Posts Tagged ‘female sexual dysfunction’

Addyi: Female Viagra Or What?

May 14, 2016

Andrew Siegel MD  5/14/16

Viagra-femminile

Clearly, sexism exists in the field of sexual medicine with a large gender gap with respect to the recognition and treatment of sexual issues. Numerous medications and options are available for male sexual dysfunction, but choices are few are far between for females with sexual problems.  Men have pelvic floor muscle training, vibrational stimulation, vacuum suction devices, pills (Viagra, Levitra, Staxyn, Cialis, Stendra), testosterone replacement, urethral suppositories, penile injection therapy and penile implants. Women have Kegel exercise programs, vibrational stimulation and estrogen replacement.  It is only fair that women have equal sexual medical rights.

One of the issues underlying this sexual gender gap is the erroneous assumption that  by virtue of possessing vaginas, females are less prone to sexual dysfunction than men are. The word “vagina” derives from the Latin word for “sheath,” a cover for the blade of a sword. The sword and sheath metaphor is convenient and assumes that the male plays the fully active role and the female the passive one. A flawed thought pattern is that while a man needs a rigid erection to perform—a complicated nerve-blood vessel-muscular event—a woman can simply lubricate and be ready to go. The truth of the matter is that female sexual response, although more subtle and nuanced than the male response, results in genital anatomical changes as profound as those that occur in males, just less apparent and obvious because the vagina is internal. Under normal circumstances, the vagina is no more “primed” for sex than is a flaccid penis, the un-stimulated vagina being merely a potential space; however, when stimulated, the vaginal walls lubricate and the vagina expands, lengthens and widens in order to accommodate an erect penis, changes that are as dramatic as the transition of a flaccid penis to an erect penis. The bottom line is that the vagina is by no means simply a passive channel.

Female sexual dysfunction is a common condition that can give rise to one or more of the following symptoms: diminished desire; decreased sexual arousal; difficulty achieving orgasm; and pain with sexual intercourse. The most prevalent issue and the subject matter of this entry is decreased or lack of sexual desire, the formal medical title being hypoactive sexual desire disorder (HSDD), although I prefer the less formal, non-medical version: “Honey, I’m not in the mood.” Diminished sex drive is complicated and involves a number of underlying factors–biochemical, psychological, and social.

In terms of biochemical factors, the neurotransmitters norepinephrine and dopamine stimulate sexual desire, whereas serotonin inhibits it. The SSRI (selective serotonin reuptake inhibitors) class of antidepressants function by increasing serotonin levels and are associated with decreased sexual desire as well as difficulty with arousal and orgasm, suggesting the important roles that serotonin plays as a regulators of sexual desire. Additionally, the hormone testosterone is a libido stimulant in both genders.

Addyi was initially developed as an anti-depressant and was investigated in a clinical trial for the treatment of depression. Unfortunately, it failed to offer a meaningful benefit as an anti-depressant, but was found to increase sexual desire in females who had depression in combination with decreased libido, providing the rationale for further investigating it as a treatment for diminished libido.

Addyi is a non-hormonal treatment that acts on the brain to normalize neurotransmitter levels and thus enhance sexual desire. Perhaps TMI… physiologically Addyi is an agonist of the serotonin receptor 1A and an antagonist of serotonin receptor 2A, inhibiting the serotonin “anti-sexual” effects while promoting dopamine “pro-sexual” effects.

Addyi was FDA-approved even though the members of the advisory committee acknowledged that its effectiveness was modest. One of the committee members who voted for its approval stated: “It’s not a little magic pink pill.” Another committee member who voted against approval claimed that it was “a mediocre aphrodisiac with some side effects with marketing winning out over science.”

Addyi 100 mg daily has been shown to be safe and effective and superior to placebo in improving female libido. It is used to treat “pre-menopausal women with acquired generalized hypoactive sexual desire disorder characterized by low sexual desire that causes marked distress or interpersonal difficulty not due to coexisting medical or psychiatric issues, relationship problems or side effects from other medications.” It cannot be used with alcohol, so no romantic dinner with a nice bottle of wine if you are taking Addyi.

