What You Need to Know About Pelvic Floor Health — & Why Kegels Aren't Always the Answer
When was the last time you did something proactive for your pelvic health? Dr. Uchenna Ossai wants to know. Ossai (or “Dr. UC,” as she’s known), is a pelvic health physical therapist, a certified sexuality educator and counselor, and the creator and founder of YouSeeLogic, a judgment-free platform for sexual intelligence — and she wants all of us to start making our pelvic floor a priority.
At the SHE Media Co-Lab Future of Health event at SXSW, Dr. UC posed this question to an attentive audience: “On the average day, you wake up in the morning, you have your coffee, you have your tea. You listen to or read the news, and then you’re thinking, ‘I’m going to do something for my pelvic health.’ How many of you — show of hands — do that every single day?”
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Let’s just say: not a lot of hands went up, and that wasn’t a surprise to Dr. UC. After all, for most of us, pelvic health hasn’t been a part of our mental scripting. “When we think of wellness, our bodies, exercise… I didn’t hear about this in grade school,” she said. “My Nigerian aunties and my parents did not tell me about my pelvic floor.”
In fact, Dr. UC’s pelvic health focus happened quite by accident. The summer before her sophomore year in high school, she explained, she got an internship with a physical therapist that she thought was a sports therapist — and realized she wasn’t when the practice’s first patient was a 19-year-old male with penis pain and rectal pain.
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“I had questions,” she said, as the audience laughed. “First of all, what is the pelvic floor? And I thought that only women and vagina owners had issues down there. What about sexy time? What about those people who always pee when they laugh or jump? You know, even as a kid, I was like, ‘That doesn’t seem like that should be happening.’”
Despite her initial shock, the subject matter stuck — and luckily for us, Dr. UC has made a career out of educating people about pelvic floor health in a way that’s frank, funny, and totally judgment-free. Read on for the things she wants everyone to know about the pelvic floor, a breathing exercise you can do right now, and why Kegels aren’t always the answer.
Our pelvic floor is in executive leadership in our bodies
“The first thing we have to realize is that we have to think of our pelvic floor as in being in executive leadership in our bodies,” she told the audience at SXSW. “Our brain is the boss. But our pelvic floor is a very much trusted advisor because it’s responsible. Because it’s oriented at the bottom of our pelvis, from the front of our pubic bone to the tailbone, It holds our organs inside of us. That’s a real task. It pumps blood back to our hearts, back up through our organs. It helps us with peeing, pooping, and childbirth if you so choose. It stabilizes our spine, hips, and abdomen. And most importantly, it’s vital for sexy time.”
Our pelvic floor is an equal opportunity employer
“The second thing we have to realize is that our pelvic floor is an equal opportunity employer,” she said. “It’s in everybody, for everybody. No matter your age, or gender, everyone has a pelvic floor, and the pelvic floor is a muscle. What happens when we don’t use muscle? What if we just sat around and didn’t move at all? It would atrophy. It wouldn’t do its job.
Kegels are not always the answer
“When people think about their pelvic floor, they [think] Kegels,” she said. “Well, I’m gonna say something controversial: Kegels are not the answer. No, because our pelvic floor is a loyal team player. It works with our abs, our diaphragm, our back, our booties. If your back is mad, guess who else is mad? Your pelvic floor.”
Dr. UC pointed out that frequently, physical therapists will recommend abdominal exercises for back pain, but rarely talk about the pelvic floor. “But your pelvic floor works as part of a team and they have to be coordinated,” she explained.
At SXSW, Dr. UC led the audience through a simple breathing exercise that you can do at home, right now:
First, if you’re sitting with your legs crossed, uncross them and make sure your feet are about hip-width apart. If you’re standing, stand with your feet hip-width apart in a neutral position. Do a quick body check: Relax your jaw; bring your shoulders down. Let your belly hang and relax your toes.
Next, “take a breath into your ribcage. Inhale in through your nose, let your ribcage expand, and feel that into your pelvic floor, into the anus, into the vagina [or] into the penis, and then exhale. And I want you to do that again. Inhale, really feel it into the bowl of the pelvis. Exhale.”
Another exercise she recommended: Pretend you’re going to blow out a birthday candle at the same time as you squeeze and lift the urethra, vagina, and anus. “Like you’re picking up a napkin,” she said. “With a penis, you want to imagine that you’re pulling it into your body or you’re nodding it toward your stomach.”
Back to kegels, she explained why they’re not her go-to prescription: “One of the things that I tell people about kegels is, your pelvic floor has to contract, it has to go up, but it also has to come down and it has to be able to lengthen. I never blindly prescribe kegels, ever. Because I don’t know what’s going on in your body. If you’re a person that has chronic pelvic pain, or constipation, if it hurts to put tampons in, if it hurts to put any type of sexual touch on your genitals… I’m going to have to assess you first. Because if you’re doing kegels and you have those issues, or if you’re holding, you know, what is it the yoni egg in your vagina the whole time or in your anus the whole time? You might be winding up that pain cycle.”
Seeing a pelvic health physical therapist like herself is ideal, but if you must do kegels on your own, she suggested inserting a finger inside your vagina or inserting a finger or toy in your anus, “and practice that squeeze-and-pull,” she said. “You’re gonna lift, you’re gonna squeeze and lift, you’re gonna let go, and then you want to make sure that you lengthen. [Think], you go to the second floor, lobby, basement. Second-floor lobby basement.”
Prioritizing pelvic floor health has one very big benefit: “Remember, the pelvic floor is one of your secret weapons for satisfying sex life,” she said, adding, “We want to be able to have control of our pelvic health. We want to have control of our pelvic floor. We need to dispel the myth that it’s only for people who have babies or only for people going through menopause or only for women and vagina owners. It’s for everybody.”
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