How Pelvic Floor Fitness Connects To Better Sex For Women
November 25, 2020
For women, pelvic floor muscles play a key role in the body as far as preventing things like urinary incontinence or pelvic organ prolapse, in addition to supporting core strength and other aspects of pelvic health and wellness. But, especially if their awareness springs from pop culture, many people may be more familiar with these muscles for one of their more fun roles. Whether it’s a Cardi B song or Samantha on Sex and the City (“Honey, my vagina ‘weights’ for no man!” is an amazing quote), people have been talking about the benefits of Kegel exercise in terms of better sex for years.
But… it’s not always that clear exactly how pelvic floor muscle exercise can impact your sex life, or whether those “Kegels = magical sex” stories are an urban legend. So, today we’re going to dive into this piece of women's health and try to dig a little deeper into the link between your pelvic floor muscles and sex.
What does the pelvic floor have to do with sex?
Let’s take a quick trip into female physiology to understand how your pelvic floor muscles are related to sexual health. The pelvic floor is essentially a kind of hammock of muscles, ligaments and connective tissue at the base of your pelvis. It has important jobs regarding support for your pelvic organs and control of your urethra and rectum, but it also has a crucial role in sexual function.
To be more specific, the pelvic floor contains uterovaginal nerves that strongly impact sexual experience, as well as autonomic nerves that mediate vascular changes that occur with arousal. The pelvic floor muscles also impact blood flow to pelvic organs like the clitoris, labia minora and vestibular bulbs. Long story short, the pelvic floor contains and/or supports multiple nerves and organs that play major roles in sexual function.
OK, so how exactly do the nerves/organs/etc in the pelvic floor affect sex?
You may not have known this, but men are not the only ones that have erectile tissues that become engorged when they are aroused. The clitoris is a pelvic organ where this is the case, and the bulbs of the vestibule in the labia minora is another example. Healthy pelvic floor muscles promote blood flow to these tissues and can improve arousal.
And it probably comes as much less of a surprise that nerves like the dorsal nerve of the clitoris or the pudendal nerve play a key part in sexual sensation (and those nerves also need good blood circulation to thrive).
Orgasm is another part of sexual response that is closely related to the pelvic floor. To start with, your pelvic floor muscles contract during orgasm, and their ability to do so can lead to better, stronger orgasms. Strong pelvic floor muscles may also make it easier to reach orgasm. Furthermore, there is also evidence that vibration stimulation (here is one example) can help with female situational anorgasmia (which basically means difficulty achieving orgasm).
Put it all together, and the pelvic floor (and specifically the pelvic floor muscles) can improve arousal, sensation, and orgasm. Pretty great, right?
Where’s the proof?
Good question! There have been a number of studies published that examine the link between the pelvic floor and sex. Here are a few interesting ones, with their conclusions:
Overall sexual function:
“Our findings suggest that women with stronger pelvic floor muscles have better sexual function.” (Martinez 2014)
Orgasm (and other dimensions of sexual function):
“The improvement of scores in each domain (desire, arousal, lubrication, orgasm, sexual satisfaction, and pain) after the conclusion of pelvic floor rehabilitation was statistically significant.” (Rivalta 2010)
Qualitative effect on sexuality:
“Pelvic floor muscle exercises had a positive effect on sexuality. Sexual enjoyment, body image, self-confidence, and sexuality were enhanced.” (Kao 2015)
Great! What do I do with my pelvic floor to have better sex?
There are two categories of pelvic floor fitness that can have a huge effect on sex for women:
- Strengthening (Kegel) exercise: many of the studies cited above were looking at the effects of strengthening the pelvic floor muscles, which can have a huge effect on sexual enjoyment and quality
- Relaxation (Down Training) exercise: however, many women (and men, although that is a topic for a different article) have pelvic floor muscles that are too tense. This is called being hypertonic (or overactive, or high-tone). It is very common in this case to experience pelvic pain in general or pain with vaginal insertion specifically, and there is a lot of overlap with "dyspareunia", which basically just means pain during sexual intercourse. Down Training can help with dyspareunia and is also a key aspect of pelvic floor fitness (it's not just about Kegels!)
A well-rounded pelvic floor exercise regimen can involve both strengthening and Down Training exercises.
You may have noticed that the pelvic floor rehabilitation regimen used in the Rivalta study cited above included biofeedback (which helps identify the correct muscles and ensure you’re doing the exercises correctly). A great option to support productive pelvic floor exercise with biofeedback is to use an intravaginal pelvic floor exerciser like kGoal Classic, or a sit-on-top (no insertion) option like Boost, which can both provide biofeedback, progress tracking, guided workouts, and games to keep things interesting.
Is there a ‘but...’?
There is (isn’t there always?). Kegel exercise is a way to strengthen your pelvic floor muscles, especially if you're starting with a weak pelvic floor. But for people with hypertonic pelvic floor muscles, doing Kegels can actually be counterproductive and worse issues with dyspareunia or pelvic pain more generally.
If you fall into this camp, your best bet is likely to focus exclusively on Down Training (in this case, the Boost trainer mentioned above is much more suitable than kGoal Classic, which as an intravaginal trainer is not the best tool for those who might have discomfort with insertion.
Overall, seeing a pelvic floor physical therapist is a great way to get personalized guidance on what kind of exercise regimen is best for your body.
The Bottom Line
Kegels are not magic, and they’re far from the only thing that determines whether you’re having good sex. But there is a significant body of evidence supporting the idea that pelvic floor fitness can help women have better, more pleasurable sex -- there’s definitely a reason that pop culture keeps coming back to them!
