Could Kegels Actually Hurt Me?

Could Kegels Actually Hurt Me?

You’ve seen the claims. A stronger pelvic floor! Fewer Leaks! Better Sex! The kegel craze is hot right now and for good reason. Kegels can do all of these things and we’re a big proponent of doing them for maintaining good bladder health and a healthy pelvic floor. But before you jump on the kegel bandwagon, read this post. Because while kegels can be super effective for all the reasons listed above, they can sometimes cause problems in women who have certain conditions.

Many women suffer from a weakened pelvic floor, the series of muscles and tissues that form a hammock at the bottom of your pelvis, and are responsible for holding many of your organs (including your bladder) in place. A weakened pelvic floor can be caused by many factors, but pregnancy, childbirth, and aging are all high on the list.  This laxity in the pelvic floor can lead to things like incontinence, or even pelvic organ prolapse if not treated properly.  And a great way to treat it (most of the time) is with kegels.   

But not everyone has a weak pelvic floor – some women experience pelvic floor tension, which prevents the pelvic floor muscles from contracting or relaxing at a normal rate, again making them weak, but in a different way.  This can lead to things like constipation, painful intercourse, or the inability to empty your bladder completely.  

People with pelvic floor tension are advised NOT to do kegels, and if you think about it, it makes sense. Trying to tighten something that is already too tight can make your problems worse.

So, how do you know if you should be doing kegels or not?  Our best advice is to see a physical therapist specialized in women’s health.  A trained PT can give you a thorough evaluation and can determine if you have a pelvic floor that’s too tight or too loose.

An added bonus is that if your PT finds you’re a good candidate for kegels, they’ll be able to show you exactly how to do one – something that is actually somewhat difficult for many women.  And, if you’re advised NOT to do a kegel, they’ll be able to help you learn how to relax your pelvic floor and will show you exercises to help with that as well.

It’s also worth noting that while kegels are great for many people, they also aren’t the end all be all move for your pelvic floor. Your muscles are all connected, after all, so concentrating just on kegels won’t be as effective as if you worked your entire core, glutes and thighs. 

Want to find a PT in your area? Try our Specialist Locator

The Best Sex Positions If You Have Incontinence Or Pelvic Organ Prolapse

The Best Sex Positions For Incontinence Or Pelvic Organ Prolapse

The Best Sex Positions For Incontinence Or Pelvic Organ Prolapse

We all want a satisfying sex life.  But sometimes, medical conditions can get in the way of that. If you struggle with incontinence or pelvic organ prolapse, sex can often be a source of great anxiety. Fear of leakage, odors, or even pain can sabotage intimacy and leave you feeling undesirable or anxious when it comes to intercourse. There are many things you can do to prevent incontinence and pelvic organ prolapse from interfering with your sex life. However one of the simplest things you might try changing is your sexual position.

Your sexual position can make big difference when it comes to easing anxiety about leakage or pain and enjoying sex. Certain positions can put lots of pressure on the bladder, making it more likely that you may have an episode of stress incontinence. And if you have pelvic organ prolapse, some positions may feel more uncomfortable than others.  Here are a few sexual positions you may want to try, depending on your condition.

Sex Positions If You Suffer From Bladder Leakage: 

Just as you may experience bladder leakage when you sneeze, laugh, or workout, putting extra pressure on your bladder or urethra during sex can also cause incontinent episodes. This shouldn’t hinder your sex life. While it may make you feel anxious, there are ways to avoid bladder leaks during intercourse. Women who are concerned about leakage during sex should avoid positions that put extra pressure on these areas.

 Avoid:  The missionary position, or all fours.

Try:  Lying on your back with some pillows underneath your lower back. This position raises your pelvis and helps to reposition your bladder, reducing the extra pressure.

Sex Positions If You Suffer From Pelvic Organ Prolapse:

Pelvic Organ Prolapse (POP) is a condition in which your pelvic floor is weakened to the point that one of your pelvic organs (bladder, uterus, or rectum) “falls” into your vagina. Many women with POPs report feeling a heaviness or bulging feeling in their vagina, or a feeling that they are sitting on top of a ball. In severe cases, the pelvic organ may protrude past the vaginal opening. 

While this condition may leave you feeling uncomfortable and anxious about sex, rest assured that sex is still completely possible and will not affect the POP at all. Many women report having great sex even with a POP and, since it is extremely difficult for non-medical professionals to detect a prolapse, your partner probably doesn’t even know it’s there.

However, certain sexual positions can create discomfort in women with POP. Here are some positions to avoid, and some to try:

Avoid: Standing, “Cowgirl” or “Reverse Cowgirl” (where the woman is sitting on top). Gravity is not on your side here, and sitting or standing upright will only create more pressure on your pelvic floor during sex.

