Straight Talk About Sex and the Pelvic Floor with Leslie Rickey, MD

Straight Talk About Sex and the Pelvic Floor with Leslie Rickey, MD

Recently, Dr. Leslie Rickey, a urogynecologist at Yale University School of Medicine, participated in a Twitter Chat with the National Association For Continence (@Bhealth_). During the conversation, they cover the topic of urinary incontinence and the connection with your sex life.  Data has shown that strengthening pelvic floor muscles can improve incontinence, with some studies suggesting that women with stronger pelvic floor muscles experience superior sexual function. In this Twitter Chat recap, Dr Rickey answers questions posed by women just like you. Some of the answers may surprise you.


Q: Is my pelvic floor really involved in my sex life?

A: Yes! Pelvic floor muscles are critical to bladder vaginal and bowel function. Studies have suggested that pelvic floor muscle strength may be related to increased sensation and sexual satisfaction.


Q: Isn’t less satisfying sex just a function of aging? Can you really “fix” this?

A: Unfortunately, many women feel that decreased sexual function and other pelvic floor disorders are an inevitable part of aging. But, women should know there are self-help strategies and home pelvic floor training support that can help improve pelvic floor muscle strength and sexual function at ANY age. Of course sexual function can also be associated with several variables including psychological, biological or interpersonal factors.


Q: What should I notice about my sexual satisfaction if I strengthen my pelvic floor?

A: Women report more intense orgasms after completing pelvic floor muscle training, according to studies.


Q: Why hasn’t my doctor talked to me about my pelvic floor strength?

A: Female pelvic floor disorders are under-evaluated, under-diagnosed & under-treated. Don’t just to “learn to live with” bladder leaking or sexual dysfunction. It’s common but not normal. Start the conversation with your doctor.


Q: What can I do to strengthen my pelvic floor if I’m leaking a little and would like more sexual satisfaction?

A: Pelvic floor muscle exercise is first-line treatment for bladder control issues & can improve sexual function. Many women can do these exercises on their own at home. Others may need to see a pelvic floor physical therapist.


Q: I’ve tried doing “Kegels” on my own. I don’t know if I’m doing them right and I usually lose interest. How can I stick to a regular program?

A: There are home pelvic muscle training systems, such as PeriCoach, a device + smartphone app that are easy to use and allow women to see real-time biofeedback on their phone while doing kegel exercises. PeriCoach tracks your progress, sends reminders and helps you contract the muscles that matter.


Q: How long do I need to keep up a pelvic floor muscle program before I see results?

A: Women should plan on starting with a 6 week course of PFM exercises, try for 3 sets of 10 contractions a day


Q: What if I don’t have any of these problems? I don’t leak. I’m happy with my sex life and want to keep it that way.

A: Pelvic floor muscles are muscles like any other in the body. You need to keep them fit and toned.  There is some evidence that a pelvic floor muscle program can not only treat incontinence, but also prevent progression.