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.

Q: Can I believe what I read about a product for vaginal tightening?

You asked. Dr. Barb answered.I’m not sure which "tightening product" you’ve seen. The only way to tighten the vagina is to tighten the surrounding muscles. Kegel exercises (we give instructions on our website) target the muscles of the pelvic floor. And many women find that exercise tools (like vaginal weights or a barbell) helps them be sure they’re flexing the right muscles. I also recommend the Intensity Pelvic Tone Vibrator, which uses a combination of electrical pulses and vibration to build pelvic tone.

Q: Can I tighten my vagina?

You can’t really tighten your vagina. What you can do is tighten your pelvic floor muscles, which surround the vagina. We offer a variety of products designed to help you improve pelvic floor tone, as well as instructions on how to do Kegel exercises.

There are some laser treatments that have been offered to tighten the vagina. They’re relatively new treatment options, and the outcomes seem quite variable.

Strengthen your floor!I hope this helps! (And I’ll note that strengthening your pelvic floor is also good for preventing incontinence, so there’s lots of reason to develop the Kegel habit!)

 

 

Q: Do Kegel exercises really help with incontinence?

The short answer is yes, Kegel exercises, which strengthen the pelvic floor, do help prevent and then counter incontinence. The exercises need to be done consistently, and they need to be done "correctly," which means flexing the right muscles. You can read how to do the exercises on your own on our website, but there are also tools available that can help.

I saw in my practice last week two women who said their incontinence was 80 percent better after six to eight weeks of daily use of the Intensity pelvic tone vibrator. The Intensity uses electrical pulses to contract the muscles of the pelvic floor; the vibration leads to orgasm, which also contracts those muscles.

Luna BeadsSimpler options for targeting the right muscles with Kegel exercises are vaginal weights (like Luna Beads) or BFIT Classic Vaginal Weights; Luna Beads are the most popular option at the MiddlesexMD shop). Any of these options inserted in the vagina as directed will help you assure you're flexing the pelvic floor as you intend. With Luna Beads, you can increase the weight for more resistance as you build muscle tone.

The key in any case, with or without tools, is to be faithful in doing the exercises! It's definitely worth it--for lots of reasons that keep you active and enjoying life.

Q: Why would I need physical therapy for the pelvis?

The pelvic floor is made up of multiple muscles and supporting tendons. They act like a hammock or trampoline to support a number of vital organs: the bladder and urethra, uterus and vagina, and rectum and anus, to name a few. It's a very unique area of the body, involving organs that play a role in varied and important functions: urination, defecation, sex, and childbirth.

Many things can disrupt the proper function of the pelvic floor; childbirth, natural aging, and menopause are common. Surgery can have an immediate effect. Sexual trauma may result in damage, and so can actions as simple as lifting or coughing. Symptoms of the pelvic floor not behaving properly might be urinary incontinence (involuntary loss of urine), painful sex, or constipation or difficulty moving bowels. Pelvic organ prolapse can cause or exacerbate some of those symptoms; that's when one or more of the organs resting on the pelvic floor sag into one another.

A discussion with your provider about your symptoms, accompanied by a good pelvic exam, can help in determining whether pelvic physical therapy is likely to help your condition. To get the best outcome it is best to find someone who specializes in this area of the body. A great pelvic physical therapist can work magic!

A common reason for referring to physical therapy is urinary incontinence. As part of treatment, physical therapists use electrical muscle stimulation, employing devices that stimulate the muscles of the pelvic floor to teach them to properly contract and relax. One of these devices recently became available for home use. In addition to increasing continence, Intensity also treats orgasmic dysfunction (difficulty achieving orgasm). It works in two ways: providing electrical stimulation to the pelvic muscles (you increase the stimulation as the muscles get stronger) and offering a very intense vibration that improves the ability to orgasm. Orgasm is, after all, a series of very intense muscle contractions; as the muscles grow stronger, you improve orgasm. So far my patients have given Intensity two thumbs up! Other, lower-tech options to improve pelvic floor muscle function are vaginal weights and barbells.

Q: Why do I have cramps after a hysterectomy?

You describe cramps, not unlike menstrual cramps, after masturbation. Orgasm includes contraction of pelvic floor muscles, and it sounds like you're experiencing some spasms of those muscles. Radical hysterectomies often require tissue removal or dissection surrounding the uterus and ovaries. It's likely your spasms are caused within nerves and muscles that are still healing.

