FIRST of ALL..if you are here because you are searching for pics of vaginas...your search engine has failed you. This is NOT a post on PORN!
Ok, Moms...Raise your hand if you "dribble when you giggle!" Awesome, right? It's great having to wear a panty-liner 24/7 and always wondering whether it's you..or your toddler who smells like tinkle!
Here are some, oh-so familiar, scenarios....
You are in the grocery store, feel a sneeze coming on, you cross your legs, hold onto the cart and pray you don't pee! OR your doing that spin class and the instructor yells "jump!", you're thinking..please, not in the Yoga pants!! OR (which is most of the time with me) you are yelling at a kid, and the moment you loose your shit...you piss yourself...seriously, how incredibly annoying.
OH MY GOD!! What BULLSHIT that nobody tells you to expect this kind of stuff! I mean, you have just gone through the most painful experience in your life, followed by the most AMAZING moment of your life but NOBODY tells you to expect your nips to feel like shredded wheat, about the poop possibility during the push...and now you are peeing in your pants??!! Seriously, WTF.
Let's get personal. After I had my second child, I experienced some SEVERE incontinence issues. SEVERE. I was totally freaking out. I had never been told that this could happen!! THANK GOD my husband was SO understanding because it was, well, quite embarrassing!!
My OB had told me that kegels "could help," but offered the solution of a surgery VERY quickly. Seriously?? I am in a hospital bed, 24 hours after giving birth, and now I am being told that I needed surgery to correct a pee problem that I might have for the rest of my life?? Next answer, please....
I immediately went home and tore up my Play Group's message board:
"Did anyone else experience this?"
"OMG, the pee just happens...is it going to ever stop?"
"How sweet...you want to bring a meal? Can you stop and pick up some Depends?"
Thankfully, a mom in the group is a Physical Therapist that works SPECIFICALLY with Women's Pelvic Issues...SCORE!! She gave me some GREAT pointers, and TRULY changed my life.
Well, I have decided to Pay It Forward Mamas! Thanks to the help of my dear friend, Crystal...my vagina is cured!! No more peeing in my pants...EVER! I can sneeze, jump, laugh and yell!!
Today I am going to share the SECRET with all of you! I interviewed my friend, Crystal, to find some answers that might help other moms out there, who are suffering from the "dribble." I am hoping that people can take this information and use it to change their lives, and STOP PEEING IN THEIR PANTS!!
This, my friends, is how to Give You Vagina a Workout!!
First off the definition of a kegel (taken from Wikipedia): repeatedly contracting and relaxing the muscles that form part of the pelvic floor.
Here is the interview:
ME: What causes women to pee in their pants after having babies?
CRYSTAL: Peeing in pants can be caused by a fallen bladder, especially if it's a large leak. It also can be because the muscles that close off the hose that urine goes through are too weak, so any increase in pressure on your abdomen, like a laugh or sneeze, squeezes your bladder which forcefully pushes urine out the hose. You want super strong muscles to stop those forces!
ME: So should everyone just place "Depends" on their Baby Registries? What percentage of women face this annoying issue?
CRYSTAL: Urinary incontinence occurs in 1 out of 3 women within first year postpartum. Women who delivered vaginally or had c-section after attempted labor have 31% prevalence of UI. Women who had elective c-section have decreased prevalence of 15% UI.
ME: Wow. So tell me...How does one actually DO a Kegel?
CRYSTAL: It's funny. Different key words make sense to different people. So, here are few phrases that tend to help people:
"Try stopping the flow of urine, the muscles you just used are your pelvic floor muscles. Now when you are not urinating, contract those same muscles. That is a kegel!"
"Try lifting your vagina up and in making the opening close."
"Lift the muscles between your legs up and in."
And for those who like detail:
"Think of the pelvic floor muscles as a hammock that only has 3 openings and is tied at one end to your pubic bone and the other end to your tailbone. When you pull on the ends of a hammock it lifts up and the openings close, right? Same is true when you do a kegel. These openings are around the urethra, vagina, and anus."
If you are squeezing your buttocks, thighs, holding your breath or grunting then you don't quite have it. These are tiny muscles, don't try as hard and focus on the area near vaginal opening.
ME: Hmm..doesn't sound so hard! Just wondering, can we do this DURING Sex? Thinking it might ROCK my husband's world..haha...
CRYSTAL: Yes! You can do them while having sex & your husband will love it. Its actually a good way to measure your strength. You can even ask him if he can feel the contraction to see how strong you are. If he says "no" or "kind of" then you know you need to get kegeling each day. After 4 weeks of doing kegels, ask again. Let him be your strength judge! And if stopping the annoying leak isn't reason enough to strengthen, then do it to improve your sexual arousal & make your orgasms more intense (because orgasm involves involves repetitive contracting of the pelvic floor muscles).
