Better sex and a happier uterus: Why every woman should do Kegel exercises
How to exercise the pelvic floor muscles you didn’t even know existed
I’m in the office conference room, on the phone, as a gentle voice encourages me to “clench”, “release, “clench”, “release”. It’s not my fist or teeth she’s coaching, but my pelvic floor muscles, a body part that I didn’t even know existed. This is probably true for most women, even though the pelvic floor — muscles which support organs including the bladder, uterus and intestines — plays an important role whether you’re a teenager, prenatal, postnatal or menopausal.
Vanshika Gupta-Adukia, pregnancy specialist, founder of Therhappy and pelvic floor physiotherapist, asks you to picture your pelvic floor muscles like a hammock. The hammock is tied properly to two poles and the weight on it isn’t significant so it retains its shape and elasticity. The minute you start putting more weight on that hammock, you’re going to see it sagging down towards the floor.
“The pelvic floor is tied between two ends of your pelvic bones and the more load or pressure on it, the more stress it’s going to take,” explains Gupta-Adukia.
Importance of pelvic floor strength and how it can weaken
Pregnant women often complain about having to use the washroom a lot. The urgency to keep peeing is understandable when your uterus is pressing against your bladder. “But what about when a woman coughs, laughs or sneezes, and she feels a bit of urine trickling out?” says Gupta-Adukia. The lack of control is not a ‘pregnancy thing’ which sorts itself out. It means your pelvic floor muscles are weak. And like any other muscle in your body, it benefits from being regularly worked out.
Apart from having babies, hormonal imbalances can wreak havoc on the pelvic floor as well. Gupta-Adukia says, “Very close to menopause, women experience a drop in oestrogen levels. Oestrogen has a big role to play in pelvic floor musculature and physiology, so during menopause, it starts becoming weak.”
Though incontinence in older women is attributed to old age, Gupta-Adukia says, “If you ask these women their obstetrics history– how many kids have you had? How many vaginal deliveries? You’ll see a close link and connect the dots.”‘
Pelvic floor exercises also help improve sexual pleasure after childbirth. Interestingly, even if you have never given birth but find sex painful because of involuntary spasms, Kegels could help you control the vaginal muscles, making penetration easier.
She advises pelvic floor exercises be integrated into pre- and postnatal exercise routines. Even with a strong and trained pelvic floor, there will be a strain but not to a degree of extreme repercussions like incontinence and organ prolapse.
How to identify and strengthen your pelvic floor muscles
This first step towards strengthening our pelvic floor muscles, which Gupta-Adukia says women of all ages should do, is by identifying the muscles. There are two ways you can do this:
1. Imagine you have to pee but there’s no washroom around. What do you do to hold it? You clench. You feel the muscles contracting. That distinct squeeze and lift—those are our pelvic floor muscles working.
2. Next time you go to the washroom and you’re urinating, stop mid flow. “The muscles you’re using are the ones you’re going to engage when you’re performing your pelvic floor exercises,” says Gupta-Adukia. She cautions that this should not be done as part of the routine. This is purely to identify the muscles. A stagnation in urination can have negative results, even UTIs.
Pelvic floor exercises for beginners
Gupta-Adukia teaches her patients one exercise at a time. Once you’ve mastered one, then she moves onto the next level. Through all the exercises, we need to breathe normally and relax the muscles in our stomach, buttocks and thighs.
Pulses – Sit in a comfortable position. You can even lie down. Remember the muscles we previously identified? You contract, hold for a second and release. This is something we can easily do a couple of times during the day. Gupta-Adukia says to start with 15 counts and work your way up.
Contract and hold – In this exercise, you contract your muscles and hold it for 2-3 counts and then release. This can be done 10 times in a row, and the exercise can be done 3-4 times in a day.
“For any exercise, it’s crucial to keep in the mind the intensity at which you’re contracting. At which count does the intensity of the contraction start dipping? That count is your fatigue point. It can be as early as 7 or high as 20-30. For every individual it varies, the number of counts don’t indicate how weak or strong your pelvic floor is,” says Gupta-Adukia.
“If you drop at count 15, don’t look at trying 20 or 25 right away. Do sets of 15 counts. After a week if you realise you can do it till 20 and your intensity remains the same that means you’ve progressed. That is your self-progress check method,” says Gupta-Adukia.
The great thing about pelvic floor exercises is that you can pretty much do it anywhere at any time. Nobody knows it’s going on. There are no special equipment (other than what nature gave us), attire or space requirements. So, there’s no real excuse not to do them, right? In fact, I’m doing them right now.
Dr. Vanshika Gupta-Adukia is a Pregnancy Specialist and the Founder of Therhappy. She is an internationally certified Pre and Post Natal Fitness Educator, a CAPPA certified Childbirth & Lactation Educator Counselor and a Pelvic Floor Physiotherapist. Read more about her work here and follow Therhappy on Instagram.