Q: Does long-term sitting contribute to pelvic muscle spasms? What can help?

You say you’re using estrogen therapy, have sufficient lubrication, but are experiencing pelvic muscle spasms that cause you some discomfort during sex. You’re wondering whether being sedentary contributes to the problem, and whether a vibrator, which your doctor recommended, may help.

VibratorsIt’s unlikely that sitting too much would contribute to the muscle spasms (although as a doc, I need to recommend more physical activity). Unfortunately, most of the time we don’t have a good explanation as to the cause of muscle spasms. A vibrator works by increasing (through stimulation) blood supply to surrounding tissues, which, in turn, promotes vaginal health. If you choose a vibrator, make sure it’s one you can use internally, not just externally on the clitoris.

The other tool that’s often helpful with muscle spasms is a set of vaginal dilators. These are designed to provide a gentle stretch to pelvic floor muscles to reduce spasm.

I hope this is helpful! Part of the solution is to be confident you can address the issue.

Q: Does the Intensity’s vibration help to strengthen the pelvic floor?

The Intensity Pelvic Tone Vibrator works in two ways: It has electrodes that stimulate the muscles of the pelvic floor, causing them to contract and therefore strengthen. The vibration feature of the Intensity, which you can control separately, improves pelvic floor muscle tone the same way any vibrator does: They all help the user to experience orgasm, which is intense contractions of the pelvic floor. Those contractions, whether from the electric pulses or orgasm, improve muscle tone, just like flexing your bicep does. The contractions also increase blood supply to the pelvis, which improves function and sensation, too.

Yes, orgasm is good for muscle tone! And improved muscle tone can strengthen future orgasms, as well as holding organs in place and preventing or minimizing incontinence. I guess I’d call that a virtuous cycle.

The Things Up With Which We Put

We have recently learned that women will live with incontinence 7 (seven) times longer than men will before seeking help for it. 

Wow.

I am the help, so I had to put this to my friends to help me understand why this would happen, because, well, frankly, I try so hard to be easy to talk with, and so do my colleagues, especially my colleagues and all their care teams in urogenital care.

So why, oh why would it take so long for anyone to come to us with such a difficult problem? No news could be more worrying.

As it turns out, it’s one of those problems many of us imagine is untreatable, undiscussable, more embarrassing because we imagine a leaking bladder makes us somehow… less. I just read the word on an incontinence forum: Unwantable. It broke my heart.

Then it sort of made me mad. Because nothing could be further from the truth! If a leaky bladder made us unwantable, most of us would be unwanted! Because here’s the truth! Humans Leak! I’m a doctor! I know this for a fact. We leak all over, all the time! 

But particularly menopausal women leak. I hardly need to mention that, do I? Sneeze, leak. Laugh, leak. Giggle fit, leak. Dream about peeing, major leak.  

Fully a third of us will experience some form of incontinence in our lifetimes. That’s way too many unwanted people, isn't it? So of course that's not right. Incontinence is just human. And it's got lots of causes. And it's treatable. 

Today’s truth is, there are so many varied and layered causes, treatments and options for managing incontinence that we understand now so much better than before, it's as if we have dozens of baseball bats we can grab hold of to smash that tired old stigma to bits.

But we have to do this out loud, and together, and among all of our friends and acquaintances. Let no one you know not help with the stigma smashing! It especially makes sense for us to pay attention to continence issues, and the great people who are helping us understand it and learn to manage it before it manages us. We look forward to sharing more on this and related topics from our friends at the Below Your Belt, where resources are available for women of every age on all aspects of pelvic health.

Too, this month the National Association for Continence (NAFC) is gearing up with free classes all over the United States, and then continuing all year long with Twitter chats on bladder health to help you learn what you need to know to Stay Strong.

Their message: Kegels are important, yes. But we must learn to do them correctly. And they are not the only way to strengthen your pelvic basket. These coaches will teach us to get to know our whole anatomy and strengthen our entire pelvic arena by teaming up with physical therapists and pelvic floor experts across the country to help all of us learn and gain control that we may have lost or may have never had to begin with.

Knowledge is power. Partnering with a provider you trust can get you that knowledge quickly. Check out Below Your Belt and the NAFC website, where you can find classes, coaches, products, a forum to speak openly and honestly with other people who are experiencing exactly what you are, descriptions of different kinds of incontinence and lots of treatment options. It’s a whole new world for us. We don’t have to just live with any of it any more.