Posts Tagged ‘pompoir’

Sex And The Female Pelvic Floor Muscles

July 15, 2017

Andrew Siegel MD   7/15/17

The vagina and clitoris are the stars of the show, but the pelvic floor muscles are the behind-the-scenes “powerhouse” of these structures. The relationship between the pelvic muscles and the female sexual organs is similar to that between the diaphragm muscle and the lungs, the lungs as dependent upon the diaphragm for their proper functioning as the vagina and clitoris are on the pelvic muscles for their proper functioning.  The bottom line is that keeping the pelvic muscles fit and vital will not only optimize sexual function and pleasure, but will also benefit urinary, bowel and pelvic support issues as well as help prevent their onset. 15606-illustrated-silhouette-of-a-beautiful-woman-or

Image above, public domain

Size Matters

While penis size is a matter of concern to many, why is vaginal size so much less of an issue?  The reason is that penises are external and visible and vaginas internal and hidden. The average erect penis is 6 inches in length and the average vagina 4 inches in depth, implying that the average man is more than ample for the average woman. The width of the average erect penis is 1.5 inches and the width of the average vaginal opening is virtually zero inches since the vagina is a potential space with the walls touching each other at rest. However, the vagina is a highly accommodative organ that can stretch, expand and adapt to the extent that 10 pound babies can be delivered vaginally (ouch!).

More important than size is the strength and tone of the vaginal and pelvic floor muscles. Possessing well-developed and fit vaginal and pelvic floor muscles is an asset in the bedroom, not only capable of maximizing your own pleasure, but also effective in optimally gripping and “milking” a penis to climax.  Additionally, when partner erectile dysfunction issues exist, strong pelvic floor muscles can help compensate as they can resurrect (great word!) a penis that is becoming flaccid back to full rigidity.

Female Sexuality

Sex is a basic human need and a powerful means of connecting and bonding, central to the intimacy of interpersonal relationships, contributing to wellbeing and quality of life. Healthy sexual functioning is a vital part of general, physical, mental, social and emotional health.

Female sexuality is a complex and dynamic process involving the interplay of anatomical, physiological, hormonal, psychological, emotional and cultural factors that impact desire, arousal, lubrication and climax. Although desire is biologically driven based upon internal hormonal environment, many psychological and emotional factors play into it as well. Arousal requires erotic and/or physical stimulation that results in increased pelvic blood flow, which causes genital engorgement, vaginal lubrication and vaginal anatomical changes that allow the vagina to accommodate an erect penis. The ability to climax depends on the occurrence of a sequence of physiological and emotional responses, culminating in involuntary rhythmic contractions of the pelvic floor muscles.

Sexual research conducted by Masters and Johnson demonstrated that the primary reaction to sexual stimulation is vaso-congestion (increased blood flow) and the secondary reaction is increased muscle tension.  Orgasm is the release from the state of vaso-congestion and muscle tension.

Pelvic Muscle Strength Matters

Strong and fit pelvic muscles optimize sexual function since they play a pivotal role in sexuality. These muscles are highly responsive to sexual stimulation, reacting by contracting and increasing blood flow to the pelvis, thus enhancing arousal.  They also contribute to sensation during intercourse and provide the ability to clench the vagina and firmly “grip” the penis. Upon clitoral stimulation, the pelvic muscles reflexively contract.  When the pelvic muscles are voluntarily engaged, pelvic blood flow and sexual response are further intensified.

The strength and durability of pelvic contractions are directly related to orgasmic potential since the pelvic muscles are the “motor” that drives sexual climax. During orgasm, the pelvic muscles contract involuntarily in a rhythmic fashion and provide the muscle power behind the physical aspect of an orgasm. Women capable of achieving “seismic” orgasms most often have very strong, toned, supple and flexible pelvic muscles. The take home message is that the pleasurable sensation that you perceive during sex is directly related to pelvic muscle function. Supple and pliable pelvic muscles with trampoline-like tone are capable of a “pulling up and in” action that puts bounce into your sex life…and that of your partner!

Factoid:  “Pompoir” is the Tamil, Indian term applied to extreme pelvic muscle control over the vagina. With both partners remaining still, the penis is stroked by rhythmic and rippling pulsations of the pelvic muscles. “Kabbazah” is a parallel South Asian term—translated as “holder”—used to describe a woman with such pelvic floor muscle proficiency.  

