By Veronique Adams
Before I gave birth to my first child, I asked my husband something that had started to concern me. I was shortly going to be passing a small human being out my birth canal and already the relaxin hormone that helps such a miracle happen was impacting. I asked him, frankly, “what if, after birth, sex feels like a sausage in the grand canyon?”
After having a baby, it’s not unusual for women to feel their vagina is more loose or dry than usual, and have perineal pain or pain during sex. Nor is it uncommon for women to experience incontinence after childbirth. Pelvic floor exercises can help limit this. They can also help sex feel better because pelvic floor muscles are integral to achieving an orgasm.
You can do pelvic floor exercises anywhere and at any time, either sitting or standing up:
- squeeze and draw in your anus at the same time, and close up and draw your vagina upwards
- do it quickly, tightening and releasing the muscles immediately
- then do it slowly, holding the contractions for as long as you can, but no more than 10 seconds, before you relax
- repeat each exercise 10 times, 4 to 6 times a day
You may find it helps to imagine you’re stopping a bowel movement, holding in a tampon or stopping yourself urinating.
I would do the exercises each time the car was at traffic lights, queuing for a check-out in the shops, or watching TV. A great tip I received from my osteopath was to do the exercises whilst standing pigeon toed. By having your toes pointed inwards together, you isolate the pelvic floor muscles and ‘switch off’ your butt muscles – so you’re really working the area you want to improve!
I thought I’d done okay after childbirth with my pelvic floor (or Kegel) exercises. But when I climbed on a trampoline with my youngest I realised things weren’t quite as tight as I’d hoped. If your pelvic floor is weak, any increase in pressure – such as a good cough, let alone jumping on a trampoline! – can overcome the muscles and urine leaks out.
Childbirth weakens your pelvic floor, as does getting older – this is especially the case after menopause. Even now, years after child birth, I notice hormone shifts in my body can impact the ‘quality’ of my pelvic floor. Stress incontinence can worsen during the week before your menstrual period. Lowered oestrogen levels at this point in your cycle can lead to lower muscular pressure, increasing chances of leakage. This is why the incidence of stress incontinence increases following menopause.
About six out of ten cases of stress incontinence will improve by strengthening the pelvic floor muscles. But it won’t be good enough to squeeze the muscles a few times only when you remember.
If self-help is unsuccessful you can get a referral from your GP to see a physiotherapist or a continence adviser. They will ensure you are squeezing the correct muscles.
They may suggest other options, including electrical stimulation or increasingly heavy vaginal cones/weights to work very weak muscles – such as playballs, the Yany or the battery-operated Miu Miu kegel exerciser found on The MoS store (ranging between $60 and $100 excl. delivery).
But here’s a warning: too tight isn’t good either!
Getting your pelvic floor in shape doesn’t just means overcoming stress incontinence. Remember, your pelvic floor muscles are integral to achieving an orgasm. But please don’t confuse having a healthy pelvic floor with hyper tense pelvic floor muscles. When you do a kegel, you are doing a muscular contraction, and if you already have a tight pelvic floor, contracting these muscles will only make it tighter, making your pelvic floor problems worse.
Your pelvic floor muscles are the only group of muscles in the body that never get to rest. If they completely relaxed you would be incontinent. They are working all the time to maintain continence, support pelvic organs, and to contribute to your posture and stability.
Therefore, these muscles are “working out” all the time, and don’t follow the same rules as the other muscle groups in our body. If you do get carried away with kegels and over-strengthen your pelvic floor muscles, they can become too tight, which in turn can cause dysfunction and symptoms, such as pain, urinary urgency and frequency, among others.