No Gym Needed for This Muscle Group
Published in NCCA Newsletter, Summer 2023
Gym membership has important benefits. Regular workouts can improve physical, mental, and emotional health. Gyms provide us with a variety of ways to improve cardiovascular function and to strengthen muscles. Unfortunately, our workout sessions usually neglect an important group of muscles. So let’s take a few moments to consider the benefits of strengthening the pelvic floor muscles.
Pelvic floor muscles (PFM) help with a variety of functions. These functions include having bowel movements, urinating, and sexual functioning (Cleveland Clinic, 2022). The PFM not only helps keep one’s core strong, but they can help decrease the chances of developing sexual dysfunction issues (Cleveland Clinic, 2022). Also, Having strong PFM can offer a variety of sexual benefits.
One sexual benefit of having a strong PFM is the extent and intensity of orgasm. There are certain PFM that contribute to the orgasmic experience and satisfaction. These muscles are the pubococcygeus and the iliococcygeus muscles. The orgasm occurs when these muscles reach their maximum tension and then relax, thus creating a spasm in the pelvic floor (Huang & Chang, 2022). A lot of research has shown that having strong PFM contributes to better sexual functioning and orgasm satisfaction (Sartori et al., 2021; Martinez et al., 2014; Rosenbaum, 2007).
Another benefit of strong PFM is the decreased chance of developing sexual dysfunction disorders. There are two ways that weak PFM affect individuals with male genitalia. First, individuals may develop erectile dysfunction if the ischiocavernosus and bulbocavernosus muscles are weak (Lavoisier et al., 2014). The ischiocavernosus muscle is important because it helps maintain the blood pressure to keep penile rigidity (Lavoisier et al., 2014). Second, the ischiocavernosus and bulbocavernosus muscles aid in the control of ejaculation, which can help with premature ejaculation (Pischedda et al., 2013). A benefit of strong PFM in individuals with female genitalia is the decreased chance of developing genito-pelvic pain/penetration disorder. Unfortunately however, having overactive PFM can also lead to painful sex issues, such as dyspareunia and vaginismus (Eserdağ, 2022). Not only are these issues physically painful, but they can cause mental and emotional distress (Eserdağ, 2022). Sometimes, this will cause the individual to remember how painful intercourse is. Thus, this results in continuous and painful tightening up of the PFM even more than they already are.
Fortunately, sex therapists can provide help when treatment of painful PFM is needed. Of course, in any case when treating sexual dysfunction, the individual’s mental health and relationship functioning needs to be addressed to rule out underlying psychological factors. Generally, sex therapists treat sexual dysfunctions when caused by emotional or mental distress. But, sex therapists can also contribute to helping clients find relief with physical self care. For instance, sex therapists may instruct clients on how to implement Kegel exercises (Alappattu & Bishop, 2011). Kegel exercises are used to strengthen the pelvic floor muscles. Sex therapists may also instruct clients who have genito-pelvic pain/penetration disorder in the use of vaginal dilators. Researchers found that vaginal dilators are effective in treating vaginismus (Gari et al., 2023). While sex therapists do provide effective treatments in many cases, clients have the best chance for positive outcomes if they collaborate together with both sex therapists and pelvic floor therapists (Eserdağ, 2022; Bukhari, 2022).
Pelvic floor therapists can perform manual therapy, use biofeedback, and use electrical stimulation to treat pelvic floor dysfunctions (Gasnick, 2023). Sex therapists can offer a few physical interventions but can also help clients find relief from the emotional and mental distress contributing to or resulting from particular sexual dysfunctions. Generally, best outcomes result from collaboration between sex therapists and pelvic floor therapists when treating a spectrum of sexual dysfunctions.
References
Alappattu, M. J., & Bishop, M. D. (2011). Psychological factors in chronic pelvic pain in women: Relevance and application of the fear-avoidance model of pain. Physical Therapy, 91(10), 1542-1550. https://doi.org/10.2522/ptj.20100368
Bukhari, S. Y. (2022). Psycho, pharmaco, and sex therapy for the treatment of premature ejaculation. Pakistan Journal of Medical Sciences, 38(8), 2350-2355. https://doi.org/10.12669/pjms.38.8.5217
Cleveland Clinic. (2022, April). Pelvic floor muscles. https://my.clevelandclinic.org/health/body/22729-pelvic-floor-muscles
Eserdağ, S. (2022). Female genito-pelvic pain and penetration disorders. In S. Sarikaya, G. I. Russo, & D. Ralph (Eds.), Andrology and Sexual Medicine (pp. 243-257).
Springer, Cham. Gari, R., Alyafi, M., Gadi, R., & Alsaud, R. A. (2023). Assessing treatment outcome of primary vaginismus using vaginal dilators among women in Saudi Arabia. Journal of Sexual Medicine, 20(1), i120-i121. https://doi.org/10.1093/jsxmed/qdad060.188
Gasnick, K. (2023, March 15). What is pelvic floor therapy? Treatment for urine leaking and other conditions. Verywellhealth. https://www.verywellhealth.com/pelvic-floor-physical-therapy-5189474#toc-pelvic-floor-therapy-what-to-expect
Huang, Y.-C., &; Chang, K.-V. (2022). Kegel exercises. National Center for Biotechnology Information. https://pubmed.ncbi.nlm.nih.gov/32310358/
Lavoisier, P., Roy, P., Dantony, E., Watrelot, A., Ruggeri, J., & Dumoulin, S. (2014). Pelvic-floor muscle rehabilitation in erectile dysfunction and premature ejaculation. Physical Therapy, 94(12), 1731-43. https://doi.org/10.2522/ptj.20130354
Martinez, C. S., Ferreira, F. V., Castro, A. A. M., & Gomide, L. B. (2014). Women with greater pelvic floor muscle strength have better sexual function. Acta Obstetricia et Gynecologica Scandinavica, 93(5), 497-502. https://doi.org/10.1111/aogs.12379
Pischedda, A., Fusco, F., Curreli, A., Grimaldi, G., & Pirozzi, F. F. (2013). Pelvic floor and sexual male dysfunction. Archivio Italiano di Urologia e Andrologia, 85(1), 1–7. https://doi.org/10.4081/aiua.2013.1.7
Rosenbaum, T. Y. (2007). Pelvic floor involvement in male and female sexual dysfunction and the role of pelvic floor rehabilitation in treatment: A literature review. The Journal of Sexual Medicine, 4(1), 4-13. https://doi.org/10.1111/j.1743-6109.2006.00393.x
Sartori, D. V. B., Kawano, P. R., Yamamoto, H. A., Guerra, R., Pajolli, P. R., & Amaro, J. L. (2021). Pelvic floor muscle strength is correlated with sexual function. Investigative and Clinical Urology, 62(1), 79–84. https://doi.org/10.4111/icu.20190248