Try:  Modified Missionary Position: Woman is lying on her back with a pillow under her pelvis and her partner is on top.

 From behind: Woman is lying flat on her stomach or in supported kneeling position with her partner entering the vagina from behind.  (Note: Avoid this position if you have a rectal POP.)

Above all, be sure to communicate with your partner about what feels good and what doesn’t. Sex should be enjoyable for both of you so if something feels uncomfortable or doesn’t make you feel good, speak up.  And, if you’re still having difficulty finding a position that works for you, talk with a pelvic floor physical therapist. They’ll help create a custom treatment plan to strengthen up your pelvic floor muscles, and can suggest other tips that may make sex more enjoyable to you.


If you are worried about leaking during sex, you may also want to practice kegels. Kegels can help strengthen your pelvic floor so that you have more control over bladder leakage. Want to learn how to perfect your kegel? Read our how-to guide!

Your Guide To Personal Lubricants

Your Guide To Personal Lubricants

Sex is a great way to connect with your partner. But as our bodies change, certain conditions can make sex more challenging than it used to be.  For those with pelvic floor issues, it’s common to also see a reduction in natural lubrication. And as women enter menopause, the decrease in estrogen levels can reduce the amount of moisture available, and can make the vaginal wall thinner and less elastic. And even if you aren’t yet experiencing menopause, common occurrences such as stress, lack of sleep, or other medical conditions can often lead to vaginal dryness.

Vaginal dryness can cause discomfort on it’s own, but it can wreak havoc on your sex life, making it painful and uncomfortable. Lucky for us there are a plethora of choices for personal lubrication that will have you back on track in no time. If you experience any dryness during sex, try using lubrication to help remove the unwanted friction and make sex more enjoyable for both you and your partner. 

Popular Types Of Personal Lubricants

Water-based lubricants  

This is the most natural feeling lubricant and one of the most poplar. Note that a water-based lubricant will dry out faster than other forms and you may need to reapply it during sex.

Silicone-based lubricants 

Silicone lubricants are a bit slicker than water-based ones, and they may be used in water. They also last a bit longer than water-based lubricants so you won’t need to apply them as often. Avoid using silicone-based lubricants with silicone sex toys though, as it can deteriorate softer silicone sex toys due to how the molecules interact with other silicone products.

Hybrid lubricants  

Hybrids are a blend of water-based and silicone-based lubricants. They provide the feeling usually associated with a water-based product, but they won’t dry out quite as quickly. Note: because these are typically 90% water-based, they won’t work well in water.

Oil-based lubricants 

Oil-based lubricants – including petroleum jelly – are the least commonly used. Coconut or VitE oil are good daily options to use for general vaginal dryness. However, oil-based lubricants should never be used with condoms, latex, diaphragms, or rubber, since the oil will weaken these materials and may cause them to be ineffective.

Everyone’s preference is different and what may work great for one person may not be the best choice for you. Don’t be afraid to try out different types of lube to find one that you like best. 

ASK THE EXPERT: Is It Safe To Have Sex With A Vaginal Prolapse?

Is it Safe To Have Sex With A Vaginal Prolapse?

Each month, we ask our expert panel to answer one of our reader's questions. To learn more about the NAFC Expert Panel, and how to submit your own question, see below.

Question: Is it safe to have sex if you have a vaginal prolapse?

Answer: Yes! A prolapse occurs when a woman’s vaginal wall weakens and collapses, causing the uterus, rectum or bladder to fall into the vagina. However, in most cases, it is completely fine to have sex as long as the woman feels comfortable.  And, having sex when you have a prolapse will not cause any harm to the bladder, rectum or uterus, nor will it make the prolapse worse.

Some women with a prolapsed organ may feel some slight discomfort during sex. Using lubricant can help, as well as ensuring your pelvic floor is completely relaxed before you begin. Trying other positions may also alleviate any pain you are experiencing too. Talk with your partner about what feels best for you.

Are you an expert in incontinence care? Would you like to join the NAFC expert panel? Contact us!

Is a Pelvic Floor Exerciser For You? Read Our Thoughts And A Review Of Three Popular Products That Claim To Improve Pelvic Floor Strength

Is a Pelvic Floor Exerciser For you?

We’ve all heard the age-old advice that doing kegels are good for us.  And for the majority of people, they are. Kegels, when done along side other workout moves, can help tone and strengthen the pelvic floor, making things like bladder leaks and incontinence less likely.  And if that doesn’t mean much to you, consider this: experts say that a stronger pelvic floor can help make orgasms more intense, heightening sexual sensation.

