From Cardi B's song "WAP" to Gweneth Paltrow's endorsement (then rescinded) of Yoni eggs, people are talking about their pelvic floor health now more than ever. But what exactly is a pelvic floor—and does it really matter if you neglect your Kegels?
The pelvic floor muscles are a group of muscles located at the base of the pelvis. "The muscles within that area support the bowel, bladder, as well as the uterus and vagina," OB-GYN Nichole Butler, tells HelloGiggles. Essentially, the pelvic floor is a critical set of muscles that support the body's urinary and bowel health, as well as sexual wellness.
The pelvic floor, like with all muscles, can be strengthened with isolated exercises or weakened through trauma or underuse. A weak pelvic floor can result in painful sex and incontinence (i.e. bladder leakage). According to the Cleveland Clinic, pelvic floor issues are often associated with pregnancy, weight, age, trauma to the pelvic area, or even long-term exercise like repetitive lifting.
But because of its sensitive, and often embarrassing nature, many women are hesitant to talk openly about their pelvic floor and its impact on their sex life and health. "Opening up the uncomfortable conversation is really important," says co-founder of the Kegel device Yarlap, MaryEllen Reider, "You should never feel embarrassment or shame when it comes to bettering your health."
As a lesbian sex writer with a degree in gender and sexuality, I and a few experts are tackling the top three myths about pelvic floor health and breaking them down one by one (so you don't have to).
Pelvic health myths:
1. Pelvic floor issues are rare.
Though some folks may hesitate to disclose their pelvic floor disorder, pelvic organ prolapse, dyspareunia, and other difficulties accessing arousal or orgasm, these issues are quite common. "If adults with incontinence were to form a country," says Reider, "it would be the third-largest country in the world."
For instance, The Center for Women's Pelvic Health at UCLA estimates that 1 in 3 people with vulvas will experience pelvic floor disorder (PFD) in their lifetime. The treatments for PFDs vary on individual need, but options include physical therapy, medication, pessaries, and surgery.
2. You should be doing Kegels every day.
Kegels, or pelvic floor muscle exercises, are like any other exercise meant to strengthen muscles and improve performance, says Dr. Butler. "Kegel exercises are exercises where you contract and release [the pelvic floor] muscles," says Dr. Butler, "Essentially this exercise is the same one that if you were trying to stop urine or gas. [When] you contract those muscles, those are kegel exercises."
Improved pelvic floor function often means better bladder control, and even preventing PFDs from occurring in the first place. But tightening your pelvic floor muscles all the time is not necessarily advisable.
However, when you do pelvic floor exercises, they should be done with proper form, knowledge, and attention. According to Nursing Times, a pelvic floor rehabilitation program should be tailored to the specific needs and abilities of the patient and can be stepped up progressively over the course of treatment. Persistence is often more important than intensity when it comes to muscle training; the Nursing Times indicates that improvement of conditions can take up to three months.
3. Kegels can fix any pelvic floor issue.
Pelvic floor exercises, when performed properly, do improve and address symptoms associated with PFDs. According to one 2012 study of almost 8,500 women, found that training the pelvic floor muscles of pregnant women reduced the risk of urinary incontinence by 50% prenatally and 35% postnatally.
However, Kegels and other training exercises are not always enough to resolve, reduce, or prevent issues like incontinence or painful intercourse. Physical therapy, pelvic floor devices, or even surgery may be needed to fully address symptoms. Dr. Butler has personally seen pelvic floor physical therapy "work miracles," but the most important thing when it comes to pelvic floor health is being attuned to your body's needs and having regular, honest conversations with your doctor.
No matter what stage of life you're in—looking to improve your sex life, expecting a child, or going through menopause—you can take charge of your pelvic floor health and either prevent or improve, pelvic floor issues.