Pelvic Floor Dysfunction

As sexual function is optimized when the pelvic floor muscles are working properly, so sexual function can be compromised when the pelvic floor muscles are not working up to par (pelvic floor muscle “dysfunction”).  Weakened pelvic muscles can cause sexual dysfunction and vaginal laxity (looseness), undermining sensation for the female and her partner. On the other hand, overly-tensioned pelvic muscles can also compromise sexual function because sexual intercourse can be painful, if not impossible, when the pelvic muscles are too taut.

Vaginal childbirth is one of the key culprits in causing weakened and stretched pelvic muscles, leading to loss of vaginal tone, diminished sensation with sexual stimulation and impaired ability to tighten the vagina.

Pelvic organ prolapse—a form of pelvic floor dysfunction in which one or more of the pelvic organs fall into the vaginal space and at times beyond the vaginal opening—can reduce sexual gratification on a mechanical basis from vaginal laxity and uncomfortable or painful intercourse. The body image issues that result from vaginal laxity and pelvic prolapse are profound and may be the most important factors that diminish one’s sex life. As the pelvic floor loses strength and tone, there is often an accompanying loss of sexual confidence.

Urinary incontinence—a form of pelvic floor dysfunction in which there is urinary leakage with coughing, sneezing and physical activities (stress incontinence) or leakage associated with the strong urge to urinate (urgency incontinence or overactive bladder)—can also contribute to an unsatisfying sex life because of fears of leakage during intercourse, concerns about odor and not feeling clean, embarrassment about the need for pads, and a negative body image perception. This can adversely influence sex drive, arousal and ability to orgasm.

A healthy sexual response involves being “in the moment,” free of concerns and worries. Women with pelvic floor dysfunction are often distracted during sex, preoccupied with their lack of control over their problem as well as their perception of their vagina being “abnormal” and what consequences this might have on their partner’s sexual experience.

Pelvic Floor Training

Pelvic floor muscle training is the essence of “functional fitness,” a workout program that develops pelvic muscle strength, power and stamina. The goal is to improve and/or prevent specific pelvic functional impairments that may be sexual, urinary, bowel, or involve altered support of the pelvic organs.

Many women exercise regularly but often neglect these hidden–but vitally important muscles– that can be optimized to great benefit via the right exercise regimen.  The key is to find the proper program, and for this I refer you to your source for everything Kegel: The KEGEL FIX: Recharging Female Pelvic, Sexual and Urinary Health.

Wishing you the best of health,

2014-04-23 20:16:29

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

Dr. Andrew Siegel is a practicing physician and urological surgeon board-certified in urology as well as in female pelvic medicine and reconstructive surgery.  Dr. Siegel serves as Assistant Clinical Professor of Surgery at the Rutgers-New Jersey Medical School and is a Castle Connolly Top Doctor New York Metro Area, Inside Jersey Top Doctor and Inside Jersey Top Doctor for Women’s Health. His mission is to “bridge the gap” between the public and the medical community that is in such dire need of bridging.

Author of MALE PELVIC FITNESS: Optimizing Sexual & Urinary Health

Author of THE KEGEL FIX: Recharging Female Pelvic, Sexual and Urinary Health 

 

The Ins And Outs Of The Vagina

November 19, 2016

Andrew Siegel MD 11/19/16

Chances are that you may be clueless about female genital anatomy and for good reason, as you had no formal instruction…no “vagina-ology” class exists. Education often involves knowledge imparted from friends and schoolmates and perhaps a talk from a parent on the “birds and the bees,” generally less than adequate means. “Sex Ed” classes in junior high school (a.k.a. middle school) were cursory and insufficient. Your dad’s Playboy, your mom’s Cosmo and other magazines may have provided some insight, but were certainly not the gospel. Pornography offers a totally skewed perspective. As a consequence, most people have been educated through practical experience with their own vagina or with those of sexual partners. Although there is no substitute for “hands on” experience, a bit of vaginal academics is certainly a good addition to practical experience.

For many men—and women for that matter—the vagina is a dark and mysterious place, a “black hole” of human anatomy, hidden in the deep recesses of the body. This landscape is complex terrain and unfortunately does not come with a topographical map explaining its intricate subterranean geography.

The following are quotes about the vagina from Tom Hickman’s book: “God’s Doodle: The Life and Times of the Penis”:

“A place of procreative darkness, a sinister place from which blood periodically seeped as if from a wound.”

“Even when made safe, men feared the vagina, already attributed mysterious sexual power – did it not conjure up a man’s organ, absorb it, milk it, spit it out limp?”

