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Sex and Your Pelvic Floor

January 27, 2017 | Mary South, MD, MHA


As Valentine’s Day approaches, we may find ourselves or our partners in a more amorous mood. Quite frankly, sexual intercourse or being intimate is a very important way for a couple to connect and to feel close. However, some women tell me that they have lost some of the sensation they used to experience during sex or that they feel they are “too loose” after giving birth to their children. Some even say that they find it harder and harder to achieve an orgasm.

One of the reasons for these complaints can be attributed to the weakening of the pelvic floor muscles. The pelvic floor muscles, which are also known as the levator ani muscles or to most women as “Kegel muscles,” can weaken during pregnancy and childbirth, after pelvic surgery (i.e. hysterectomy), and even secondary to decreased physical activity and aging. When pelvic floor muscles are weak, some women experience decreased sensation during sex and a decreased sexual response. In addition, weakened pelvic floor muscles are more prone to spasm, which can result in significant pain during sex.

So, doing your Kegel exercises is important to strengthen your muscles and keep them healthy. Just like strengthening your biceps with bicep curls, repetitively squeezing and relaxing your pelvic floor muscles results in increased strength. In order to identify the Kegel muscles, I usually tell women to imagine they are trying to hold back gas in a crowded elevator…slightly embarrassing and crude, I know, but most people can relate. I also suggest that if you are squeezing your buttocks, your thighs or your abs, you are not isolating the Kegel muscles. (A trained pelvic floor physical therapist can also assist you if you can’t seem to identify the correct muscles to squeeze.) Once you know what you need to squeeze, the rule of thumb or “goal,” is to hold the squeeze for 10 seconds, relax for 10 seconds, and repeat 8-10 times. This cycle should be done three times per day. Some women will find they can’t hold the squeeze that long, so working up to that from your baseline is usually a good idea. You don’t want to tire those muscles out if you really are in an elevator and need to refrain from passing gas!

Women who have worked to strengthen their pelvic floor muscles report increased sensation during sex. Others state they have been able to achieve climax for the first time in years. So in preparation for Valentine’s Day, or if you are not one to celebrate Hallmark Holidays but just want to enjoy sex more…work those muscles!

See articles like this and more in The Women’s Journal.

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