Last weekend I attended the San Diego American Urological Association meeting in San Diego, where Dr. Irwin Goldstein (a female sexual dysfunction expert with extensive experience prescribing Addyi) reported effectiveness in 60% of his patients with impaired libido, in some cases with life-changing results.

The adverse effects associated with Addyi –usually mild to moderate in severity–include dizziness, lightheadedness, nausea, dry mouth and sleepiness. On occasion it can cause reduced blood pressure (hypotension) and passing out (syncope), particularly if used with alcohol.

Bottom Line: Although Addyi may not be as effective in increasing libido in women as Viagra is in improving erections in men, in the properly selected female it can provide a meaningful improvement in sexual drive.  It is the first FDA-approved drug for sexual dysfunction in women and hopefully represents the beginning of the end of sexism in the field of sexual medicine. 

Reference: Gao Z, Yang D, Yu L, and Cui,Y: Efficacy And Safety Of Flibanserin Center In Women With Hypoactive Sexual Desire Disorder: A Systematic Review And Meta-Analysis. Journal of Sexual Medicine 2015; 12:2095 – 2104

Wishing you the best of health,

2014-04-23 20:16:29

http://www.AndrewSiegelMD.com

A new blog is posted every week. To receive the blogs in the in box of your email go to the following link and click on “email subscription”:  www.HealthDoc13.WordPress.com

Author of THE KEGEL FIX: Recharging Female Pelvic, Sexual and Urinary Health– newly available on Amazon Kindle, Apple iBooks, B&N Nook and Kobo (paperback edition will be available soon).

Author page on Amazon: http://www.amazon.com/Andrew-Siegel/e/B004W7IM48

Apple iBook: https://itunes.apple.com/us/book/the-kegel-fix/id1105198755?mt=11

Trailer for The Kegel Fix: https://www.youtube.com/watch?v=uHZxoiQb1Cc  

Co-creator of Private Gym and PelvicRx: comprehensive, interactive, FDA-registered follow-along male pelvic floor muscle training programs. Built upon the foundational work of Dr. Kegel, these programs empower men to increase pelvic floor muscle strength, tone, power, and endurance: www.PrivateGym.com or Amazon.  In the works is the female PelvicRx pelvic floor muscle training DVD. 

Pelvic Rx can be obtained at http://www.UrologyHealthStore.com, an online store home to quality urology products for men and women. Use promo code “UROLOGY10” at checkout for 10% discount. 

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The Clitoris: What’s Under The Hood?

May 7, 2016

Andrew Siegel MD 5/7/16

The clitoris is a complex and mysterious organ possessed by all female mammals. Many men (as well as a fair share of women) are clueless (“uncliterate”) about this curious, unique and fascinating structure. The intent of this entry is to provide a primer of useful knowledge so that you can understand what is under the (clitoral) hood, literally and figuratively.  Advances in imaging—especially magnetic resonance (MR)—have provided a much clearer understanding of clitoral anatomy. Whether you are a female or a male, a greater knowledge and appreciation of the anatomy, function and nuances of this special female body part will most certainly prove useful and beneficial. 

Female External Genital Anatomy

The clitoris is part of the vulva, the outer part of the female genitals. The vulva consists of the mons, outer lips, inner lips, vestibule, vaginal opening, urethral opening and the star of the show–the clitoris.

5. vulva 

(Female external genital anatomy, from The Kegel Fix, credit to illustrator Ashley Halsey)

Clitoral Geography: Mountains, Hills and Earthquakes

The vulva is home to some hilly and bumpy terrain that is well worth gaining familiarity with so it can be traversed with finesse. The word mons derives from Latin meaning “mountain” because it is the rounded and prominent fatty tissue overlying the pubic bone. The word clitoris derives from the Greek “kleitoris” meaning “little hill.”