ME: Sweet! Hmm..maybe I will save that for a special occasion. Ok, how do you know if you are doing them the right way?
CRYSTAL: If you stop the flow of urine, it's right. Don't try this very much though because can lead to infection. Just make sure you are lifting up and in, not bearing down, and that your buttocks and thighs aren't moving. A correct kegel is so discreet that no one watching you should be able to tell you are doing anything!!
ME: Hmmm.. ok, what if things DON'T get better. What are the options?
CRYSTAL: If they don't work, be really honest with yourself. Did you do at least 30 per day? If you really did, then ask your OB to check your technique. She may give a simple change or decide more is going on and refer you to PT. You may also be a candidate for surgery.
If you have pain with kegels, STOP doing them and talk to your OB to consider referral to PT.
ME: So what is a visit with a PT like to help with this issue?
CRYSTAL: A physical therapist sees people with incontinence because we are the musculoskeletal experts and their OB, urogynecologist, urologist, or PCP determined that the leaking is a musculoskeletal problem. Pelvic PT is for people who tried kegels at home and just don't see improvement. Also for those with pelvic pain.
A PT will perform a 2 part examination for incontinence.
1. Pelvic exam: this looks and feels like a gynecologic examination, but we are not looking for disease, rather looking for how the muscles and nerves are working or not working.
--Is sensation normal? Reflexes normal? Is there abnormal tension on muscles, muscle spasms, or scar tissue restricting ability of muscles to stretch and contract.
2. Posture examination, muscle length and strength assessment of core, low back, hips, knees, and ankles.
--faulty alignment can cause increased pressure on pelvic floor.
Treatment
--Biofeedback to increase awareness of kegel muscles. This is where we put electrodes outside on perineum, you do a contraction and watch a bar graph that increases as you contract more.
--Personalized exercise routine including stretches/strength for postural alignment and appropriate level of kegel exercises
--Some people need relaxation training instead of strengthening. If you keep the muscles contracted all day long, they are too weak to work when you need them. We use biofeedback, stretching, manual therapy, and e-stim for this.
--Scar tissue massage
--manual release of muscle spasms
--Functional exercises to get you back to your every day life!
ME: Wow, that seems pretty personal. Ok, What about all of these devices I see on google that claim to be exercise equipment for your vagina...that sounds kinky.
CRYSTAL: Vaginal weights: not necessary, but some people like having "things" to help them exercise. Kind of like you can do lunges & kicks to keep your legs toned or you can buy any array of fancy machines to do the same job. Most important is to be CONSISTENT. So, if hitting the vaginal weights makes you feel more sporty & more likely to exercise, then great! But if it sounds like a hassle you are just fine without them!
ME: Ok, good to know. So does incontinence get worse depending on how many babies a woman delivers?
CRYSTAL: No. The severity of leaking does not get worse with non-traumatic multiple deliveries. However, every time you have a vaginal delivery there is a 1/3 chance of developing UI. So, regardless of whether you were one of the lucky two or unlucky one, your chances are the same each delivery.
ME: What could cause a delivery to result in incontinence?
CRYSTAL: The risk factors for urinary incontinence are: birth weight, duration of second stage of labor (the pushing and delivery part), instrument use (forceps or vacuum etc), and vaginal delivery or attempted labor followed by c-section.
ME: Interesting. OK, any last thoughts, tips or recommendations for moms going through this issue?
CRYSTAL: Sure, let me summarize:
How do you stop the leaking?
By STRENGTHENING pelvic floor muscles with kegels and COORDINATING them.
STRENGTHEN
If you are strong enough to stop flow of urine and know you ARE NOT contracting extra muscles...then...
Position:
Sit, stand, lie down, (any position works) to begin the exercise.
Where:
You can do kegels anywhere! In the car (when stopped), in line at store, while changing a diaper...
How many?
Shoot to do 30 kegels by end of the day. Usually this means 3 sets of 10. If you are fatigued wait and start again later.
How long?
Contract (lift up and in) at 50% for 10 sec, rest for 10-20 sec **For an extra challenge do several quick flicks at full effort.
If you can slow flow of urine, but can't stop it then:
Position:
Lie down on your back or side to begin.
Where:
Choose a quiet room with no distractions. It is important to carve out the time to do these with no distractions at first, once you are stronger you won't have to do this.
How many?
Try to do 30 by the end of each day. Usually you want to do 6 sets of 5 reps.
How long?
Contract the muscle for 2-3 sec, then rest for 10 sec.
