Copyright © 2009 by Amy Stein. Click here for terms of use.
Everybody wants a better sex life—and there's no shortage of advice on how to get one.
Some say it's a matter of position. Others say it's all about what you eat. Still others insist it's a question of hormones, pure and simple. There are those who tell you environment is everything and that at the right time of day, with the right mood music and appropriately scented candles, you can't miss. And of course, in this day and age, one of the most common prescriptions for better sex is to take a pill.
None of these suggestions is necessarily wrong. Yet one of the best ways to have a better sex life is also one of the simplest: strengthen your pelvic floor if it is weak, or stretch and relax it if the muscles have shortened or are tight.
The reason for the strengthening is simple: the muscles, nerves, and tissues that make up the pelvic floor are essential to sexual arousal and sexual fulfillment in both men and women. So it follows that the stronger and healthier your pelvic floor, the better your sexual performance and the more intense your sexual pleasure. In fact, just by doing the exercise program in Chapter 4 of this book, you're likely to improve your sexual skills and enhance your ability to enjoy the sexual experience.
Similarly, if your pelvic floor muscles have spasmed or shortened, you may be feeling pain during or after intercourse. By following the exercises in Chapter 3 of this book, and by doing the self-massage you learned in Chapter 5, you will be helping yourself to enjoy sex again.
In doing so, you'll do something else as well. By making your pelvic floor strong and supple—and by keeping it that way—you'll extend your sexual longevity. You won't just be enjoying sex more, you'll also be enjoying it for more years to come. And that will help you stay healthy for more years to come as well.
There's a simple formula at work here: sex is important for good health, and health is important for good sex. Good sex and good health nurture and reinforce one another. And a healthy pelvic floor is key to both.
Why is sex good for us? Sexual activity increases the blood flow. That, in turn, equips the body to fight off such harmful bacterial infections and viruses as urinary tract and yeast infections, or to rid itself of them if they take hold. That helps keep our organs strong.
Sexual activity also helps our muscles stay strong. Orgasms, after all, are muscle contractions, so the more intense the orgasm, the greater the strengthening of the muscles. (And vice versa, of course: the stronger your pelvic floor muscles, the more intense your orgasm can be.) Strengthened muscles, in turn, mean lowered risk of incontinence. Orgasm also relaxes the body. And the stronger and less tense the muscles at our core, the less hard our bodies have to work to hold us upright.
Just as important as these physiological benefits are the psychological and emotional payoffs of healthy sexual experiences. Sex, after all, is an essential component—some would say the crowning characteristic—of the kind of intimacy that is such a keystone of psychological and emotional well-being. It embodies and exemplifies that closeness to another that answers the most profound human need.
In so many ways, therefore, sex is very, very good for us, and that means that better sex is even better for us.
That's where the pelvic floor comes in. It is, after all, at the core of the body and as such, the seat of sex. The nerve endings of the pelvic floor are what respond to sexual stimulation. Its tissues and blood flow are where arousal takes place. Its muscles are literally the vehicles of sexual pleasure. In men, sexual arousal increases the sensitivity of the nerves and causes the tissues of the penis to become engorged with blood and thus erect. During orgasm, the male's pelvic muscles contract rapidly and rhythmically. In women, the main areas of sexual stimulation are the clitoris and the G-spot, the small area of tissue on the back wall of the vagina named for the German gynecologist Ernst Gräfenberg, who did groundbreaking research into female sexual physiology. The nerve endings of the pelvic floor muscles assist in the stimulation of these areas; they're the receptors of sexual excitement and arousal. Once a woman has become sexually aroused, the clitoris and G-spot engorge with blood, the nerve endings become more sensitive, and in turn the muscles of the pelvic floor contract.
But the specific muscle of the pelvic floor that is key to sexual pleasure in both men and women is the pubococcygeus, or PC muscle, which contracts rapidly during orgasm. So while a number of factors like hormone levels and positioning and the mood of the moment certainly affect sexual activity, the pelvic floor is clearly key to both performance and pleasure. A healthy pelvic floor—one with well-toned, relaxed muscles capable of going through their full range of motion, with a healthy blood flow nourishing healthy tissue, with nerve cells that respond well to stimulation—has all the ingredients necessary to ensure sensitivity to stimulation, powerful arousal, and highly satisfying climax. Bottom line: a healthy pelvic floor contributes to healthy sex, and healthy sex contributes to a healthy life.