An earthquake is the shaking of the Earth’s surface caused by the sudden release of energy resulting from movements within the earth’s crust that creates seismic waves. If a female orgasm is thought of as an “earthquake,” the clitoris is the “epicenter.” The head of the clitoris—typically only the size of a pea—is an extraordinarily dense bundle of sensory nerve fibers.

 Pleasure (and Reproduction)

The clitoris is central to the female sexual response and sexual climax, the only human organ that exists solely for pleasure, although nature has secondary motives. The clitoris is a vital part of the anatomical design used for nature’s clever “bait and switch” trick, in which the pursuit of a pleasurable activity drives reproduction of the human species and the perpetuation of life. In the mammalian kingdom, if reproduction was not associated with sexual pleasure, how much sexual activity do you think would actually occur?

Male and Female Comparative Genital Anatomy

It might surprise you how remarkably similar the female and male external genitals are. In fact, in the first few weeks of embryonic existence, the external genitals are identical. The female embryo’s external genitals are the “default” model that will remain female in the absence of masculinizing hormones. The female clitoris and the male penis are essentially the same structure, as are the female outer lips and the male scrotum. In fact, there is not much difference in appearance between a very large clitoris and a very small penis.

Although the clitoris is the female equivalent of the penis, it is exclusively a sexual organ, whereas the penis is a urinary, sexual and reproductive organ. Like the penis, the clitoris is largely composed of erectile tissue that upon arousal and stimulation engorges with blood and with increasing stimulation becomes erect. After sexual climax, the clitoris returns to its normal relaxed state.

Interesting trivia: The female spotted hyena, squirrel monkey, lemur, and bearcat all have in common a very large clitoris. When erect, it appears very similar to the male’s penis and is used to demonstrate dominance over other members of their clans. It is referred to as a “pseudo-penis.”

The Tip of the Iceberg, But Far From Frigid

 Most of the clitoris is hidden and internal. Commonly misrepresented as a “bean” or “button,” the external nub is the clitoral head, merely the “tip of the iceberg.” The iceberg metaphor is an apt one in terms of anatomy, but is off target with respect to what a clitoris is—the seat of female genital passion—with its head having a greater concentration of nerve endings than any other body part, a far cry from “ice.”

Clitoral Anatomy

The glans (head) is the external and visible part of the clitoris. It is located just above the opening of the urethra. The remainder of the clitoris is internal and consists of the clitoral shaft (body) and its extensions, known as crura (legs). The prepuce (foreskin), a hood of skin formed by the inner vaginal lips, covers the clitoral shaft.

clitoris

(Anatomy of the vulva and the clitoris by OpenStax College – Anatomy & Physiology, Connexions Web site. http://cnx.org/content/col11496/1.6/, Jun 19, 2013., CC BY 3.0, https://commons.wikimedia.org/w/index.php?curid=30148635, no changes made to original)

The crura are wishbone-shaped and are attached to the pubic arch as it diverges on each side. The shaft and crura contain erectile tissue, consisting of spongy sinuses that become engorged with blood at the time of sexual stimulation, resulting in clitoral engorgement and erection. Beneath the crura on either side of the vaginal opening are the clitoral bulbs, sac-shaped erectile tissues that lie beneath the outer vaginal lips. With sexual stimulation, they become full, plumping and tightening the vaginal opening.

One can think of the crura and bulbs as similar to the roots of a tree, hidden from view and extending deeply below the surface, yet fundamental to the support and function of the clitoral shaft and head above, comparable to the tree’s trunk and branches.

Pelvic Floor Muscles

These important muscles are critical to sexual function in general and clitoral function in particular. They control the voluntary tightening and relaxing of the vagina, increase genital blood flow, support clitoral erection and contract rhythmically at the time of orgasm. Two of the pelvic floor muscles are especially vital to clitoral function: the ischiocavernosus and bulbocavernosus muscles that surround the crura and the bulbs, respectively. They stabilize the deep roots of the clitoris and compress the roots when engaged, increasing genital blood flow and maintaining clitoral erection, since their compressions push blood from the roots back towards the shaft and glans.

