvic floor. The resulting contractions mean that you are gently strengthening the pelvic floor without having to practice the specific squeeze-and-release action of a traditional “Kegel exercise”.

Balls are often connected to a retrieval cord, which you can tug on to increase friction and provide some resistance – making the exercises a bit more challenging. This cord is often a loop, which is also handy if you have a penis: you can hang Kegel balls on it to add some weight to your pelvic floor exercises.

Some people like to wear Kegel balls as they stroll around at home, walk up stairs or even go for a swim, but be aware that using heavy Kegel balls or doing active Kegel exercises for too long can lead to muscle strain, potentially doing your body more harm than good. Depending on the weight of the Kegel balls you're using, wearing them for approximately 10 minutes to 1 hour is usually fine. If you want to leave them in for longer, consider using a larger and lighter ball so that there's less of a strain on the pelvic floor.

At Other Nature, you'll find a variety of Kegel balls on offer, all in body-safe materials. We’re happy to talk with you about pelvic floor health and help you decide what's right for you.

Medical help

If you are experiencing incontinence, pain during sex, erectile problems, or any other issues associated with the pelvic floor, we encourage you to get a professional medical opinion from your GP, gynecologist or a physiotherapist specialised in the pelvic floor.



Further reading

http://pelvichealthsolutions.ca/for-the-patient/

https://www.blacklocustgardens.com/single-post/2018/01/29/A-Practitioner%E2%80%99s-Guide-to-Pelvic-Floor-Dysfunctions-and-Herbs-That-Can-Help