Seriously, You Should Be Doing More Kegels. Here's Why (And How)

"I wish I wasn't afraid to laugh. Or cough." (Photo by Artem Bali/Flickr CC)

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First of all, take a moment to thank your pelvic floor. Because you'll really want to after reading this.

Your pelvis is home to over 1,000 muscles and ligaments, forming a stretchy structure for your reproductive system, urinary organs and the lower portion of your digestive tract.

In other words, all those muscles and connective tissue are quietly working hard to literally keep you — or at least your pelvic bits — together.

However, like many aspects of life, things can go horribly, terribly wrong.

Those muscles that you probably don't even notice can, over time, weaken, atrophy or fail completely. And suddenly, you end up with organs in places where they shouldn't be.

Yes, Virginia, your vagina — among other things — can fall straight out of your body.

While there are different stages and severities, this phenomenon is known as pelvic organ prolapse. And it's surprisingly common — nearly half of all women who have had kids will experience some form of prolapse or pelvic weakening in their lifetime, and about 11 percent of all women (yes, all women) choose to undergo surgery to correct it.

Because it's so prevalent, the consequences, and treatment, vary depending on the severity of the prolapse.

A cross-section of the pelvic muscles (Courtesy of OpenStax) (OpenStax, via Wikimedia)

"Not everybody's symptomatic," said Dr. Andrey Petrikovets, an L.A. urogynecologist who specializes in prolapse cases. "If it doesn't bother you or interfere with your day-to-day life, you can just live with it."

However, a severe prolapse, depending on the affected organ, can cause urinary or fecal incontinence, which, aside from being an obvious quality of life issue, can have serious side effects, like infections.

WAIT, HOW THE HELL DOES THIS EVEN HAPPEN?

Think of all the muscles in your pelvis as a hammock — maybe suspended between two palm trees on a tropical island if you're feeling fancy. Over time, it'll eventually lose its elasticity. The same thing happens to muscles and ligaments, especially if they're subjected to a lot of stress without proper conditioning.

One of the biggest risk factors is - surprise! - childbirth. The uterus can expand as much as 1,000 times its normal size during pregnancy, which is totally normal and amazing. However, that can put a strain on the supporting tissues around it.

Vaginal delivery is especially taxing on the pelvic muscle groups (for obvious reasons), but certain delivery techniques — such as the use of forceps or a vacuum — can increase the likelihood of prolapse.

And let's face it: time isn't on your side either. Age can play a big role in whether your body can keep everything together. Like we mentioned before, menopause is a normal stage in the aging process, but the gradual loss of estrogen can also accelerate muscle atrophy.

Certain ethnic groups are also at higher risk, particularly Latinas and white women. The reason why isn't totally clear, but researchers believe there could be a genetic link. What's more, your job or socioeconomic class can also increase the likelihood of triggering a more severe prolapse.

You may be wondering if your beast-mode CrossFit workout sessions are going to make your bits fall out. The good news: probably not!

In fact, in 2016 a group of researchers decided to find out, by measuring the pelvic pressure placed on a group of female CrossFitters. Their observations couldn't find any definitive evidence that certain lifts create a greater risk than others, but they did find that sit-ups exert more pressure on your nether region than you'd think (pro tip: Try planks instead).

(This should really be the only thing you have to worry about if you're lifting heavy.)

This does assume, of course, that you're not lifting enormous amounts of weight compared with your own body weight and ability.

OK, GREAT - I DON'T WANT THIS TO HAPPEN. HOW DO I PREVENT IT?

Speaking of workouts, there are a few ways you can strengthen the muscles of your pelvic floor.

There's a lot of advice floating around on the internet claiming that doing standard abdominal core exercises will help build complementary strength in that area.

Unfortunately, you're not going to get a strong pelvic floor by doing crunches or mountain climbers — or even going to Barre classes (though it doesn't hurt to do either!).

Instead, you need to specifically target those internal muscles.

"I'll see patients who are really fit, but during a pelvic exam they may not necessarily be able to, or even know how to, recruit the correct pelvic floor muscles," said Petrikovets.

The best way to get up to speed is to do Kegels. These exercises are designed to activate specific muscles that surround the vaginal wall.

Sounds easy, right? Are you doing them right now? Are you sure?

"It does take some education to properly do a Kegel," Petrikovets said.

If you want to be certain, here's a (safe for work) explainer to get you started:

Doing them a few times a day should do the trick, and no one needs to know you're doing them.

There are other targeted exercises you can do to help strengthen some of the larger external muscles as well, and you can do them with your own body weight.

While it is possible to train your pelvic floor to be super strong, as with any exercise, all you need to do is stay consistent.

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(It's ok if you don't get to this point, but kudos if you do.)

BUT WHAT IF THIS HAPPENS TO ME, ANYWAY?

Again, prolapse or pelvic floor disorders aren't all-or-nothing conditions — as anyone who's ever been pregnant and afraid to sneeze can tell you.

Some women don't even know they have prolapse until they see their OB/GYN; and as long as it doesn't cause pain or embarrassment, there's no need to do anything else.

In cases where it's causing problems, your doctor can fit you for a removable device called a pessary, which is designed to provide internal support.

In more extreme cases, surgery is an option. Some procedures will use your own connective tissue, while others utilize artificial slings to hold everything in place.

More doctors are leaning away from using controversial materials like the transvaginal mesh, which is now the subject of many class-action lawsuits for their potential to cause painful and sometimes irreversible injuries.

But as we like to say here on LADYist, you need to talk to your doctor as soon as possible if you feel like something is wrong.

According to the National Association for Incontinence, it takes women on average more than six years to bring up the issue with their doctor. And as we've said before, waiting to delay care can have serious consequences for your health.

If you think you need additional help, consider seeing a physical therapist who specializes in treating pelvic floor disorders. They can come up with a treatment plan that works for your specific situation.

In the meantime, keep doing those Kegels — your body will thank you for it.


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