Posts Tagged ‘premature ejaculation’

“Size” Should Never Outrank “Service”

November 11, 2017

Andrew Siegel MD  11/11/2017

As I stood in the gateway line during the painful process of boarding an airplane, I caught sight of a poster ad stating the following: “Size should never outrank service.” This referred to the smaller size regional jets that offer amenities including first-class, Wi-Fi, etc. Later, I saw another poster ad for the same airline stating: “How fast the flight goes isn’t always up to pilot.” As a physician interested in sexual/pelvic health and language, I found these sentences with double meanings amusing and entertaining.  The ultimate phallic structure is an aircraft and aeronautics provides a rich metaphor for male sexual function, the topic of today’s entry.  

Large and clunky

Airbus_A380-861,_Airbus_Industrie_AN2032144

By Oleg V. Belyakov – AirTeamImages [CC BY-SA 3.0 (https://creativecommons.org/licenses/by-sa/3.0), CC BY-SA 3.0 (https://creativecommons.org/licenses/by-sa/3.0) or GFDL 1.2 (http://www.gnu.org/licenses/old-licenses/fdl-1.2.html)%5D, via Wikimedia Commons

Small and nimble

800px-F-15_vertical_deploy

Above image, public domain

 

Terms that apply to aeronautics and sexual function

Aircraft: a machine capable of flight—the penis

Pilot: the person who occupies the cockpit and controls the aircraft—the possessor of the penis

Cockpit (I really like this word!): the front of the fuselage where the pilots sit—the head of the penis

Fuselage: the body of the aircraft—the shaft of the penis

Horizontal and vertical stabilizers of the tail:  aircraft parts that provide stability to keep it flying straight—the pelvic floor muscles that stabilize and support the penis

Flight: the process of flying that includes a launch, a flight pattern and a landing—a sexual encounter

Launch: the takeoff—obtaining an erection

Flight pattern: the aircraft’s movement after takeoff—the sexual act

Landing: the conclusion and most difficult part of the flight, which requires skill, precision and timing to perform competently — ejaculation/orgasm

 Cruising Altitude: the altitude at which most of a flight is flown in route to a destination—a fully rigid erection

Jet fuel: fuel designed for use in an aircraft—in erectile terms, penile blood flow

Fuel line: the means by which fuel is pumped from the storage tanks to the engine—the penile arteries

Thrust: the propulsive force of an aircraft—the surging power of the erect penis

Throttle: a device for controlling the flow of fuel to an aircraft’s engine—the nerves that control the smooth muscle within the penile arteries and within the erectile tissue

Failure to Launch: a condition in which the aircraft is unable to get airborne—erectile dysfunction

Emergency landing: unanticipated landing before the scheduled arrival time—premature ejaculation

Aborted Landing: when an aircraft is about to land, but the pilot halts the landing and regains altitude deferring the landing—delayed ejaculation

Ground Time: the amount of down time between landing and the next flight—refractory period

Mayday: distress signal indicative of a significant problem with the aircraft or flight—a major sexual failure

Bottom Line:  Aeronautics provides an excellent metaphor for male sexual function.  The pilot can be accorded better control, longer flight times, higher altitudes, as well as launching a second flight with less ground time by attending to a few key measures. Although it is impossible to convert a F-15 Eagle (pictured above) into an Airbus A380 (pictured above), it is a fact that size should never outrank service!  Bigger is not always better as function often trumps form. 

Wishing you the best of health,

2014-04-23 20:16:29

A new blog is posted weekly. To receive a free subscription with delivery to your email inbox visit the following link and click on “email subscription”:  www.HealthDoc13.WordPress.com

Dr. Andrew Siegel is a physician and urological surgeon who is board-certified in urology as well as in female pelvic medicine and reconstructive surgery.  He is an 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.

Dr. Siegel has authored the following books that are available on Amazon, iBooks, Nook and Kobo:

 MALE PELVIC FITNESS: Optimizing Sexual & Urinary Health

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

PROMISCUOUS EATING: Understanding and Ending Our Self-Destructive Relationship with Food

Cover

These books are written for educated and discerning men and women who care about health, well-being, fitness and nutrition and enjoy feeling confident and strong.