3. superficial and deep PFM

(Female pelvic floor muscles, from The Kegel Fix, credit to illustrator Ashley Halsey)

The pelvic floor muscles strongly contribute to the transformation of the clitoris from flaccid to softly swollen to rigid. By compressing the roots of the clitoris, they elevate blood pressure within the clitoris to maintain clitoral swelling and erectile rigidity. At the time of climax, these muscles contract rhythmically, and an orgasm would not be an orgasm without the contribution of these muscles working together with the clitoris.

Interesting trivia: The blood pressure within the clitoris at the time of a clitoral erection is hypertensive (high blood pressure) range, accounting for the rigidity. This is largely on the basis of the contractions of the aforementioned pelvic floor muscles. The only regions of the body where hypertension is desirable are the penis and clitoris.

Sexual Function And The Clitoris

With arousal and sexual stimulation, the clitoral erectile tissue engorges, resulting in clitoral shaft thickening and swelling of the glans. With increasing clitoral stimulation, clitoral retraction occurs, in which the clitoral shaft and glans withdraw from their overhanging position, pulling inwards against the pubic bone.

When a sufficient threshold of sexual stimulation is reached, climax occurs with contraction of the pelvic floor muscles, vagina, urethra, uterus and anus.

The clitoris plays a central role in orgasm for the majority of women and for most, clitoral stimulation is necessary to achieve orgasm. Some women require direct clitoral stimulation, while for others indirect stimulation is sufficient; about 25% are capable of achieving orgasm via vaginal intercourse alone. Vaginal intercourse often results in indirect clitoral stimulation since the crura and bulbs flank the vaginal opening and these inner parts of the clitoris are stimulated with penetrative thrusting.

Interesting trivia: Magnetic resonance studies have shown that a larger clitoral head size and shorter distance from the clitoris to the vagina are correlated with an easier ability to achieve a vaginal orgasm.

There is a clitoral literacy movement that is gaining momentum. Please visit:

http://projects.huffingtonpost.com/cliteracy for more information on the clitoris and this campaign to foster awareness of this curious organ.

Wishing you the best of health,

2014-04-23 20:16:29

http://www.AndrewSiegelMD.com

A new blog is posted every week. To receive the blogs in the in box of your email go to the following link and click on “email subscription”:  www.HealthDoc13.WordPress.com

Author of THE KEGEL FIX: Recharging Female Pelvic, Sexual and Urinary Health– newly available on Amazon Kindle, Apple iBooks, B&N Nook and Kobo (paperback edition will be available soon).

Author page on Amazon: http://www.amazon.com/Andrew-Siegel/e/B004W7IM48

Apple iBook: https://itunes.apple.com/us/book/the-kegel-fix/id1105198755?mt=11

Trailer for The Kegel Fix: https://www.youtube.com/watch?v=uHZxoiQb1Cc

Author of Male Pelvic Fitness: Optimizing Sexual and Urinary Health and Promiscuous Eating: Understanding Our Self-Destructive Relationship With Food   

Co-creator of Private Gym and PelvicRx: comprehensive, interactive, FDA-registered follow-along male pelvic floor muscle training programs. Built upon the foundational work of Dr. Kegel, these programs empower men to increase pelvic floor muscle strength, tone, power, and endurance: www.PrivateGym.com or Amazon.  In the works is the female PelvicRx pelvic floor muscle training DVD. 

Pelvic Rx can be obtained at http://www.UrologyHealthStore.com, an online store home to quality urology products for men and women. Use promo code “UROLOGY10” at checkout for 10% discount. 

 

 

 

 

 

 

Limping Along

November 14, 2015

Andrew Siegel MD   11/14/15

Blausen_0257_CoronaryArtery_Plaque

(Above image courtesy of: Blausen.com staff. “Blausen gallery 2014“. Wikiversity Journal of MedicineDOI:10.15347/wjm/2014.010ISSN 20018762.)

