Kegels, the Perineum, and How to Keep Your A** Out of Adult Diapers Down the Road
Pregnancy takes a toll on the whole body, not just what you can see, like your ever-expanding belly, your swollen ankles, face, and sometimes your wrists. But also, what you can’t see like your pelvic floor muscles, aka the perineum. The perineum is a significant part of our female anatomy.
The pelvic floor muscles support the uterus and your growing baby, but they also act as a basket to hold your internal organs up and in place, like the uterus, the bladder, and the vaginal wall—all very necessary Lady Parts. Now, these are some hard-working muscles. And can create havoc in our lives down the road if we don’t rehab them after each pregnancy and continue to maintain them throughout our lives. That’s right for the rest of your life!
One of my favorite Wayne Dyer quotes, “When you change the way you look at things, the things you look at change.” Pregnancy, in my opinion, is the perfect time to practice and absorb this idea. Especially when it comes to body issues during pregnancy and postpartum, but that’s a different topic.
Changing how you look at your pregnancy experience and seeing this as a time to adopt some good self-care habits to benefit not only the pregnancy but also crucial in helping you to feel stronger for the postpartum phase (which I believe lasts one full year) so be patient with yourself.
Motherhood requires strength primarily upper body strength for all the carting, carrying, and schlepping of baby junk and equipment. A strong, balanced body is needed. Surviving motherhood is no easy feat. You need to be resilient for this 18 yr marathon you now find yourself on!
Self-care is always a hot topic, but I see the same advice over and over. Get a pedicure, take a walk, take in a movie by yourself, have lunch with the girls, hide in a closet, get in some retail therapy, one of my favorites, not that those things aren’t also life sustaining—but it’s not enough.
Self-care has to start with awareness of your physical self and practicing a mind-body connection that not only helps energize you throughout your day but keeps your body better balanced.
This is important to pay attention to. Are you gliding gracefully throughout your day, paying attention to posture and breathing? Or are you unconsciously dragging your ass around using up all your precious energy, because it takes more energy to haul your ass around, just saying!
Everyone says to a pregnant woman, “hope you’re doing your Kegels,” or at least they should be saying that to remind you to do your Kegels. Maintaining a strong perineum during your pregnancy by doing Kegels (I can’t say that enough) will not only help you during a vaginal birth by helping to prevent tearing, (along with the perineum massage that you’ll start doing about 37 weeks), but also a strong pelvic floor will help you recover faster postpartum and postpartum is when you’ll need all the help you can get—just saying!
When the pelvic floor is weakened, the bladder, uterus, rectum, or small intestine can descend, creating a bulge in the vagina and resulting in the condition known as pelvic organ prolapse. Vaginal childbirth is the most common risk factor for developing pelvic organ prolapse, but women who have never been pregnant can still acquire the condition. You can even develop pelvic organ prolapse after a hysterectomy.
Symptoms such as urinary incontinence, difficulty emptying the bladder, and a sensation of pressure in the vagina can occur with prolapse. Pelvic organ prolapse can also make it difficult for women to have bowel movements as pelvic muscles become weakened. Though pelvic organ prolapse rarely causes an immediate threat to your health, it can cause discomfort and interfere with your ability to do many things, including sexual activity.
Can You Say Incontinence!
in·con·ti·nence
inˈkänt(ə)nəns,iNGˈkänt(ə)nəns/
noun
noun: incontinence
1. lack of voluntary control over urination or defecation. “causes of urinary incontinence.”
Incontinence is a real thing! It’s an important but under-acknowledged issue in women’s health. 50% of women over 50yrs old experience some form of incontinence. That’s shocking to me. Every one of my clients gets my thanks for coming to my Ted Talk pelvic floor rehab speech.
I’m sure some of you out there know a least one woman in your family or friend circle, that has had a run-in with this problem, especially if she has had a child or two or three. Or maybe you don’t know. She might not be comfortable sharing with you her experience, and she may not want you to know she’s wearing adult diapers no matter how good they look. You can have your adult diapers delivered right to your door nowadays, discretely, no one ever has to know, not even the mailman.
I always wondered why my mom went thru so many mini pads. What’s up with the mini pads I asked her. You haven’t had your period in 30 years. “They make me feel fresh,” she told me. Fresh really? What was happening down there? I couldn’t wait for the day to never have to wear a pad again. Ok, whatever, mom. I realized later she probably had a leakage problem and would instead go through a million mini pads than wear a diaper. I think I still have a pack or two of her mini pads in my closet.
Why the OB/GYN community is not stressing this critical info to us is a mystery to me? I don’t know why? Maybe surgery is something they look forward to doing to us down the road? I don’t know?