The objective of this entry is to explore and demystify the vagina to help you comprehend and navigate its complexities. Knowledge is power and whether female or male, a greater understanding and appreciation of the anatomy, function and nuances of this curious and special female body part will most certainly prove useful.

Female Genital Anatomy 101

The hidden female nether parts and their inner workings are a mystery zone to a surprising number of women. Many falsely believe that the “pee hole” and the “vagina hole” are one and the same…not surprising given that lady parts are much more unexposed, subtle and complex than the more obviously exposed man parts. However, what lies between the thighs is more complicated and intricate than one might think…. three openings, two sets of lips, swellings, glands, erectile tissue, muscles and more.

Let’s first set the record straight on the difference between the vagina and vulva, geography that is often confused. When referring to external visible “girly” anatomy, most people incorrectly speak of the “vagina”—this is actually the “vulva,” divided in half by a midline slit known in medical jargon as the pudendal cleft or cleft of Venus or in slang terms, “camel toe.” The “vagina,” on the other hand, is the internal, flexible, cylindrical, muscular passageway that extends from vulva to cervix (neck of the uterus). The vaginal opening on the vulva is known in medical terms as the vaginal introitus. Further down south is the landscape between the vulva and the anus known in medical jargon as the perineum or in slang terms, “taint.”

vulva

(Anatomy of the vulva 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)

Bottom Line: The vulva is external, the vagina internal. Good to remember.

Fact: The word “vulva” derives from the Latin “cunnus” (hence the derivation of the slang C-word. The word “vagina” derives from the Latin word for “sheath,” a cover for the blade of a knife or sword, an apt term.

vagina-collage-public-domain

Above image (public domain) entitled “Vagina Collage”…note that it should be entitled  “Vulva Collage”

Many Functions Of The Vagina

The vagina is an amazingly versatile and multifunctional organ that is truly a “cave of wonders.” Beyond being a sexual organ, it is an inflow pathway and receptacle for semen, an exit pathway for menstrual blood, and a birth canal. It is not simply a passive channel, but an active and dynamic, highly responsive passageway that has the capacity for voluntary muscular contraction.

Anatomy Of The Vagina

The average depth of the vagina (without sexual stimulation) is 3-4 inches or so, but with sexual stimulation and arousal, the vagina is capable of considerable expansion and distension to a much greater potential. The elasticity of the vagina is truly impressive (perhaps the most elastic and stretchable organ in the body), with the ability to stretch to accommodate a full-term infant and then return to a relatively normal caliber. The width of the vagina varies throughout its length, narrowest at the vaginal opening and increasing in diameter throughout its depth. It is typically about 1 inch in diameter at the external opening.

Joke from Maxim.com:

  1. Just how deep is the average vagina?
  2. Deep enough for a man to lose his house, his car, his dog and half of all his savings and assets…

All vaginas are unique with a great variety in shape, size and even color, similar to variations in penile anatomy. The vagina is a banana-shaped structure and when a woman lies down on her back, the more external part of the vagina (closest to the vaginal opening) is straight, and the inner, deeper part angles/curves downwards towards the sacral bones (the lower part of the vertebral column that forms the back bony part of the pelvis). This vaginal “axis” often changes with aging and childbirth.

banana-25239_960_720

Banana representing vaginal axis, with inner portion curved towards sacrum and outer portion straight (Thank you Pixabay for image)

Fact: Although the vagina recovers remarkably well after childbirth, anatomy does generally change to some extent. Pelvic examination is usually easily able to distinguish between women who have and have not had children vaginally. Of note, elective C-section (no labor) preserves vaginal anatomy. Women who have an enlarged vaginal outlet due to childbirth may have difficulty in satisfactorily “accommodating” the penis, resulting in the vagina merely “surrounding” the penis rather than firmly “squeezing” it, with the end result being diminished sensation for both partners.

The vagina has pleats and corrugations called rugae that maximize the elasticity and stretchiness of the vagina. They are accordion-like ruffles and ridges that supply texture, which increase friction for the penis during sexual intercourse. In a young woman they are prominent, but with aging they tend to disappear.

Fact: Vaginal rugae are like tread on a tire…in young women they appear like deep grooves on a new snow tire, whereas in older women they appear like thinning tire tread, completely bald at their most extreme…aging can be cruel.

The vaginal wall has an inner lining of “skin” known as epithelium, which is surrounded by connective tissues and a muscular coat. The vaginal muscle is comprised of an inner layer that is circular in orientation and an outer layer that is oriented longitudinally. Contraction of the inner muscle tightens the vagina. Contraction of the outer muscle shortens and widens the vagina. The vagina is secured within a “bed” of powerful pelvic floor muscles.