This  entry is intended to be unisex, since both genders are equally susceptibility to clogged arteries and impaired blood flow to muscles and other vital organs (a.k.a., ischemia).  Although sexual dysfunction resulting from compromised pelvic blood flow is outwardly more obvious in the male with the inability to achieve an erection or difficulty in obtaining or maintaining an erection, females as well can suffer with sexual consequences to a similar degree with impaired arousal, lubrication and climax.

Male sexual response is so evident, conspicuous and literally palpable, a binary system with a digital “one” or “zero” response, whereas female sexuality is to all appearances so much less obvious and so much more subtle and nuanced. However, this framing of human sexual response is off target as the female sexual response results in genital anatomical changes as profound as those that occur in males, just less apparent. Under normal circumstances, the vagina is no more “primed” for sex than is a flaccid penis, the un-stimulated vagina being merely a potential space with the vaginal roof and floor in direct contact. However, when stimulated, the vaginal walls lubricate and the vagina expands, lengthens and widens in order to accommodate an erect penis, changes that are as dramatic as the transition of a flaccid penis to an erect penis.  

Because the primary driver of the human sexual response is BLOOD FLOW, females can be as susceptible as males to compromised circulation and can “limp” in the bedroom just as much as males can. It’s just not as ovvious and apparent. Furthermore, both genders are susceptible to limping in the street. 

In terms of ambulation, many people limp instead of walk because of peripheral arterial disease (PAD), a medical condition in which the arteries in the legs clog due to a buildup of fatty plaque. This impairs blood flow and the delivery of oxygen and nutrients to muscles and other tissues, giving rise to pain when exercise increases the muscle’s demand for oxygen.

PAD commonly occurs on the basis of poor lifestyle–obesity, diabetes, an unhealthy diet, a sedentary existence and often the use of tobacco. When muscles are denied the increased blood flow required with the demands of movements such as walking or exercisizing, pain and limping result, known as claudication, from the Latin “claudeo,” meaning “to limp.”

Claudication often does not demonstrate itself until there is significant blockage–usually about a 70% restriction– to arterial flow. It occurs because of insufficient oxygen to the leg muscles causing the buildup of lactic acid, which causes discomfort and pain. Claudication typically responds to stopping movement, which resolves the pain.

Claudication is by no means limited to the leg muscles, but can happen to any muscle in the body. “Claudication” of the heart muscle—which occurs when the coronary arteries are compromised—is known as angina. “Claudication” of the brain—which occurs when the carotid arteries are compromised—can give rise to mini-strokes or transient ischemic attacks (TIA). “Claudication” of the penis—which occurs when the penile arteries are clogged with years of accumulation of fatty plaque—is known as erectile dysfunction (ED), a.k.a., when the penis limps along.

Sexual dysfunction in either gender can be a warning sign that an underlying medical problem exists, the quality of sexual response serving as a barometer of cardiovascular health. When it comes to men, the presence of rigid and durable erections is an indicator of overall cardiovascular health, and conversely, the presence of ED can be a clue to poor cardiovascular health. For this reason, men with ED should consider undergoing a basic medical evaluation seeking arterial disease elsewhere in the body (heart, brain, aorta, and peripheral blood vessels). Since the penile arteries are generally rather small—1 to 2 millimeters in diameter—and the coronary (heart) arteries are about 4 millimeters in diameter, it stands to reason that if vascular disease is affecting the tiny penile arteries, it may well be soon affecting the larger coronary arteries as well. The presence or absence of erections may thus be considered a genital “stress test.”  The same applies to females who are limping in the bedroom.

The presence of ED is as much of a predictor of cardiovascular disease as is a strong family history of cardiac problems, tobacco smoking, or elevated cholesterol. The British cardiologist Graham Jackson expanded the meaning of the initials ED to: Endothelial Dysfunction (endothelial cells being the type of cells that line the insides of arteries); Early Detection (of cardiovascular disease); and Early Death (if missed).