The problem many people face is doing kegels correctly. The nature of kegels makes it hard to know if you’re tightening (and releasing!) the right muscles.  That’s where kegel exercisers come in. This new-ish breed of exercise equipment helps you to know exactly how you are performing in the kegel department. 

Here’s a overview of three devices that are currently on the market:

Elvie

Elvie is a popular device that allows you to literally do your pelvic floor workout anywhere. It’s the smallest kegel tracker available and uses a combination app to track your progress. Elvie is made up of medical-grade silicone and has multiple sensors that measure force and help you see your efforts on screen, so women can visualize their kegel exercises in real-time. Elvie even corrects your lift technique, as 30% of women push down which can lead to damage. There are three levels – beginner, intermediate, and advanced. When you first set your Elvie up, you’ll run through a series of tests to gauge your strength, and then will begin advancing through the different levels as you progress, making the tool fun and challenging.  Each work out only takes 5 minutes, and as you move up in levels you unlock more games and challenges.  Elvie is priced at $199 and can be ordered online through the product’s website.

PeriCoach

PeriCoach is an FDA-cleared medical device coupled with a smartphone app to guide women through pelvic floor muscle exercises.  The exercise programs ques the user to squeeze and relax against the PeriCoach, providing real-time feedback and guidance for proper contractions of the muscles through displaying activity on the smartphone app. The app also offers a bladder diary to record such things as leaks and pad usage, this information along with exercise history allows the user to see progress over time. PeriCoach real-world user data has demonstrated that the product improved incontinence symptoms in more than 75% of users. Additionally, the PeriCoach user may connect with a doctor or PT and share their exercise data.  PeriCoach is available for $299 USD at http://www.pericoach.com.  

Yarlap

Yarlap is another pelvic floor exerciser, but this one does much of the work for you. It’s an FDA cleared pelvic floor stimulator that instructs your pelvic floor muscles to gently contract and relax in order to show you how a Kegel exercise should actually feel.  The difference between Yarlap vs. Elvie and Pericoach is that the Yarlap does the workout for you. It uses a technology called AutoKegel, which perfomrs the Kegel exercises comfortably, correctly, and easily to help you regain muscle tone.  Yarlap consists of a probe, which is inserted into the vagina, and is attached to a display unit, which you can program based on your needs. Yarlap is priced at $299 and can be purchased at http://www.yarlap.com.

A word of caution when considering an electronic device for kegels:  Kegels aren’t for everyone, and for some women who have pelvic floors that are too tight, they can even be harmful.  It’s just as important for the pelvic floor to be able to relax as it is for it to be able to contract, so use these devices with caution, and, preferably, with the guidance of a physical therapist specialized in the pelvic floor.  And, because the pelvic floor connects to many muscles in the body, they shouldn’t be done in isolation. It’s important to strengthen your entire core to ensure that everything is working together, and one muscle isn’t overly taxed during your day-to-day activities.  This is where a trained physical therapist can really help customize your workout. If you need help finding a physical therapist in your area, check out our Doctor Finder Tool.

Have you ever tried a pelvic floor exerciser? What were your results? 

Why Do I Feel Like I Need To Pee During Sex? 3 Ways To Overcome It.

Why you feel like you need to pee during sex and how to fix it.

If you’ve ever had the feeling that you’re going to wet yourself during the act, you’re not alone. Many women report feeling this sensation – even those that don’t normally experience incontinence. The main reason this typically occurs is the pressure that is put onto the bladder by the penis.

Here are 3 ways to help you eliminate the feeling of needing to pee during sex

1. Empty your bladder before you have sex.

One of the simplest solutions to ensure you aren’t going to have a leak is to use the bathroom prior to doing the deed. This will ensure that even if you feel pressure, your bladder will be empty, greatly reducing the chance of an accident. (This will probably reduce your fears about it too, so you can actually enjoy yourself!)

2. Try a change in position. 

Sometimes, a simple position change can do the trick to eliminate the sensation. Experiment with your partner to see what sexual position feels best for you.

3. Experiment on your own to see what works best for you. 

Some women feel the sensation to pee before having an orgasm. To know if your fears are really a precursor to pleasure, spend some alone time exploring your body with your fingers or a small vibrator. When you feel the sensation to pee, keep going. If it passes, you know that it is just the way your body reacts to the sensation and you’ll be able to better tell in the future between actually having to pee and being on the verge of experiencing an orgasm.

Tips to keep incontinence from interfering with your sex life

Tips To Keep Incontinence From Interfering With Your Sex Life

If you struggle with incontinence and have concerns about leaking during sex, you're not alone. The American Foundation for Urologic Disease (AFUD) reports that one in three women with stress incontinence avoids sex due to fears of leaking during intercourse or orgasm. But incontinence during sex doesn't have to be an issue.  