I suspect this will improve with continued healing, but using an anti-inflammatory medication like ibuprofen may help relieve the pain. If, three months or so after surgery, when most healing has taken place, the spasms and pain persist, a consultation with a pelvic floor physical therapist may be helpful. They can assess the muscles and nerves of the pelvic floor and often remedy persistent pain.

Continue that healing work! I'm hopeful the pain will resolve itself.

Working out like Fifty Shades

We know about muscles. We use them; maybe we tone them; maybe we watch them get saggy over the years.

But the vagina?

Yep. That too.

Our pelvic floor is encased in muscle. And just like all the rest of our muscles, it needs regular exercise, especially as we grow older. Age, childbirth, and loss of estrogen take their toll on all that musculature. Like everything else in our anatomy, it ain’t what it used to be.

We’ve talked about the importance of vaginal exercise before—in the form of kegels. That clenching-and-holding of the pelvic floor muscles helps keep our pelvic floor muscles toned, which in turn keeps us continent, keeps our abdominal organs in place, and creates a firm “vaginal embrace” that our partners ought to find very, um, invigorating.

What many of us don’t know is that a handy exercise tool exists to help us tone our pelvic floor. We call them vaginal weights. (A similar version is called ben wa balls, which is an ancient Eastern sex toy that uses weighted balls of various materials. These are said to be mildly stimulating.)

Ana of Fifty Shades renown tucked these little numbers into her vagina for a hot date with Christian and “wore” them throughout the evening. This is a tricky maneuver, requiring good muscle tone and constant attention. Stand up without clenching those pelvic muscles, and you’ll lose your balls, so to speak.

I’m thinking that, by the end of the evening, Ana may have experienced some fatigue “downtown,” but, what with rocks in her sock, she surely was reminded at every turn about where the evening was headed.

In the MiddlesexMD store you’ll find our Luna Beads—four interchangeable balls that allow you to increase the weight you’re carrying. You could try to imitate Ana’s trick on your next date night, but I’d suggest trying them out at home until you’re confident you can keep the things where they belong. Your muscles will thank you, and your partner may, too.

*Luv* Your Pelvic Floor

The pelvic floor may be the most neglected and underrated part of our anatomy—on the level of the pinkie toe or the back of the knee. But for sheer impact on our quality of life, we neglect the pelvic floor to our peril. Those muscles play a critical role in everyday function, like bladder and bowel control, orgasm, and keeping our organs where they belong.

Ergo, not a good idea to neglect the pelvic floor.

Maybe you noticed that you had less urinary control after the birth of a child. Maybe you noticed a slackening of the “vaginal embrace” during sex. Maybe lately you’re even feeling like you’re sitting on a stone “down there” or have a little bulging protrusion in your vagina. Maybe you have to urinate more often or you get more urinary tract infections. Maybe sex is more painful.

Did I mention it’s not a good idea to neglect the pelvic floor muscles?

The pelvic floor is like a sling that runs from our pubic bone in front to our tailbone in back and to our hip bones on either side. (Or—as one doctor put it: once, it was like a trampoline; now, it’s like a hammock.) It performs a fancy figure eight around the vagina, urethra, and anus, controlling, supporting, and maintaining good function in those unsung and important areas.

But it’s also a deep muscle that works in tandem with other muscles in the back and abdomen. And all these muscles have to be balanced and working harmoniously for us to be pain-free and without uncomfortable symptoms, such as that bulge that signals a uterine prolapse or that tendency to “laugh and leak.”

This is because the pelvic floor is subjected to unique demands compared to other body parts. It literally holds our organs in place, so pressure from childbirth, obesity, trauma, heavy lifting, even hard coughing, and, of course, simply getting older, can weaken the muscle and cause things to sag over time.

Further, as we lose estrogen during menopause, this muscle tends to lose tone. And since the pelvic floor surrounds the vagina, its ability to help out with orgasm and that nice, firm vaginal embrace is compromised, too. Darn it.

The crazy thing is that about half of women will experience some level of incontinence or prolapse in the course of a lifetime often without saying a word, sometimes for decades. Surgical procedures, in addition to carrying all the risks of major surgeries, are controversial and without good long-term outcomes. One-third of women who have had surgery for incontinence return for a second surgery.

Now, you could have surgery to fix incontinence or prolapse. But why not start with a safe, simple approach? Like maintaining a healthy weight. Like not smoking. Like exercise.

Like kegels. (You knew I was going there.)