To better understand  vaginal anatomy, it is useful to divide it arbitrarily into thirds: outer, inner and middle. The outer and inner thirds are where “all the action is,” the outer third being the hub of sexuality, the inner third the hub of reproduction and the middle third essentially a connection between the inner and outer thirds.

Outer third: The outer third of the vagina is rich in nerve fibers and is the most sensitive part of the vagina. The “orgasmic platform” is the Masters and Johnson term for the anatomical “base” that responds to sexual arousal and stimulation with pelvic blood congestion. It consists of the outer third of the vagina and the engorged inner lips.

Middle third: The middle third is a conduit connecting the outer and inner thirds.

Inner third: The cervix (opening to the uterus) sits in the inner third of the vagina. Its presence within the deep vagina defines the deepest recesses of the vagina, which are referred to as the fornices (singular fornix), derived from the Latin word for “arches.” The largest fornix is the one behind the cervix (posterior fornix) with the two smaller fornices above and to the sides of the cervix (anterior and lateral fornices).

Question: What do you think is the origin of the word “fornicate”?

sobo_1906_508

Image above:  Uterus, Cervix and Inner Third Vagina from Dr. Johannes SobottaSobotta’s Atlas and Text-book of Human Anatomy 1906, note the vaginal rugae and the relationship of the cervix with the inner vagina

Fact: In the man-on top sexual intercourse position, the penis reaches the anterior fornix, while in the rear-entry position it reaches the posterior fornix.

The Pelvic Floor Muscles And The Vagina

The pelvic floor muscles play a pivotal role with respect to vaginal and sexual function, their contractions facilitating and enhancing sexual response. They contribute to arousal, sensation during intercourse and the ability to clench the vagina and firmly “grip” the penis. The strength and durability of their contractions are directly related to orgasmic potential since the pelvic muscles are the “motor” that drives sexual climax and can be thought of as the powerhouse of the vagina. During orgasm, the pelvic floor muscles “shudder.”

There is great variety in the bulk, strength, power and voluntary control of the pelvic floor muscles that support the vagina. Some women are capable of powerfully “snapping” their vaginas, whereas others cannot generate even a weak flicker.

3-superficial-and-deep-pfm

Image above: Female pelvic floor muscles, illustration by Ashley Halsey from The Kegel Fix

Fact: “Pompoir” is a sexual technique in which a woman contracts her pelvic floor and vaginal muscles rhythmically to stimulate the penis without the need for pelvic motion or thrusting. Women who diligently practice Kegel exercises can develop powerful pelvic floor muscles and become particularly adept at this technique resulting in extreme vaginal “dexterity” and the ability to refine pulling, pushing, locking, gripping, pulsing, squeezing and twisting motions, which can provide enough stimulation to bring a male to climax.  

Fact: “Penis Captivus” is a rare condition in which a male’s erect penis becomes stuck within a female’s vagina. It is thought to be on the basis of intense contractions of the pelvic floor muscles, causing the vaginal walls to clamp down and entrap the penis. It usually is a brief event and after female orgasm and/or male ejaculation, withdrawal becomes possible. However, it sometimes requires medical attention with a couple showing up in the emergency room tightly connected, like Siamese twins. Not a good call to 911!

Sexual Function And The Vagina

Under normal circumstances, the vagina is not “primed” for sex and is little more prepared for intercourse than is a flaccid penis. The un-stimulated vagina is essentially a closed “potential space” in which the vaginal roof and floor are in contact. With sexual stimulation, the vagina expands with lengthening and widening of its inner two-thirds and flattening of the rugae. The cervix and uterus pull up and back. Pelvic blood flow increases and the vaginal walls undergo a “sweating-like” reaction as a result of pelvic blood congestion, creating a slippery and glistening film. Most of the lubrication is based upon seepage from this increased blood flow, but some comes from Bartholin’s and Skene’s glands. Bartholin’s glands are paired, pea-size glands that drain just below and to each side of the vagina. During sexual arousal they secrete small drops of fluid, resulting in moistening of the opening of the vagina. Skene’s glands are paired glands that drain just above and to each side of the urethral opening. They are the female equivalent of the male prostate gland and secrete fluid with arousal.

With sexual excitement and stimulation, in addition to vaginal lubrication from increased pelvic blood flow, there is congestion and engorgement of the vulva, vagina and clitoris.

