Your Pelvic Floor Doesn’t Always Need More Kegels

Let's talk about something women hear ALL. THE. TIME:

“Do your Kegels!”

Leak when you sneeze?

Kegels.

Had a baby?

Kegels.

Want better pelvic-floor strength?

Kegels.

But here's the thing…

Your pelvic floor is a little more complicated than that.

And understanding that can make a huge difference in how you care for your body.

First: What IS your pelvic floor?

Your pelvic floor is a group of muscles and connective tissues that support structures in your pelvis, including your bladder, bowel and reproductive organs.

These muscles help with things like bladder and bowel control, pelvic support and sexual function.

And just like any other muscle group, they need to be able to do more than one thing.

They need to contract AND relax.

That's where things get interesting.

Strong doesn't always mean better.

Kegel exercises—also called pelvic-floor muscle training—are designed to strengthen the pelvic-floor muscles.

They can be helpful for certain problems, particularly some types of urinary or bowel leakage. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) notes that pelvic-floor muscle training can strengthen these muscles and may improve bladder and bowel control.

But that doesn't mean everyone should automatically start doing hundreds of Kegels.

Why?

Because sometimes the problem isn't weak muscles.

Sometimes the muscles are already too tight.

And if a muscle that's already tense is constantly being told to squeeze harder…

Well, you can see where that could become a problem.

People experiencing certain types of pelvic pain or pelvic-floor muscle spasms may actually need help relaxing and lengthening those muscles, rather than simply strengthening them. NIDDK notes that people with interstitial cystitis symptoms or pelvic-floor spasms may be referred to a pelvic-floor physical therapist to help stretch tight muscles and keep them relaxed.

So… should you do Kegels?

Maybe.

But the better question is:

“What does MY pelvic floor actually need?”

That's where a healthcare professional or pelvic-floor physical therapist can be incredibly helpful.

A pelvic-floor physical therapist can evaluate how your muscles are functioning and help you learn whether you need strengthening, relaxation, coordination or another approach.

And if you've ever thought:

“I'm doing all these exercises, but I'm not getting better…”

That's a really good reason to stop guessing and get evaluated.

Some signs it's worth talking to someone

Pelvic-floor issues can show up in lots of different ways.

You might experience:

• Leaking urine when you cough, sneeze, laugh or exercise

• A sudden or frequent urge to urinate

• Difficulty emptying your bladder

• Bowel-control problems

• Pelvic pressure or heaviness

• Pelvic pain

• Pain or discomfort with intimacy

• A feeling of tightness in the pelvic area

• Symptoms that started after childbirth, surgery or another significant physical change

These symptoms can have different causes, so don't assume you know what's happening just because someone on social media told you to “do more Kegels.”

And please don't practice Kegels while you're peeing.

This is one of those tips that gets passed around online.

You may hear that you should stop your urine stream to “find” your pelvic-floor muscles.

NIDDK does mention this as one way to initially identify the muscles, but specifically says not to regularly do Kegels while urinating, because repeatedly stopping your urine flow can interfere with normal bladder emptying and may increase the risk of bladder problems.

So use that information to identify the muscles if a healthcare professional has suggested it—but don't turn your bathroom trips into your daily workout. 😂

What does pelvic-floor physical therapy actually do?

This is another area where there's a lot of misunderstanding.

Pelvic-floor physical therapy isn't simply:

“Come in and do some Kegels.”

Depending on your individual needs, a pelvic-floor physical therapist may work with you on:

• Muscle strengthening

• Muscle relaxation

• Breathing and coordination

• Movement patterns

• Core and pelvic stability

• Bladder habits

• Bowel habits

• Managing pelvic pain

• Learning how to correctly contract and relax the pelvic floor

NIDDK notes that a physical therapist trained in pelvic-floor therapy can help people perform pelvic-floor exercises correctly and may use tools such as biofeedback when appropriate.

Your pelvic floor is part of your sexual health, too.

And THIS is the part I especially want women to hear.

Pelvic-floor health isn't just about whether you leak when you sneeze.

These muscles are involved in sexual function, and pelvic-floor symptoms can affect comfort and intimacy.

So if you're experiencing discomfort during intimacy, pelvic pain or other changes that are affecting your intimate life, that's a perfectly legitimate reason to bring it up with your healthcare provider.

You don't have to wait until the problem becomes unbearable.

And you definitely don't have to be embarrassed.

Your Pelvic Floor Resource List

If you're ready to learn more, these are the resources I'd recommend starting with.

🩷 NIDDK — Kegel Exercises

A comprehensive, government-backed guide explaining what pelvic-floor exercises are, how they're performed, who may benefit and why getting professional guidance can be helpful.

Read NIDDK's Kegel Exercises Guide

🩷 NIDDK — Treatments for Bladder Control Problems

This resource explains different approaches to urinary incontinence, including pelvic-floor muscle training and the role of a physical therapist specializing in pelvic-floor therapy.

Read NIDDK's Bladder Control Treatment Guide

🩷 NIDDK — Interstitial Cystitis Treatment

If pelvic pain or bladder pain is part of your experience, this resource is especially important because it discusses pelvic-floor physical therapy and why strengthening exercises aren't automatically appropriate for everyone.

Read NIDDK's Interstitial Cystitis Treatment Guide

🩷 NIDDK — Bladder Health & Prevention

A helpful resource for learning more about bladder health, urinary leakage and pelvic-floor muscle exercises.

Explore NIDDK's Bladder Health Resources

🩷 Office on Women's Health

The U.S. Office on Women's Health provides a collection of women's-health resources, guides and educational materials you can use to learn more and prepare for conversations with your healthcare provider.

Explore the Office on Women's Health Resources

The Bottom Line

Your pelvic floor isn't a one-size-fits-all situation.

Maybe you need strengthening.

Maybe you need to work on relaxation.

Maybe you need better coordination.

Maybe you need a professional evaluation to figure out what's actually going on.

You don't have to guess.

And you definitely don't have to be embarrassed about asking for help.

Your pelvic floor is part of your body.

Your body deserves to be understood—not ignored.

One last reminder from Amy…

I'm your Intimacy Extraordinaire, not your healthcare provider.

I'm here to help you ask better questions, find reliable information and feel a little less awkward talking about topics that women have been taught to whisper about for far too long.

If you're having pain, leaking, pressure, difficulty emptying your bladder or bowel, or other symptoms that concern you, talk with your healthcare provider or ask whether a pelvic-floor physical therapist may be appropriate for you.

Knowledge is sexy.
Advocating for your health is even better. ❤️

— Amy
Vibrant Synergy Intimacy Boutique