Regularly exercising and toning your pelvic floor with kegel exercises is cheap, noninvasive, and incredibly effective in reversing the symptoms of incontinence and prolapse. Plus, a well-toned pelvic floor will have better blood flow and nerve pathways, which amounts to more sensation, stronger orgasm, and a nice, firm vaginal embrace.

The tricky part is to exercise the right muscles. You shouldn’t be tightening the abdomen or the buttocks. You shouldn’t be holding your breath. Our website has a little primer for correctly doing kegels. Kegel exercise tools, such as vaginal weights, may also help because you have to exercise the right muscles to hold them in place.

There are even some smart-phone apps to help you with the regimen. (You know it’s gone mainstream when there’s an app.)

First, discuss your symptoms with your doctor to make sure there aren’t any complicating issues involved. And then… start kegeling!

Q: Will Kegel exercises help me recover from pelvic floor damage from trauma?

It sounds like you could benefit from a really good pelvic floor physical therapist. While many physical therapists have some training with the pelvic floor, there are only a few with that specialty. Find out who that person is in your community and ask for a referral to him or her.

Physical therapists will have tools that help them determine the strength of the muscles, which helps them make an informed plan for properly improving the tone; Kegel exercises are just one tool in that process. Sometimes after a trauma there is muscle spasm; part of the therapy may be training certain muscles to relax.

It's a good approach to see how far you can get with exercise and therapy before you consider reconstructive surgery. Good luck with your continued recovery from your accident!

Our Secret Recipe for Sex after Menopause

The post title is just tongue-in-cheek, folks. A little health writing humor, poking a stick at the whole idea of health “secrets.”

We don’t believe in keeping information about attaining good health secret.

So here, today, long before going live with our website, we are happy to divulge our recipe for sex after menopause. The ingredients are:

Tada!  Whooot!!! We have balloons falling and confetti rising over here at MsMD headquarters!! How about you?! No?

Wait, No?

Maybe you don’t realize how hard it is to distill good-sex-after-menopause down to an easy-to-remember system? So let me explain: Months ago, we began our work with a hard look at the American Psychiatric Association's DSM-IV description of disorders contributing to Women’s Sexual Dysfunction (There’s a phrase we won’t use a lot around here, because it worries us. If we don’t yet understand Women’s Sexual Function, how can we comfortably describe its dysfunction?).

We embraced (and strive to remain mindful of) the point of view of women’s sexual problems developed by the New View Campaign, and their concerns about the medicalization of human sexuality. We reduced by our focus on peri-menopausal and menopausal women. Filtered all of these concerns through recent research and publications by members of the North American Menopause Society (NAMS) and the International Society for the Study of Women’s Sexual Health (ISSWSH).

We surveyed current literature on female sexuality. We added recent work by sex researchers and therapists and coaches, relationship coaches and mindfulness gurus.

That was the first step.

The next step was sorting all of the helpful advice, tips, skills, and learning into clear descriptions of conditions and pragmatic actions so that women in menopause can understand exactly what is going on with their bodies and what they can do about it if they want things to be different.

We didn’t go looking for the recipe. It surfaced from the work, organically. We began to see how all of the latest and best advice of medical, psychiatric, and sex researchers and coaches, seeking to help older women enjoy their sexuality, clustered into just a few central goals. What does a woman need to do to enjoy sex after menopause? (Assuming, of course, that she wants to enjoy sex after menopause at all. Because that is still her choice.)

1. Knowledge

She needs to know the physiology of menopause, so she understands what is happening when it happens, and especially that though her experiences are unique to her, she's not alone. And she needs to know some new sexual techniques that will keep sex enjoyable as she ages.

2. Vaginal Comfort

She needs to learn how to take care of her vulvo-vaginal tissues so that sex remains comfortable.

3. Pelvic Tone

She needs to learn how and why to strengthen and maintain her pelvic girdle to encourage circulation and maintain or strengthen her orgasms.

4. Genital Sensation

She needs to compensate for less blood flow and less sensitivity in her genital tissues by providing herself with more stimulation, more sexual sensation.

5. Emotional Intimacy

She needs what every woman needs at every age for sex to be good. Sex needs to be intimate. It needs to mindfully create and reinforce a real connection. There it is. No secrets. When we take our site live in April, you’ll get all the rest, descriptions of conditions that get in the way of achieving these five goals, actions you can discuss with your doctor or take on your own to enjoy sexuality for life, and products we have selected to help you on your way.