Below are some tips to manage your incontinence and reclaim your sex life.

Be Prepared. 

Believe it or not, your behavior prior to sex can have a big impact on your chances of leaking during the act.  Here are a few tips to help you avoid an uncomfortable situation:

Avoid bladder irritating foods or drinks a couple of hours before bedtime.  

Not sure what your food and drink triggers are? There are some common ones, but you can also track your own habits for a week or so to determine what foods and drink you.

Limiting your fluids prior to having sex.

After all, the less you have in the bladder the less likely you may be to have a leak during sex.

Practice "double voiding" prior to sex.

This is when you go to the bathroom, wait a few minutes, and then go again to empty any residual urine that may still be present in the bladder.

Use protective bedding.

In case you do have an accident, at least your mattress will be protected.

Try a new position. 

You may find that a new position creates less stress on your bladder muscles, making leakage less likely. 

Strengthen up "down there".

Regular pelvic floor workouts can do wonders for women who experience incontinence. An added bonus?  Studies have shown that by strengthening your pelvic floor muscles you may also experience stronger orgasms and find sex more satisfying.

Talk about it with your partner. 

While this is an uncomfortable discussion to have, the mere act of telling your partner about your condition may relieve some of the stress associated with it. 

Talk to your Doctor.

If you've tried the steps above to no avail, consider talking to your doctor about your condition. Incontinence is not a normal part of aging and many things can be done to correct the situation. Your doctor can tell you about options that will best fit your needs.  Need help finding a physician?  Click here.

Fecal Incontinence In The Bedroom

Fecal Incontinence In The Bedroom

Is fecal incontinence (FI) affecting your romantic relationships?

If you are single, do you avoid meeting new people, dating, or sex? If you're married, are you worried that your partner no longer finds you attractive? Dealing with incontinence during intimate moments can be a frustrating experience for both partners. Most of us have problems talking about sex at all, and talking about problems in the bedroom is just about impossible. It might be an uncomfortable conversation to have with your partner, but talking about Fecal Incontinence (FI) is the best way to gain the support and understanding needed to get back to enjoying your sex life again.

The causes of FI can include inflammatory bowel disease (IBD), irritable bowel syndrome (IBS), constipation, diarrhea and, for women, weakened muscles in the anus or rectum after childbirth. In most cases, incontinence is not a permanent condition, and will improve when the cause is treated. If incontinence is a long-term issue, then dealing with the problem directly and how it affects romance becomes even more important.

Talking about fecal incontinence with your healthcare provider.

The first step to improving your sex life will be to work with your doctor, or nurse practitioner, to explore the ways that you can treat the cause of the incontinence. Make sure your healthcare provider is aware that incontinence is affecting your romantic relationships and that you are interested in finding ways to treat the problem. This can be a difficult conversation so use the words you are most comfortable with and remember that your healthcare provider has heard about all of these problems before. The treatment of FI will depend largely on the cause. Your doctor or nurse practitioner may have some new suggestions for you once you have made him or her aware of your concerns.

Think about ways your sex life can be improved. If you're avoiding intimacy, obviously you'll want to get back to it! How can you and your partner work together to make your romantic moments more fulfilling for both of you? When is incontinence the most troublesome and how can you improve it so you can enjoy your sex life? If you find that incontinence is a problem during intercourse, perhaps exploring different positions or other forms of intimacy would be helpful. If avoiding intimacy is causing you emotional stress and worsening your symptoms, perhaps beginning to talk about it with your partner will help lower your stress level.

Discussing FI with your partner.

Now for the more difficult conversation: discussing how FI affects your sex life with your current or future partner. If your partner is not already aware of the condition that's causing the incontinence, you'll want to discuss it first. You can talk about all the ways your life is affected, including everything from your job to your feelings about your medical problems. Your partner may not be aware of the stress and difficulties you are having and that you are worried about how it's affecting your relationship.

Once you both have the whole picture in mind, you can move on to discussing how FI affects your intimate moments. Bring up the ideas you have on how you can be more comfortable being romantic. Your partner will likely also have some suggestions and ideas. Work together to come up with some solutions, whether they are short-term or long-term.

When you need more help.

The above approaches will be helpful in a perfect world. But we're often not in situations or in relationships that are perfect. If your healthcare provider has not proven to be helpful you have the option of searching for a provider who is more willing to listen to your concerns. If your partner does not want to talk about your intimacy concerns, you don't have that same options. In that case you will want to seek outside help. The best option is to seek counseling as a couple but if your partner is unable or unwilling, you should seek help alone.