 

 

 

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10 Reasons For Men To Kegel

June 4, 2016

Andrew Siegel, M.D. 6/4/16

The pelvic floor muscles—a.k.a. the Kegel muscles—are internal, hidden and behind-the-scenes muscles, yet they are vital to a healthy life. There are numerous advantages to keeping them fit and robust with pelvic floor exercises.  Last week’s entry detailed why this is the case for females and today’s will explain how and why are equally beneficial for males.  As the saying goes: “What’s good for the goose is good for the gander,” and when it comes to the pelvic floor, this is an absolute truth.  Kegel popularized these exercises for females and it is my intent to do the same for men!   If you would like more information on pelvic floor muscle training in men, visit AndrewSiegelMD.com, the opening page of which has the link to a review article I wrote for the Gold Journal of Urology on the topic. 

 

pixabay image

  10 REASONS FOR MEN TO DO KEGEL EXERCISES 

  1. To improve/prevent erectile dysfunction.
  1. To improve/prevent premature ejaculation.
  1. To improve/prevent ejaculatory dysfunction (skimpy ejaculation volumes, weak ejaculation force and arc, diminished ejaculatory sensation).
  1. To improve/prevent post-void dribbling (that annoying after-dribble of urine that occurs after finishing urinating).
  1. To improve/prevent stress urinary incontinence (leakage with coughing, sneezing, exercise, etc.) that may occur following prostate surgery.
  1. To improve/prevent urinary and bowel urgency (“gotta go”) and urinary and bowel urgency incontinence (inability to get to the bathroom on time to prevent an accident).
  1. To improve/prevent pelvic pain due to pelvic floor tension myalgia by learning how to relax your pelvic floor muscles.
  1. To help prevent pelvic impairments from high impact sports and saddle sports (e.g., cycling, motorcycling and horseback riding).
  1. To improve core strength, posture, lumbar stability, alignment and balance.
  1. To maintain good health and youthful vitality.

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– and MALE PELVIC FITNESS: Optimizing Sexual & Urinary Health available on Amazon Kindle, Apple iBooks, B&N Nook and Kobo; paperback edition available at TheKegelFix.com

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. 

Gone In 60 Seconds: What You Need To Know About Premature Ejaculation

March 7, 2015

Andrew Siegel MD  3/7/15

stopwatch-153398_1280 

(Thank you Pixabay for above image)

 

Be sure that you do not sail too fast and leave your mistress behind.

—Ovid

 

What Is Premature Ejaculation?

Premature ejaculation (PE) is a condition in which sexual climax occurs before, upon, or shortly after vaginal penetration, prior to one’s desire to do so, with minimal voluntary control. It is the most common form of male sexual dysfunction.   “Rapid” ejaculation may be a kinder term than “premature” ejaculation.

The key features are:

  • Brief time to ejaculation (often less than one minute)
  • Lack of control over ejaculation
  • Sexual dissatisfaction, distress and frustration of sufferer and partner.

How Long Should It Take To Climax?

In a study of over 1500 men, The Journal of Sexual Medicine reported that the average time between penetration and ejaculation for a premature ejaculator was 1.8 minutes, compared to 7.3 minutes for non-premature ejaculators.

Another study of 500 couples across five countries reported results ranging from 33 seconds to 44 minutes with the median being 5.4 minutes.

What Causes PE?

PE can be psychological and/or biological and can occur because of over-sensitive genital skin, hyperactive reflexes, extreme arousal or infrequent sexual activity. Other factors are genetics, guilt, fear, performance anxiety, inflammation and/or infection of the prostate or urethra and also can be related to the use of alcohol or other substances.

PE occurs in up to 30% of men, involving all ages, ethnicities, and socio-economic groups. PE can cause embarrassment, frustration and loss of self-confidence and can be devastating to a relationship. It is very typical among men during their earliest sexual experiences.

Who Knew? “Coming Attractions.” One can always use the excuse that being “fast and furious” occurred because of the tremendous attraction and turn-on of your smoking hot partner. However, this trump card can only be played once or twice before it gets very old.  

PE can be lifelong or acquired and sometimes occurs on a situational basis. Lifelong PE is thought to have a strong biological component. Acquired PE can be biological, based on inflammation/infection of the reproductive tract or psychological, based upon situational stressors. PE can sometimes be related to ED, with the rapid ejaculation brought on by the desire to climax before losing the erection.