COORDINATION
Practice contracting before you cough. Do a few fake coughs a day to make this a natural activity. Then always contract before and during a laugh, cough, sneeze, or lift!
ME: Thanks Crystal, you are amazing. I hope you know how much you have changed my life..and hopefully will be changing others' too.
CRYSTAL: Glad to help! It's not a glamorous job, but it truly improves lives! Women so rarely discuss these issues in public. A forum like this blog is invaluable to spreading the word!! Your personal story is one so many can relate to. I hope this information helps others as well.
Here is the interview:
ME: What causes women to pee in their pants after having babies?
CRYSTAL: Peeing in pants can be caused by a fallen bladder, especially if it's a large leak. It also can be because the muscles that close off the hose that urine goes through are too weak, so any increase in pressure on your abdomen, like a laugh or sneeze, squeezes your bladder which forcefully pushes urine out the hose. You want super strong muscles to stop those forces!
ME: So should everyone just place "Depends" on their Baby Registries? What percentage of women face this annoying issue?
CRYSTAL: Urinary incontinence occurs in 1 out of 3 women within first year postpartum. Women who delivered vaginally or had c-section after attempted labor have 31% prevalence of UI. Women who had elective c-section have decreased prevalence of 15% UI.
ME: Wow. So tell me...How does one actually DO a Kegel?
CRYSTAL: It's funny. Different key words make sense to different people. So, here are few phrases that tend to help people:
"Try stopping the flow of urine, the muscles you just used are your pelvic floor muscles. Now when you are not urinating, contract those same muscles. That is a kegel!"
"Try lifting your vagina up and in making the opening close."
"Lift the muscles between your legs up and in."
And for those who like detail:
"Think of the pelvic floor muscles as a hammock that only has 3 openings and is tied at one end to your pubic bone and the other end to your tailbone. When you pull on the ends of a hammock it lifts up and the openings close, right? Same is true when you do a kegel. These openings are around the urethra, vagina, and anus."
If you are squeezing your buttocks, thighs, holding your breath or grunting then you don't quite have it. These are tiny muscles, don't try as hard and focus on the area near vaginal opening.
ME: Hmm..doesn't sound so hard! Just wondering, can we do this DURING Sex? Thinking it might ROCK my husband's world..haha...
CRYSTAL: Yes! You can do them while having sex & your husband will love it. Its actually a good way to measure your strength. You can even ask him if he can feel the contraction to see how strong you are. If he says "no" or "kind of" then you know you need to get kegeling each day. After 4 weeks of doing kegels, ask again. Let him be your strength judge! And if stopping the annoying leak isn't reason enough to strengthen, then do it to improve your sexual arousal & make your orgasms more intense (because orgasm involves involves repetitive contracting of the pelvic floor muscles).
ME: Sweet! Hmm..maybe I will save that for a special occasion. Ok, how do you know if you are doing them the right way?
CRYSTAL: If you stop the flow of urine, it's right. Don't try this very much though because can lead to infection. Just make sure you are lifting up and in, not bearing down, and that your buttocks and thighs aren't moving. A correct kegel is so discreet that no one watching you should be able to tell you are doing anything!!
ME: Hmmm.. ok, what if things DON'T get better. What are the options?
CRYSTAL: If they don't work, be really honest with yourself. Did you do at least 30 per day? If you really did, then ask your OB to check your technique. She may give a simple change or decide more is going on and refer you to PT. You may also be a candidate for surgery.
If you have pain with kegels, STOP doing them and talk to your OB to consider referral to PT.
ME: So what is a visit with a PT like to help with this issue?
CRYSTAL: A physical therapist sees people with incontinence because we are the musculoskeletal experts and their OB, urogynecologist, urologist, or PCP determined that the leaking is a musculoskeletal problem. Pelvic PT is for people who tried kegels at home and just don't see improvement. Also for those with pelvic pain.
A PT will perform a 2 part examination for incontinence.
1. Pelvic exam: this looks and feels like a gynecologic examination, but we are not looking for disease, rather looking for how the muscles and nerves are working or not working.
--Is sensation normal? Reflexes normal? Is there abnormal tension on muscles, muscle spasms, or scar tissue restricting ability of muscles to stretch and contract.
2. Posture examination, muscle length and strength assessment of core, low back, hips, knees, and ankles.
--faulty alignment can cause increased pressure on pelvic floor.
Treatment
--Biofeedback to increase awareness of kegel muscles. This is where we put electrodes outside on perineum, you do a contraction and watch a bar graph that increases as you contract more.