Fact: The profound vaginal changes that occur during sexual arousal and stimulation are entirely analogous to the changes that occur during male arousal: expansion of penis length and girth, retraction of the testicles towards the groin, and the release of pre-ejaculate fluid.

With increasing stimulation and arousal, physical tension within the genitals gradually builds and once sufficient intensity and duration of sexual stimulation surpass a threshold, involuntary rhythmic muscular contractions occur of the vagina, uterus, anus and pelvic floor muscles, followed by the release of accumulated erotic tension (a.k.a. orgasm) and a euphoric state. Thereafter, the genital engorgement and congestion subside, muscle relaxation occurs and a peaceful state of physical and emotional bliss and afterglow become apparent.

Fact: Anatomy can affect potential for experiencing sexual climax.

Sexual intercourse results in indirect clitoral stimulation. The clitoral shaft moves rhythmically with penile thrusting by virtue of penile traction on the inner lips, which join together to form the hood of the clitoris. However, if the vaginal opening is too wide to permit the penis to put enough traction on the inner lips, there will be limited clitoral stimulation and less satisfaction in the bedroom. Furthermore, studies have suggested that a larger clitoris that is closer to the vaginal opening is more likely to be stimulated during penetrative sexual intercourse.

At the time of sexual climax, some women are capable of “ejaculating” fluid. The nature of this fluid has been controversial, thought by some to be hyper-lubrication and others to be Bartholin’s and/or Skene’s gland secretions. There are certain women who “ejaculate” very large volumes of fluid at climax and studies have shown this to be urine released because of an involuntary bladder contraction that can accompany orgasm.

Fact: “Persistent genital arousal disorder” is a rare sexual problem characterized by unwanted, unremitting and intrusive arousal, genital engorgement and multiple orgasms without sexual interest or stimulation. It causes great distress to those suffering with it and there are no known effective treatments. It typically does not resolve after orgasm.

The G-Spot—named after German gynecologist Ernst Grafenberg—was first described in 1950 and was believed to be an erogenous zone located on the upper wall of the vagina, anatomically situated between the vagina and the urethra (urinary channel). Stimulation of this spot was thought to promote arousal and vaginal orgasm.

Fact: There is little scientific support for the existence of the G-spot as a discrete anatomical entity; however, many women feel that they possess an area on the roof of the vagina that is a particularly sensitive pleasure zone. Although its existence remains controversial, the G-spot is certainly a powerful social phenomenon.

Regular sexual activity is vital for maintaining the ability to have ongoing satisfactory sexual intercourse with the vagina staying fit and healthy if one remains sexually active, as nature intended. Vaginal penetration increases pelvic and vaginal blood flow, optimizing lubrication and elasticity, while orgasms tone and strengthen the pelvic floor muscles that support vaginal function. “Disuse atrophy” is a condition when the vagina adapts to not being used, with thinning and fragility of the vaginal walls and weakness of the pelvic floor muscles. Use it or lose it!

Wishing you the best of health,

2014-04-23 20:16:29

http://www.AndrewSiegelMD.com

Dr. Andrew Siegel is a practicing physician and urological surgeon board-certified in urology as well as in female pelvic medicine and reconstructive surgery. Much of the content of this entry was excerpted from his recently published book: The Kegel Fix: Recharging Female Pelvic, Sexual and Urinary Health. For more info: http://www.TheKegelFix.com.

He has previously authored Male Pelvic Fitness: Optimizing Sexual & Urinary Health; Promiscuous Eating: Understanding And Ending Our Self-Destructive Relationship With Food; and Finding Your Own Fountain Of Youth: The Essential Guide For Maximizing Health, Wellness, Fitness & Longevity. Dr. Siegel serves as Assistant Clinical Professor of Surgery at the Rutgers-New Jersey Medical School and is a Castle Connolly Top Doctor New York Metro. Area and Inside Jersey Top Doctor and Inside Jersey Top Doctor for Women’s Health. His mission is to “bridge the gap” between the public and the medical community that is in such dire need of bridging.

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

The Kegel Fix is available in e-book format on the Amazon Kindle, iPad (Apple iBooks), Barnes & Noble Nook and Kobo and in paperback, all accessible via the following website: www.TheKegelFix.com. The e-book offers discretion, advantageous for books about personal issues, is less expensive, is delivered immediately, saves the trees, has adjustable fonts, as well as numerous hyperlinks—links to other sites activated by clicking—that access many helpful resources.  The book was written for educated and discerning women who care about health, well being, nutrition and exercise and enjoy feeling confident, sexy and strong.