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Behind Closed Doors: What Are Kegels Really?

EDITORIAL FEATURES

I subscribe to many a newsletter in hopes that I'll bring you Fleshlings the best and boldest sex info I can. Kim Anami (the lady who carries teapots and pineapples and other strange heavy objects from her vagina) is one of them, because though she's rather "woo," many of her points are very salient. This particular video grabbed my attention immediately, probably because it was all in upper case, but also because of its controversial title: DON'T Do Your Kegels. I encourage you to watch the short video before we begin.

Eh hem. Ok then, moving on. 

Let's be clear on one thing: clenching your PC muscles (your pubococcygeus muscles, in Science Speak) isn't flapping your vagina in the wind as Kim says here, but it's also not really a kegel, according to, I don't know, Arnold Kegel, the renowned gynecologist responsible for the practice. Strengthening your pelvic floor will improve your vagina's tightness and responsiveness and make you more likely to orgasm, yes, but merely squeezing your muscles the way most magazines advise is not exactly going to achieve that particular phenomenon. That's why there's a fair amount of research suggesting that women who clench their vags at work three times a day aren't really doing much for their sex lives

I find this miseducation to be particularly aggravating because Arnold Kegel wrote an article about the who, what, when, where, and why of these pelvic floor exercises that will tell you everything you need to know. It takes five minutes to read and is reprinted many, many places on the internet. Much like with the pros and cons of saturated fat, daily boozing, and masturbation, people seem reluctant to personally review actual research, but I digress. I will instead lead you on this kegel journey from the beginning, using what I hope is a more entertaining voice than a gynecologist reporting on his official research might use. Shall we? 

There was an old man named Arnold   

Enter: Arnold Kegel, 1948. The gyno has spent 18 years researching things like prolapse and urinary incontinence along with sexual function, and has made a startling discovery: The PC muscles have fibers and are embedded allllll over the vagina. All over it. It's nuts! He realizes that some women have never had strong PC muscles and some have PC muscles that have weakened post childbirth. No matter! Let's fix it! 

I will know quote directly from the grand doctor's actual article, like the journalist I am:

"Physiologic therapy of genital muscle relaxation is divided into two phases or steps: (1) specific muscle education and (2) resistive exercises of the pubococcygeus and its visceral extensions."

Say what? How do I specifically educate myself about my muscles and how do I create a resistive exercise? (Yes, you will note the first common misconception is just how Kim has described it - you need resistance. We'll get into what he means by that, but I can guarantee one thing: The air in your vaginal canal does not count. 

Your pelvic floor: A kind of PC we can all agree on 

So! Muscle education - why is it important? Well, for starters, the magazines will tell you to clench down there like you would to stop the flow of urine. What they don't tell you is that you can do this wrong, and what's worse, if you do this wrong repeatedly, you will injure yourself and make the problem worse. The entire first phase of Arnie's muscle education includes working with a gynecologist to ensure what you are squeezing is, in fact, your PC musculature. This is a multi-step process, but this is perhaps the most illustrative: 

"Next, the index finger is introduced into the middle third of the vagina, and the patient requested to contract upon it. Normal patients will respond immediately, and a firm grip upon the finger is felt over a wide area. Others, lacking awareness of function of the pubococcygeus, will not respond to the instruction and will often state that they did not know that it was possible to contract vaginal muscles. It is in this group of patients that palpation demonstrates the atrophy of disuse."

Go ahead. Run off to the bathroom to see if you can squeeze your finger slightly upward with your vag. I'll wait here. (Note: As always, I advise you to seek the services of your medical professional to ensure you are doing this correctly. Regardless, it's a fun little experiment, right?)  

Reason No. 1 your kegels may not be working: You're using the wrong muscles to clench. 

"In the effort to contract as though to stop the flow of urine, only a slight twitching of the meatus of the urethra is observed, without retraction of the urethra itself or of the vaginal tissues overlying it. These shallow, superficial contractions are in themselves of no value in the prevention and treatment of genital relaxation and urinary stress incontinence."

Let's say you are doing them right. Should you keep clenching away, on the train and at the gym and when you brush your teeth like Cosmo tells you? 

Feedback, feedback 

Enter: Phase Two of Arnie's treatment, resistive training. He is the inventor of the perineometer for this specific purpose. It serves two important purposes: It gives you feedback (i.e. a barometer of how strong your PC game is and if it is improving) and something to squeeze. That is the resistance he is talking about. And this is a picture of a modern perineometer: 

And here is why Dr. Arnie says this is effective: 

"Resistive exercises of this type have proved most effective in all branches of muscle therapy for the correction of disuse atrophy and for restoration of normal function. Resistive exercises are designed to strengthen the pubococcygeus in all its components, especially the minute end-fibers which, in genital relaxation, have undergone atrophy. This muscle is not accessible to any other therapeutic measure, and its function is rarely improved by surgical procedures."

There are many fun, cool options for applying this kind of a device to your real life, many providing this specific type of resistance and feedback (a reliable measurement for how strong your pelvic muscles are) in a way you can access from your smartphone. Hell, there's even Temple Run for your vagina now. But remember: Before you begin any kind of kegel routine, you need to make sure you're squeezing the right muscles. I repeat: Being able to stop your flow of urine does not automatically mean you are doing this correctly. 

So let's say you hit A+ PC strength, as measured by your contraption. What next? 

"In addition to these exercises, the patient is advised to repeat the same contractions without the apparatus many times a day. The more frequently correct contractions are repeated, the sooner will the muscular function be established as a reflex that does not require any further voluntary effort."

Well then. It would seem you move on to the kind of kegels we are familiar with - the ones when nothing is in your vagina - and then you can stop exercising the damn thing. He didn't leave behind instructions for a maintenance routine, but he did say evidence of improved strength would be a "slight, gradual increase in initial manometric readings [on the device] from a level of 1 to 5mm. Hg. to as high as 20 to 40 mm.Hg. or more." Checking in from time to time to see if your numbers are still up would seem to be maintenance enough. 

It's worth the weight 

Anyone who works in fitness will tell you that many muscles move in tandem, and holistic healthcare practitioners sometimes speak out to advise against neglecting your glutes and core muscles when developing stronger pelvic floor muscles. To create a little balance, squats, deadlifts, and yes, a little yoga is recommended. As I always say, don't neglect the booty! 

Hanging things from your vagina - should you do it? 

As Ms. Anami states in the video, the use of jade eggs really is an ancient practice, and many gynos say that the use of them (and their respective hanging objects) will provide the resistance you need. Finding studies to reflect such results is difficult, though, and of course, they lack the kind of specific feedback that a perineometer will provide about your vaginal strength (and, of course, illuminating info about whether or not you're even doing it the correct way.)

 

Though I certainly can appreciate her dedication to being able to shoot things out of her vagina as a measure of her PC mastery: 

As for me? I own Ben Wa balls out the wazoo (plus an actual vaginal dumbbell) but will stick to devices to that precisely measure my PC strength and let me know when I can put the toy down and merely check in from time to time. Would good ol' Dr. Kegel approve? I like to think so. 


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