Problems, dysfunctions, or weaknesses of the pelvic floor can adversely affect sexual performance and detract from sexual pleasure—and in turn from overall health and well-being in both men and women. If the pelvic floor's blood flow is insufficient, for example, the engorgement of the key areas of stimulation will also be insufficient, or may not take place. If the PC muscle is weak or if it has been shortened by tension—or both—it may respond only weakly during orgasm, if at all; it simply won't be able to go through the full range of motion that achieves a healthy and satisfying orgasm.
In some cases, these dysfunctions may be painful as well, and they can often undermine an individual's quality of life in disruptive, debilitating, and distressing ways. In men, erectile dysfunction (ED) and premature ejaculation are perhaps the best-known sexual dysfunctions. These days, you can't watch the nightly news or the weekly football game on television without being bombarded with ads for drugs that can remedy ED. In those cases where the disorder may result from decreased blood flow or from spasmed or weak muscles, a stronger, healthier pelvic floor may resolve the problem. Prostatitis—an inflammation of the prostate gland that can also decrease libido and cause impotence—is another fairly common male disorder, and it's been shown conclusively that 95 percent of its symptoms are nonbacterial and most likely caused by pelvic floor dysfunction.
It has also been shown conclusively that pelvic pain in men is also typically associated with sexual dysfunction. Studies have shown that more than 90 percent of men who suffer pelvic pain also experience sexual dysfunction, and that more than half of them improved their sexual function through massage of the pelvic floor muscles and relaxation techniques.
Women can suffer a range of sexual dysfunctions that are in great measure preventable if a healthy pelvic floor is maintained. Traditionally, these dysfunctions were classified under the catch-all name dyspareunia, meaning pain that interferes with sexual activity. We now know that such pain is typically associated with some very specific disorders like vestibulitis, a skin irritation or inflammation at the opening or vestibule of the vagina that renders the area painful when touched; vulvodynia, a burning or stinging sensation felt throughout the vulva; or vaginismus, an involuntary spasm of some or all of the vaginal muscles. These painful conditions can turn sex into a painful experience for a woman; in fact, they can make it simply impossible.
Other sexual dysfunctions may affect both men and women: pain during and after sexual activity, decreased libido, and difficulty becoming stimulated and/or achieving orgasm. Clearly, these dysfunctions also affect the frequency of sexual activity, and they certainly affect the quality of life of both the affected individual and his or her partner.
Sometimes, these dysfunctions may be medically induced. Anti-depressants, for example, as well as some pain medications and some cholesterol-lowering drugs, are known to decrease libido or otherwise diminish sexual activity and enjoyment. Similarly, stress and emotional challenges may reduce both the desire and the ability to have sex. The same goes for hormonal imbalance, which can lower sex drive and sexual ability in both men and women.
If you have any of the symptoms of these disorders, you should consult your physician immediately for a proper diagnosis. Like so many disorders, these may have their origin in pelvic floor dysfunctions that can be addressed by doing the natural healing methods in this book, but it's important to be sure. That isn't just sound medical practice; it's common sense. Doing exercises you should not do, or doing some exercises the wrong way, could actually add to or worsen your problems.
But for patients who receive their doctor's go-ahead, and certainly for people without symptoms of disorder or dysfunction, the exercises in this book offer not just a preventive hedge against future problems, but also a great way to enhance your sexual experience right now—and for years to come. If your problem is pain during or after intercourse, go to Chapter 3 and follow the End-the-Pain exercise routine, and do the self-massage therapies of Chapter 5. If your problem is difficulty achieving orgasm or decreased libido due to weak pelvic floor muscles—or if you want to intensify your sexual experience—follow the program of Chapter 4. Both programs will help you get healthy at the core, and as we've shown earlier, being healthy at the core is good for everything—good for your health in general and particularly good for your sex life.