Emphasis on ejaculation as the focal point of sexual intercourse tends to increase the performance anxiety that can initiate the problem. Once PE has occurred and established itself, fear of and mental preoccupation with the issue can actually induce the unwanted rapid ejaculation, creating a vicious cycle.

How Does One Overcome PE?

Diversionary Thoughts: Non-erotic mental diversionary tactics (concentrating on thoughts other than ejaculating) may prevent PE. Baseball, work, counting backwards, etc., are examples of such thoughts, but these are rarely effective and diminish the pleasure of sexual intimacy.

Down Tempo: This requires one to develop a mindfulness of the sensation immediately before ejaculation. By slowing the pace of pelvic thrusting and varying the angle and depth of penetration before the “point of no return” has passed, the feeling of imminent ejaculation may dissipate.

Pause-Start Method: If slowing the tempo is not sufficient to prevent the PE, one may need to stop thrusting completely while maintaining penetration in order for the ejaculatory “urgency” to go away. Once the sensation to ejaculate subsides, pelvic thrusting may be resumed.

Squeeze Technique: Originated by Masters and Johnson, as imminent ejaculation approaches, the penis is withdrawn and the head of the penis is squeezed until the feeling of ejaculation passes, after which intercourse is resumed. Although effective, it requires sexual interruption, is cumbersome and demands a very cooperative partner.

Pelvic Floor Muscle Training: Contracting one’s pelvic floor muscles is a less cumbersome alternative to the Master and Johnson technique. Instead of the clunky and obvious squeeze technique, a more subtle and discreet method is to slow the pace of intercourse, pause the pelvic thrusting and do a sustained pelvic muscle contraction. This is an internal “squeeze” without the external hand squeeze and can achieve the same goal, short-circuiting the premature ejaculation. With sufficient practice and the achievement of “muscle memory,” this process can become easier and the problem of PE improved, particularly with commitment to a pelvic floor muscle training program.

Decreasing Sensitivity: One method of doing so is by using thick condoms. Alternatively, local anesthetics in the form of topical creams, gels, and sprays can desensitize the penis. These include Lidocaine cream or gel, Lidocaine and Prilocaine (EMLA cream) or Lidocaine spray (Promescent) that are applied before intercourse. Another desensitization technique is increasing the frequency of ejaculation since PE tends to be more pronounced after longer periods of sexual abstinence. By masturbating prior to engaging in sexual intercourse, the PE may be controlled.

Erection Pills: Viagra, Levitra, Cialis and Stendra, which are commonly used for ED, can have a role in the treatment of men with acquired PE that is due to ED.

SSRI Anti-depressants: These selective serotonin reuptake inhibitors can substantially delay ejaculation. One is generally started on a low dose, with an increase in dosage as necessary. Once an effective dosage is achieved, the medication can be used on a situational basis, several hours prior to sexual intercourse.

Counseling: Since PE can be on a psychological basis, it may be beneficial to seek the counsel of a sexual therapist. This can be done in conjunction with some of the aforementioned techniques to hasten the resolution of the PE.

Bottom Line:   Although not life-threatening, PE is a common and distressing quality of life problem that is sometimes relationship-threatening.  The good news is that there are a number of effective treatment options available, so one need not suffer with the problem.   

 

Wishing you the best in health,

2014-04-23 20:16:29

http://www.AndrewSiegelMD.com

A new blog is posted every week. To receive the blogs in the inbox 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, B & N Nook, Kobo) and paperback: http://www.MalePelvicFitness.com

Private Gym Male Pelvic Floor Muscle Training  Program: http://www.PrivateGym.com -available on Amazon as well as Private Gym website

The Private Gym is a comprehensive, interactive, follow-along exercise program that provides the resources to strengthen the pelvic floor muscles that are vital to sexual and urinary health. The program builds upon the foundational work of Dr. Arnold Kegel, who popularized exercises for women to increase pelvic muscle strength and tone. This FDA registered program is effective, safe and easy-to-use. The “Basic Training” program strengthens the pelvic floor muscles with a series of progressive “Kegel” exercises and the “Complete Program” provides maximal opportunity for gains through its patented resistance equipment.