Bottom Line: Heart-healthy and blood vessel-healthy is sexual-healthy (and vice versa). If you do not care to limp when you walk or be limp in the bedroom, commit to a healthy lifestyle. Minimizing the buildup of fatty arterial plaque will prevent claudication everywhere in the body. To do so requires weight management, healthy eating, regular exercise, avoiding tobacco, etc. And if you are already limping (whether it is on the sidewalk or the bedroom), a lifestyle “angioplasty”—cleaning up your unhealthy lifestyle habits—can help reverse the problem.  This applies equally to both men and women. 

Wishing you the best of health,

2014-04-23 20:16:29

http://www.AndrewSiegelMD.com

A new blog is posted every week. To receive the blogs in the in box of your email go to the following link and click on “email subscription”: www.HealthDoc13.WordPress.com

Author of Male Pelvic Fitness: Optimizing Sexual and Urinary Health: available in e-book (Amazon Kindle, Apple iBooks, Barnes & Noble Nook, Kobo) and paperback: www.MalePelvicFitness.com. In the works is The Kegel Fix: Recharging Female Pelvic, Sexual and Urinary Health.

Co-creator of Private Gym, a comprehensive, interactive, FDA-registered follow-along male pelvic floor muscle training program. Built upon the foundational work of Dr. Arnold Kegel, Private Gym empowers men to increase pelvic floor muscle strength, tone, power, and endurance: www.PrivateGym.com or Amazon.

Testosterone For Females: Is There A Role?

October 31, 2015

Andrew Siegel MD   10/31/15

Many of my recent entries have been male-oriented. It’s time to give the fairer sex some equal time.

BodybuildingWoman

(Above image entitled: Mujer culturista mostrando la musculación de la espalda y los brazos, author: roonb, created November 2007, no changes to original image, creative commons license 2.0, link to license: creativecommons.org/licenses/by/2.0)

Female sexual dysfunction (FSD) is a common condition that may encompass diminished desire, decreased sexual arousal, difficulty achieving orgasm and pain with sexual intercourse. The most prevalent issue is decreased or lack of sexual desire, now given the formal medical title: Hypoactive Sexual Desire Disorder (HSDD), although I prefer the less formal, non-medical version: “Honey, I’m not in the mood.”

Testosterone (T)—the key male sexual hormone—has a strong role in stimulating sexual drive in both men and women and has long been used to manage diminished female libido and other sexual issues, despite it not being approved by the FDA for this intent. It has been shown to improve libido, arousal, sexual pleasure and overall sexual satisfaction.

Testosterone In Women

Although T is the major male sex hormone, it is also vital in females, similarly to how estrogen is the key female sex hormone, but has important functions in males as well.  In pre-menopausal women, the ovaries and adrenals (those paired glands that sit atop each kidney) each produce about 25% of T, with the other 50% produced by muscle and fat cells. The two biggest factors leading to a decrease in blood T levels are aging and menopause.

Pre-menopausal women produce about 0.25 mg T/day. (Men produce 6-8 mg T/day, about 25 times as much as females). Even after menopause, the ovaries continue to produce T.  Women who have their ovaries removed experience a dramatic decrease in T.

One of the major limitations of measuring T levels in females is the lack of reliable and accurate assays to precisely measure T levels at such low concentrations. Another shortcoming is that there is no concensus on what precisely is the lower level of T in females.

Symptoms of low T in females may include diminished libido, fatigue, lack of energy, decrease in well being, impaired concentration, depression and difficulties with arousal and orgasm. These symptoms of low T are very non-specific and have quite an overlap with the symptoms and changes that accompany normal aging, insufficient or poor quality sleep, overworking and/or an unhealthy lifestyle. Signs of low T in females are decreased muscle mass, increased body fat, thinning hair and bone wasting (osteopenia).