There are some special things women can do to relieve vaginal irritation and pain. For those suffering irritation, for example, it can even be painful to wipe after urinating, and the solution is—don't. Instead, pat the skin, as you would a newborn baby's delicate skin; wiping is too aggressive on these sensitive tissues. Use scent-free babywash or, even better, plain water to wash the area. Gently. If you use a tampon, plastic applicators, with their smooth surface, are the better choice. If you're a swimmer irritated by the chlorine in the pool, apply Vaseline before you put on your bathing suit to protect this sensitive tissue. And try applying pure vitamin E oil twice a day for at least two months; this may ease the pain.
For women who experience pain during sex, positioning may ease the pain. While every individual's anatomy is different, the woman lying on her side with the man behind her is typically a less painful position for a woman who has experienced pain during intercourse. Some women also find that being on top is helpful since they can then control the angle of their posture and the speed of the action.
In any event, women who have had pain issues during sex should always use a lubricant, even once the pain begins to subside. There is a great variety of these products, so experiment to find the one that suits you best, but avoid any lube that contains propylene glycol, which tends to burn, and be sure that the lube you choose is paraben-free. Parabens are used as preservatives in many cosmetic and personal hygiene products and have been shown to mimic estrogen; they therefore may possibly contribute to the growth of tumors in the breast.
Women may also suffer incontinence during sex—and particularly at the point of orgasm, although of course it is important to differentiate female ejaculatory fluid from urinary incontinence. Urinary tract infections, yeast infections, or symptoms that mimic these infections are all common disorders that may result from sexual activity and, obviously, will interfere with sexual activity as well. It is important to get an accurate diagnosis: is it a urinary tract infection or a pelvic floor dysfunction? Is it a yeast infection or pelvic floor dysfunction? Don't self-diagnose; see your physician.
The key to strengthening the pelvic floor is the Strengthen-the-Muscles exercises of Chapter 4—and most particularly, the Kegel. Indeed, while I've recommended Kegels as a way to avoid or cure incontinence, the fact is that Dr. Kegel was looking for a therapy to help women with sexual dysfunction when he came up with these exercises. Simply put, what Kegel found was that the more developed the vaginal muscles—specifically, the PC muscle—the more gratifying the sexual experience. The famous resistive exercise he devised develops the PC and the other pelvic floor muscles, increasing their contractile strength through voluntary control of their movement. And sure enough: as the PC muscle is developed through the Kegel exercises, becoming broader and thicker, the tone of the pelvic floor walls also increases, and the muscle's ability to contract in sexual response is substantively augmented.
Later research has repeatedly confirmed the validity of these conclusions. In fact, more recent studies that have sought to measure the difference in function between the undeveloped and developed PC muscle have yielded the dramatic finding that women with strong pelvic floor muscles enjoyed contractions two to three times more powerful than women with undeveloped muscles.
Kegel exercises also work for men. The voluntary contraction of the PC in the male engages what is called the cremasteric reflex; this lifts the testes and is a step in the sexual response cycle. Kegels may also enable multiple orgasms and can help prevent premature ejaculation.
But perhaps your problem isn't weakness but rather tightness, in which case you need to relax the muscles and free them of tension and of pain. That's where the exercises of Chapter 3 come in, as well as the self-massage techniques of Chapter 5. Lengthening the muscles and tissues of your pelvic floor and the surrounding area, reducing the points of irritation in the muscles, ridding the tissue of the toxins that cause even further tension, and increasing the flow of blood to the area all enhance your ability to become aroused and to enjoy the experience of sex.
The medical evidence is therefore undeniable: in both women and men, when the muscles and nerves of the pelvic floor are weak or dysfunctional, sexual response and sexual satisfaction are diminished. When the function of the muscles and nerves is improved through strengthening in the case of weakness, or through lengthening and massage in the case of pain and tension, both the interest in sexual activity and the satisfaction deriving from the activity rises dramatically.
For women in particular, we know today that a variety of orgasmic experiences is available to them along all those nerve pathways to the clitoris and the G-spot and in the muscle responses that can ensue. Following where the medical evidence leads, it's now clear that the program of exercise and other therapies in this book can enliven those pathways and enhance those muscle responses. Such a program can be the healthiest path possible to a much, much better sex life.