“I’m Almost There”: What You Need To Know About Delayed Ejaculation

February 21, 2015

Andrew Siegel, MD  2/21/15

Late!_chileLate!_chileLate!_chile

Male sexual problems go beyond difficulties with obtaining or maintaining a rigid erection.  Ejaculatory timing dysfunctions are commonplace, ranging from premature ejaculation on one extreme to delayed ejaculation on the other extreme. Premature ejaculation is one of the most prevalent male sexual disorders and seems to get all the attention, so today’s focus is on delayed ejaculation (DE). The condition of DE used to be referred to as “retarded” ejaculation, but because of the politically incorrect nature of the “R” word, this label has gone by the wayside, similar to “impotence,” which has been replaced by “ED” and “frigid,” which has been replaced by “anorgasmic.”

How Long Is Too Long?

A classic study of 500 couples across five countries measured time from penetration to ejaculation, with results ranging from 33 seconds to 44 minutes with the median being 5.4 minutes. It has been proposed that any time from penetration to ejaculation that exceeds 20-25 minutes that causes distress to the delayed ejaculator or partner meets the criteria for diagnosis of DE.

Ejaculation 101: A Few Words On The Science Of Ejaculation 

Ejaculation occurs after sufficient intensity and duration of sexual stimulation enables passing an ejaculatory threshold. Men with premature ejaculation are thought to have increased sensitivity and excitability of the penis, whereas men with delayed ejaculation are thought to have decreased sensitivity.

The ejaculatory center, located within the spine, integrates nerve input from the brain and the penis and coordinates the phases of emission and expulsion. Emission releases the secretions from the prostate, seminal vesicle and epididymis via the ejaculatory ducts and prostate ducts into the urethra. Expulsion propels the ejaculate through the urethra via rhythmic contractions of the pelvic floor muscles.

The spinal ejaculatory center is controlled mainly by the neurotransmitters serotonin and dopamine, although there others are involved as well. Serotonin inhibits ejaculation whereas dopamine facilitates it. One’s balance of neurotransmitters is determined by genetics and other considerations including age, stress, illness, medications and other factors.

Delayed Ejaculation

DE is a condition in which ejaculation occurs only after a prolonged period of time following penetration. Some men are unable to ejaculate at all, despite having a rigid and very durable erection.  Prolonged erection without ejaculation can result in testicular vaso-congestion, a.k.a. “blue balls.” With arousal and the increase in genital blood flow, the testicles can become swollen and a bluish tint can develop because of engorgement of veins. It can be painful, causing a tense, heavy, pressure-like discomfort in both testicles. The cure: ejaculation.

DE can be problematic for both the delayed ejaculator and his partner, resulting in frustration, exhaustion, soreness, if not pain.  The sexual partner often feels distress and responsibility because of the implication that the problem may be their fault and that they are inadequate in terms of attractiveness or having the facility to enable a climax. The combination of not being able to achieve sexual “closure,” the inability to enjoy the mutual intimacy of ejaculation, and denying the partner the gratification of knowing that they are capable of bringing their man to climax is a formula for relationship stress. As tempting as it is to think that DE is an asset in terms of pleasing your partner, in reality a marathon performance has major shortcomings.

Interestingly, some men with this condition can ejaculate in an appropriate amount of time with masturbation. As well, some men can ejaculate in a normal period of time with manual or oral stimulation from their partner although they cannot do so with intercourse. It is plausible that one’s masturbation technique can provide more sensory stimulation than can be duplicated by sex with a partner. The amount of sensory stimulation derived from intercourse is predicated upon partner skill, anatomy, pelvic floor tone, the quality of the “fit” and many other elements, both physical and emotional.

Physical Or Psychological?

There can be underlying medical conditions that factor into problems of ejaculation. For example, hypothyroidism is strongly associated with delayed ejaculation whereas hyperthyroidism is associated with premature ejaculation. Since serotonin and dopamine as well as oxytocin, prolactin, and other chemicals are involved with ejaculatory control, any drug that modifies the levels of these chemicals may affect ejaculation timing. The selective serotonin reuptake inhibitors (SSRIs) – the most widely prescribed medications for depression – are notorious for their effect on delaying ejaculation, and are in fact, used for the treatment of premature ejaculation. Various neurological conditions that disrupt the communication between the spinal ejaculatory center and the brain/penis can cause ejaculatory dysfunction. In general, as men age, they more commonly note DE that may be on the basis of declining function of nerves as well as changes in genital skin.