Decreased Female Libido

This is defined as absent or reduced interest in and arousal from sex, erotic thoughts, fantasies, or written, verbal, and visual cues.  There is usually a reduction in initiation of sex and reception to partner’s initiation attempts. When sexual activity does occur, there is often absent or reduced sensation (both genital and non-genital), excitement and pleasure. Although low T is an important cause of decreased sex drive, there are many other competing causes including other sexual issues such as pain with intercourse or inability to orgasm, medical diseases, medications, unhealthy lifestyle, fatigue, pregnancy, breast-feeding, menopause, boredom, stress, many other psycho-emotional factors and relationship issues.

Treatment Options

T has been shown to improve sexual function in both pre-and post-menopausal women. Testosterone replacement therapy (TRT) should only be a consideration after other causes of diminished libido have been eliminated.  It is challenging to predict which women will respond best to T therapy. Another concern is the safety and potential side effects with the long-term use of TRT.

There are currently no FDA-approved TRT products for women in the USA, so any usage is off-label. Products designed for TRT in males are available in a variety of preparations, including skin patches, gels and creams, buccal (gum) preparation, nasal gels, injections and long-acting pellets implanted in fatty tissue. Common side effects of TRT include unwanted hair growth, acne and mood or personality changes.

Addyi (Flibanserin) is a new oral medication for diminished libido.  It is currently being marketed largely to females, but is purportedly effective for both genders. It is the first FDA- approved prescription for diminished sex drive and has been referred to as “pink Viagra.” It is not TRT, but works centrally by affecting serotonin levels. It just became available this month.

Excellent reference on this subject: Khera, M. Testosterone Therapy for Female Sexual Dysfunction. Sex Med Rev 2015;3:137-144

Wishing you the best of health,

2014-04-23 20:16:29

http://www.AndrewSiegelMD.com

A new blog is posted every week. To receive the blogs in the in box of your email go to the following link and click on “email subscription”: www.HealthDoc13.WordPress.com

Author of Male Pelvic Fitness: Optimizing Sexual and Urinary Health: available in e-book (Amazon Kindle, Apple iBooks, Barnes & Noble Nook, Kobo) and paperback: www.MalePelvicFitness.com. In the works is The Kegel Fix: Recharging Female Pelvic, Sexual and Urinary Health.

Co-creator of Private Gym, a comprehensive, interactive, FDA-registered follow-along male pelvic floor muscle training program. Built upon the foundational work of Dr. Arnold Kegel, Private Gym empowers men to increase pelvic floor muscle strength, tone, power, and endurance: www.PrivateGym.com or Amazon.

10 Myths About Kegel Exercises: What You Need to Know

November 14, 2014

Andrew Siegel, M.D.

 

shutterstock_orange gu tract closeup

 

shutterstock_femalebluepelvic

 

Myth: Kegels are just for the ladies.

Truth: Au contraire…men have essentially the same pelvic floor muscles as do women and can derive similar benefits to sexual, urinary, and bowel health.

 

Myth: The best way to do Kegels is to stop the flow of urine.

Truth: If you can stop your stream, it is indeed proof that you are contracting the proper set of muscles. However, this is just a means of feedback to reinforce that you are employing the right muscles, but the bathroom should not be your Kegel muscle gymnasium.

 

Myth: You should do Kegel exercises as often as possible.

Truth: Pelvic floor muscle exercises strengthen and tone the pelvic floor muscles and like other muscle-strengthening routines, should not be performed every day. Pelvic exercises should be done in accordance with an intelligently designed plan of progressively more difficult and challenging exercises that require rest periods in order for optimal muscle growth and response.

 

Myth: You can and should do Kegels anywhere (while stopped in your car at a red light, waiting in line at the check out, while watching television, etc.)

Truth: Exercises of the pelvic floor muscles, like any other form of exercise, demand gravitas, focus, and isolation of the muscle group at hand. Until you are able to master the exercise regimen, it is best that the exercises be performed in an appropriate venue, free of distraction, which allows single-minded focus and concentration. This is not to say that once you achieve mastery of the exercises and a fit pelvic floor that you cannot integrate the exercises into the activities of daily living.

