When we think about the importance of exercising our muscles, what come to mind first probably things like the biceps, quadriceps, and abdominal muscles—not the muscles of the pelvic floor. But these muscles shouldn’t be overlooked, considering they help support some of our organs. It turns out they play a role in women’s sexual health, too.
“With orgasm, there is a series of involuntary but specific muscle contractions that happen in the pelvic floor,” says Maryla Podgajny, registered physiotherapist and pelvic-floor physiotherapist at Vancouver’s Reformotiv Physio and Pilates. “The idea that the stronger your pelvic floor, the better orgasm you’re going to have is not necessarily true, but it’s definitely helpful to have a muscle that’s working well. You might have better sensation and more sensation.
“People don’t often talk about the pelvic floor, but they should because it really does make difference in quality of life,” adds Podgajny, noting that men also have pelvic-floor muscles—and the potential for imbalances in them. “All can benefit from exercises for the pelvic floor.”
The muscles in the pelvic floor act like a hammock, stretching from the public bone to the end of the coccyx, or tailbone, holding the bladder, bowel, and uterus in place.
“Having a healthy pelvic floor is linked to better sexual health and experiences for some women,” says Lacey Forsyth, registered physiotherapist and owner of Bump Physio & Co in Port Moody. “A woman needs to be able to both fully contract and relax her pelvic-floor muscles in order to have a strong foundation for intercourse. If women’s pelvic-floor muscles are weak, for example, it can affect their ability to climax and reach orgasm as well as to maintain sufficient muscle tone for pleasure with penetrative intercourse. Sometimes clients report they don’t feel much when they have sex with their partners, and it may be due to low pelvic tone, muscle atrophy, or a decreased awareness of their pelvic-floor muscles. “Another area where women’s sexual pleasure might be impacted is during orgasm,” she says. “When a woman orgasms, her pelvic floor muscles maximally contract, followed by a full relaxation. If they are lacking in muscle strength, their orgasms are less intense or in some cases won’t happen at all.”
Exercises for the pelvic-floor muscles are sometimes called Kegels, taking their name from the American gynecologist who first noted that childbirth could lead to a weak pelvic floor and that these muscles could be exercised like any other. He developed a compressible bulb that went into the vagina attached to a dial; when women squeezed with their pelvic floor muscles, the dial provided visual feedback on the strength of that contraction.
During orgasm, the muscles contract anywhere from three to 15 times, on average, according to Dr. Jen Gunter, author of the newly released Vagina Bible: The Vulva and the Vagina—Separating the Myth From the Medicine. Host of the CBC docuseries Jensplaining, the Winnipeg-born obstetrician/gynecologist explains that relaxation and injury of the pelvic floor, most often in the form of tearing of the muscles during childbirth, can lead to incontinence and prolapse. Reduced orgasm strength can also result.
Exercises can be part of the therapeutic approach for women who have difficulty achieving orgasm or who experience weak orgasms. Before starting them, the first step is learning how to isolate the pelvic-floor muscles. There are a few ways to do this, including imagining the exercise as “picking up a marble with your vagina”, according to Gunter. Another is to try to stop the flow of urine. “If you slow or stop your stream, you are using the right muscles,” Gunter writes.
Once you feel comfortable with what and where the muscles of the pelvic floor actually are, there are two types of exercises you can do: sustained contractions involve holding the squeeze for five seconds, then relaxing for 10 seconds; the goal is to build up the length of the contractions to 10 seconds. “Quick flicks”, meanwhile, are simple contractions and releases lasting one or two seconds. (Gunter details the recommended number of daily reps for each in her book.)
It will take six to 12 weeks to see improvement, but Gunter suggests four to five months of daily practise.
Another helpful strategy is to practise diaphragmatic breathing—also known as deep belly breathing—on a day-to-day basis, Forsyth says.
“As adults, we typically breathe into our shoulders and upper chest, especially during times of stress,” Forsyth says. “We have moved away from breathing low down into our abdomen, hips, and pelvis. By incorporating deep breathing again into our day-to-day activities, this helps us release the tension in our pelvic floor and create a gentle pelvic-floor muscle contraction with each breath we take, normalizing pelvic-floor muscle function.
There’s another potential problem related to the muscles of the pelvis: if a woman’s pelvic floor is hypertonic—or too tight—she may be unable to relax her muscles to accommodate penetration.
“This can have a significant impact on their intimate relationships and sexual health, because sex is painful,” Forsyth says. “Sex should never be painful for anyone.”