--Personalized exercise routine including stretches/strength for postural alignment and appropriate level of kegel exercises
--Some people need relaxation training instead of strengthening. If you keep the muscles contracted all day long, they are too weak to work when you need them. We use biofeedback, stretching, manual therapy, and e-stim for this.
--Scar tissue massage
--manual release of muscle spasms
--Functional exercises to get you back to your every day life!
ME: Wow, that seems pretty personal. Ok, What about all of these devices I see on google that claim to be exercise equipment for your vagina...that sounds kinky.
CRYSTAL: Vaginal weights: not necessary, but some people like having "things" to help them exercise. Kind of like you can do lunges & kicks to keep your legs toned or you can buy any array of fancy machines to do the same job. Most important is to be CONSISTENT. So, if hitting the vaginal weights makes you feel more sporty & more likely to exercise, then great! But if it sounds like a hassle you are just fine without them!
ME: Ok, good to know. So does incontinence get worse depending on how many babies a woman delivers?
CRYSTAL: No. The severity of leaking does not get worse with non-traumatic multiple deliveries. However, every time you have a vaginal delivery there is a 1/3 chance of developing UI. So, regardless of whether you were one of the lucky two or unlucky one, your chances are the same each delivery.
ME: What could cause a delivery to result in incontinence?
CRYSTAL: The risk factors for urinary incontinence are: birth weight, duration of second stage of labor (the pushing and delivery part), instrument use (forceps or vacuum etc), and vaginal delivery or attempted labor followed by c-section.
ME: Interesting. OK, any last thoughts, tips or recommendations for moms going through this issue?
CRYSTAL: Sure, let me summarize:
How do you stop the leaking?
By STRENGTHENING pelvic floor muscles with kegels and COORDINATING them.
STRENGTHEN
If you are strong enough to stop flow of urine and know you ARE NOT contracting extra muscles...then...
Position:
Sit, stand, lie down, (any position works) to begin the exercise.
Where:
You can do kegels anywhere! In the car (when stopped), in line at store, while changing a diaper...
How many?
Shoot to do 30 kegels by end of the day. Usually this means 3 sets of 10. If you are fatigued wait and start again later.
How long?
Contract (lift up and in) at 50% for 10 sec, rest for 10-20 sec **For an extra challenge do several quick flicks at full effort.
If you can slow flow of urine, but can't stop it then:
Position:
Lie down on your back or side to begin.
Where:
Choose a quiet room with no distractions. It is important to carve out the time to do these with no distractions at first, once you are stronger you won't have to do this.
How many?
Try to do 30 by the end of each day. Usually you want to do 6 sets of 5 reps.
How long?
Contract the muscle for 2-3 sec, then rest for 10 sec.
COORDINATION
Practice contracting before you cough. Do a few fake coughs a day to make this a natural activity. Then always contract before and during a laugh, cough, sneeze, or lift!
ME: Thanks Crystal, you are amazing. I hope you know how much you have changed my life..and hopefully will be changing others' too.
CRYSTAL: Glad to help! It's not a glamorous job, but it truly improves lives! Women so rarely discuss these issues in public. A forum like this blog is invaluable to spreading the word!! Your personal story is one so many can relate to. I hope this information helps others as well.
Well, there you have it. Hoping this will change some lives! Nothing is worse than thinking you have to suffer forever. IT IS JUST NOT TRUE!! Please use this information to help yourself!! SHARE it with other moms! You never know who could use it!
Thanks to Crystal Hazelton, Physical Therapist.
She is an orthopedic physical therapist specializing in Women's Health and Pelvic Dysfunction. She also helps with injuries or pain in shoulder, hip, knee, foot/ankle, neck, back, sacroiliac joint, pelvis, interstitial cystitis, endometriosis, urinary/fecal incontinence for men and women, constipation, dyspareunia (pain with intercourse), prolapse, vulvodynia, vaginissmus, pre and post-operative care, pre-natal and postpartum care.
"I believe in treating the whole person so they have the power to move forward with an improved quality of life!"
If you would like to make an appointment to visit with Crystal, you can find her contact info here...http://www.comprehensivetherapy.com/
She is an orthopedic physical therapist specializing in Women's Health and Pelvic Dysfunction. She also helps with injuries or pain in shoulder, hip, knee, foot/ankle, neck, back, sacroiliac joint, pelvis, interstitial cystitis, endometriosis, urinary/fecal incontinence for men and women, constipation, dyspareunia (pain with intercourse), prolapse, vulvodynia, vaginissmus, pre and post-operative care, pre-natal and postpartum care.
"I believe in treating the whole person so they have the power to move forward with an improved quality of life!"
If you would like to make an appointment to visit with Crystal, you can find her contact info here...http://www.comprehensivetherapy.com/