I’ve been preaching pelvic floor rehab for over 15 years now, recommending different devices, even selling Kegel Masters, which are outdated now thanks to products like Elvie, an at-home pelvic floor rehab device that costs about $200—if your insurance company won’t pay for treatment, which they should or you don’t have insurance, purchasing one of these devices is money well spent.
I have been talking about this for years, and only in the last two years has pelvic floor rehab been brought up to me. My client, Michele, in one of her postpartum massages, shared with me, “by the way, I just finished my eight weeks of pelvic floor rehab” What I yelled!? I was so excited to hear that I almost pushed her off the table! What are you talking about, and where did you do this? I asked her.
That is how I found out about the Consortia program and how they work from various OB offices. There’s even a group of Physical Therapists here in Ft. Lauderdale now that offers a concierge service, they go to your home to do the therapy and are affordable if Insurance doesn’t pay for the treatments. Which they should!
Pelvic floor rehab should be part of the whole pregnancy experience and not something for which you should have to ask or wait until your experiencing some form of discomfort. Now is our time as women to stand up for ourselves and demand that the pregnancy package must include pelvic floor rehab.
In France, pelvic floor rehab is just routine follow-up, you have your baby you go for pelvic floor rehab. Period. This practice made me wonder about the stereotype of how French women being seen as the sexy type—the French maid, and all that went along with being French and being sexy. Then it dawned on me. Maybe it’s not just a stereotype. Perhaps they are enjoying better sex because they have been rehabbed and put back together after each child. Stronger pelvic floor may lead to stronger sexual desire followed by stronger orgasm—no downside there!
What’s also really perplexing is how they sell incontinence to us like it’s a good thing. Now we’ve all seen Whoopi Goldberg—whom I sent a Kegel device to and never received a thank you—and Lisa Renna selling their adult diapers, with Renna, on the red carpet no less, no panty lines wow that’s great! I’m peeing myself, but I’m on the red carpet, and life is good.
As if that isn’t bad enough, I was going around the house one-day doing stuff, the TV was on, and I hear one of my favorite songs “Finally it happened to me” by CeCe Peniston it stops me dead in my tracks I love this song! So, I stop to “get down” and watch the commercial, where this woman is driving down the road in her convertible.
Finally, is blasting from the radio and I’m thinking what the hell are they selling with this song? To my shock and horror, they were promoting adult diapers wait a minute, finally it happened to me is incontinence? She’s peeing herself, and she’s happy and singing about it! It can’t be SNL because it’s not Saturday. What the hell did I just watch?
The Company is Tena, and they must really like CeCe Peniston because they use another one of her songs, Let Yourself Go, to sell their incontinence products. Let yourself go, what the hell. Whoever in advertising came up with this idea should be fired. I believe they got some backlash because of their ads, but to present it a way that we should be happy about, it was just infuriating. Do they think we’re that stupid? I was pissed—no pun intended.
Doing Kegels throughout the day is an excellent way to facilitate the mind-body connection, again see this as a form of self-care. Coming out of your head and consciously thinking about your posture, breathing, and pelvic floor. Creating this new habit of doing Kegels randomly throughout the day and continuing this new habit after the baby is born is one of the tools to help keep your ass out of diapers down the road. And that road comes up pretty fast, let me tell you!
Now because of the preggo brain and you not being able to remember a damn thing—and I believe that lasts a lifetime—you’ll probably need some help in reminding yourself to do the Kegels. You can do this efficiently the old fashion way by placing post-it notes on the fridge, stick some eye level on doorways, the car dashboard, and also your computer. And if you can’t be bothered doing that, they have an app now for just this thing. An actual app with reminders, gotta love technology!
Another trick to remind yourself, is when someone is telling you their horrible birth story. You can easily distract yourself by focusing in on doing some Kegels, it’s a hard muscle to isolate so you really have to think about it, and this way you won’t hear a word they say. I really can’t believe some of the stories my preggo’s come in and tell me—SMH.
Being pregnant is one thing having a baby, and dealing with your postpartum body after birthing is another. And whether you birthed vaginal or via C-section rehabbing, this vital part of your body needs to be addressed.
The feedback coming back from my clients who have used either Consortia or the concierge service has been very positive.
Cindy, a mom I’ve massaged through five pregnancies—so I don’t want to hear any excuse why you can’t go—felt very proud of herself week after week seeing the improvement in muscle strength. She told me she is peeing a lot less during the day, which I imagine is a good thing if you’re running around after five kids all day, and also noticed she feels less back pain. Cindy also has an app that reminds her three times a day to do her Kegels. If Cindy continues to do the work to maintain her pelvic floor, there’s a good chance her ass will never see an adult diaper. I’m so proud of her.