 

Myth: Holding the pelvic floor muscles tight all the time is desirable.

Truth: Not a good idea…the pelvic floor muscles have natural tone to them and when you are not actively engaging and exercising them, they should be left to their own natural state. There exists a condition—tension myalgia of the pelvic floor muscles—in which there is spasticity, tightness and pain due to excessive tension of these muscles. Pelvic floor training in this circumstance must be done with caution in order to avoid aggravating the pain, but maximal muscle contraction can induce maximal muscle relaxation, a meditative state between muscle contractions.

 

Myth: Focusing on your core is enough to ensure pelvic floor muscle fitness.

Truth: The pelvic floor muscles do form the floor of the “core” group of muscles and get some workout whenever the core muscles are exercised. However, for maximum benefit, specific focus needs to be made on the pelvic floor muscles. In Pilates and yoga, there is an emphasis on the core group of muscles and a collateral benefit to the pelvic floor muscles, but this is not enough to achieve the full potential fitness of a regimen that focuses exclusively on the pelvic muscles.

 

Myth: Kegel exercises do not help.

Truth: Au contraire…pelvic floor muscles have proven to help a variety of pelvic maladies in each gender. In females, pelvic floor muscle training can help urinary and bowel incontinence, pelvic relaxation, and sexual dysfunction. In males, pelvic floor muscle training can help incontinence (stress incontinence that follows prostate surgery, overactive bladder, and post void dribbling), erectile dysfunction, premature ejaculation and other forms of ejaculatory dysfunction as well as help bowel incontinence and tension myalgia of the pelvic floor.

 

Myth: Kegels are only helpful after a problem surfaces.

Truth: No, no, no. As in any exercise regimen, the best option is to be proactive and not reactive in order to maintain muscle mass and strength in order to prevent problems from arising before they have an opportunity to do so. Pelvic floor muscle training done during pregnancy can help prevent pelvic issues from arising in females and pelvic muscle training in males can likewise help prevent the onset of a variety of sexual and urinary maladies. There is no better time than the present to start pelvic exercises to delay or prevent symptoms.

 

Myth: You can stop doing Kegels once your muscles strengthen.

Truth: No, “use it or lose it” applies here as it does in any muscle-training regimen. Muscles adapt positively to the stresses and resistances placed upon them and so they adapt negatively to a lack of stresses and resistances. “Disuse atrophy” is a possibility with all muscles, including the pelvic floor muscles.

 

Myth: It is easy to learn how to isolate and exercise the pelvic floor muscles.

Truth: No, not the case at all. Studies have shown that over 70% of women who think they are doing pelvic floor muscle exercises properly are actually contracting other muscles, typically the rectus, the gluteal muscles, and the adductor muscles of the thigh. One of the greatest challenges is that there have been no well-designed, easy-to-follow pelvic muscle training programs…UNTIL NOW! The Private Gym Company was established after recognizing that there was an unmet need for a means by which a pelvic floor muscle-training program could be made accessible and available in the home setting. This comprehensive, interactive, follow-along exercise program is available on DVD…PrivateGym.com.

 

Myth: Kegels can adversely affect your sex life.

Truth: Absolutely not… In both genders, pelvic floor muscle training has been found to improve sexual function. The pelvic floor muscles play a critical role in both female and male sexuality, supporting clitoral and penile erections as well as ejaculation in males and orgasm in both genders.

 

Wishing you the best of health,

2014-04-23 20:16:29

http://www.AndrewSiegelMD.com

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A new blog is posted every week. To receive the blogs in the in box of your email go to the following link and click on “email subscription”: www.HealthDoc13.WordPress.com

Author of Male Pelvic Fitness: Optimizing Sexual and Urinary Health: http://www.MalePelvicFitness.com

Private Gym: http://www.PrivateGym.com – now available on Amazon