And speaking of Cindy, she was the first one I called after hearing about the Consortia from Michelle. I mean, after having five vaginal births, she seemed like the perfect candidate for rehab. So she texted me back a few days later to tell me that her OB/GYN offered the Consortia Program. She was so excited, and I said to her, “Really, and you weren’t the first one she called. You should be pissed at her! How long have they been doing this?”
The medical community has dropped the ball on this one, but they are slowly coming around. Now is our opportunity to turn that around and get the help postpartum we deserve. And that starts by bringing this topic up with your medical community and making it a part of the whole pregnancy experience. Not just have your baby, then bye, I’ll see you in six weeks. No, that’s not good enough. We need rehab.
women-over-40-study-finds-
Dr. Elaine Waetjen, a gynecologist with the UC Davis Medical Center, has been studying urinary incontinence for more than 16 years and considers it an important but under-acknowledged issue in women’s health. Her recent study, which analyzed nine years of data from 3,000 women ages 42-64, found that 68 percent of this group experiences the problem at least once a month.
I Hope You Never Have to Say Prolapse
pro·lapse
noun
noun: prolapse; plural noun: prolapses
prōˈlaps, ˈprōˌlaps/
1. a slipping forward or down of one of the parts or organs of the body. "a rectal prolapse."
A prolapsed part or organ, especially a uterus or rectum.
verb
verb: prolapse; 3rd person present: prolapses; past tense: prolapsed; past participle: prolapsed; gerund or present participle: prolapsing
prōˈlaps/
1. (of a part or organ of the body) slip forward or down. "a prolapsed uterus."
Pelvic organ prolapse occurs when a pelvic organ such as your bladder-drops (prolapses) from its normal place in your lower belly and pushes against the walls of your vagina. Prolapse can happen when the muscles that hold your pelvic organs in place get weak or stretched from childbirth or surgery.
I was visiting my friend's mom, and she told me this horrible story about how she got up one morning made her way to the bathroom for her morning pee, and when she wiped herself she thought she felt something odd, something that shouldn’t have been there, didn’t remember that being there yesterday? Curious, she took a mirror to check it out and saw what appeared to be something hanging out of her vagina, WTH, she thought, is that a penis? To her, it looked like a penis. I’m still sorry for laughing at her notion at that moment that she could be in her early 70’s and have a penis and not know about it until now.
But the end of the story was not so funny, and it wasn’t a penis; it was her bladder. Yep ready to hit the floor! That’s how it happens your organs, and lady parts come sliding right out of you—scary! My friend’s mom is a woman who birthed three children vaginally and was never told the importance of Pelvic Floor rehab. I know because I asked her.
This lady’s experience also demonstrates how important it is to rehab the perineum area, that rehabbing and strengthening the pelvic area after childbirth might have prevented this or at least lessen the severity of her incident. She suffered from bladder prolapse. No warning, no pain, no bleeding, only her bladder was hanging out of her vagina for all to see. Hi, look, here I am, and I have the uterus and vaginal wall right behind me. Let's get you ready for surgery! Great!
Now, if keeping all your internal lady parts healthy and where they’re meant to be is not enough for you. Then I have one more pitch to get you on board with pelvic floor rehab and exercises. Data has shown that strengthening pelvic floor muscles can not only improve incontinence, but some studies also suggest that women with stronger pelvic floor muscles experience superior sexual function—like the French women?
Okay, you say, superior sexual function! Which probably means better orgasms or maybe actually having a real orgasm, and who doesn’t want that?
Have you ever wondered why some of us lose our sex drive after having kids? I did, and not that he was doing much to turn me on anyhow, but that’s another story. I just didn’t have much of a drive.
So, if the perineum is an erogenous zone, or better yet a muscle group that affects sexual satisfaction, and your perineum is weakened and lacks proper blood flow due to childbirth or even a sedentary lifestyle, then it’s no wonder you don’t feel turned on. If you take a penis and cut off its blood flow, it won’t get hard. If you don’t strengthen your perineum, you won’t feel as turned on. And what better way to end your day of doing everything for everybody then to let it all out with a kick-ass orgasm.
And speaking of penises, let me leave you with this. Thanks to Viagra, your man could be getting a hard-on well into his 90’s. That could mean a great deal of sex for you. So, to make sure you’re up to that challenge and enjoying all that great sex you’ll be having at the retirement village, please get your pelvic floor rehabbed, and please do your Kegels.
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