As with so many sexual dysfunctions, excessive focus on the problem instead of allowing oneself to be “in the moment” can create a self-fulfilling prophecy of doom.  In other words, if a man goes into a sexual situation mentally dwelling and consumed with the problem, it is likely that ejaculation will be prolonged.

One solution is to avoid ejaculation for a number of days prior to intercourse, the same line of reasoning used for managing premature ejaculation by masturbating immediately before intercourse. Although numerous medications have been tried to help improve DE, none are FDA approved and none have met with much success. This is as opposed to premature ejaculation, which can be managed with topical anesthetics, selective serotonin reuptake inhibitors, and pelvic floor training. Sexual counseling using sensate focus therapy has proven to be of benefit to some patients with DE. This is a series of specific exercises for couples originally developed by Masters and Johnson.

Wishing you the best of health,

2014-04-23 20:16:29

http://www.AndrewSiegelMD.com

6922

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 (Kindle, iBooks, Nook, Kobo) and paperback: http://www.MalePelvicFitness.com

Private Gym: http://www.PrivateGym.com -available on Amazon as well as Private Gym website

The Private Gym is a comprehensive, interactive, follow-along exercise program that provides the resources to properly strengthen the pelvic floor muscles that are vital to sexual and urinary health. The program builds upon the foundational work of Dr. Arnold Kegel, who popularized exercises for women to increase pelvic strength and tone. This FDA registered program is effective, safe and easy-to-use: The “Basic Training” program strengthens the pelvic floor muscles with a series of progressive “Kegel” exercises and the “Complete Program” provides maximum opportunity for gains through its patented resistance equipment.

Applied Kegels: Functional Pelvic Fitness

November 19, 2014

Andrew Siegel MD 11/19/14

I’ll be in Miami for a few days at the SMSNA (Sexual Medical Society of North America) meeting, so will upload this blog earlier than usual.

 FUNCTIONAL PELVIC FITNESS

It’s one thing to work out your muscles in order to make them stronger, better toned and more durable, but it’s another dimension when you can put that effort to practical use over the course of your day. Since the pelvic floor muscles are muscles of function rather than form, muscles for “go” rather than “show,” they can be put into service when applied to common real life situations.

Urinary and Bowel Urgency (for both sexes)

Chances are that at one time or another you have experienced a sudden and urgent desire to use the bathroom when none was nowhere in sight. This often occurs as a result of an involuntary bladder or bowel contraction, when the bladder or bowel squeezes without your permission, sometimes on the basis of triggers that induce a conditioned response (classic triggers are hand washing, placing a key in the door to your home, rising from sitting, exposure to running water, entering the shower, cold or rainy weather, getting closer and closer to the bathroom, etc.). By recognizing the occurrence of the involuntary contraction and by actively squeezing your pelvic floor muscles using a “rapid flex” technique—rapidly pulsing the pelvic muscles 3-5 times—the urgency can be relieved (and the leakage that can sometimes occur can often be prevented). This works equally as well for bowel urgency as it does for urinary urgency.

Going a step beyond inhibiting urgency after it occurs is preventing it from occurring before it occurs. In order to do so, it is important to recognize any triggers that may induce your urgency. Immediately prior to exposure to a trigger, rapid flexes of the pelvic floor muscles can thwart the involuntary contraction before it even arises.

 

Dribbling After Urinating (for men)

An “after-dribble” of urine is more annoying than serious and is often a sign of weakening pelvic floor muscles, for which strengthening exercises have proven an effective remedy. Squeezing the pelvic floor muscles is the body’s natural way of expelling the contents of the urinary channel. When contracted, the bulbocavernosus muscle—the body’s urethral “stripper”—compresses the deep portion of the urethra, pushing the urine out. The 1909 Gray’s Anatomy aptly labeled this muscle the “ejaculator urine.”

By actively squeezing your pelvic floor muscles immediately after urinating by using a “basic flex” technique—powerfully pulsing the pelvic floor muscles 3-5 times for 1-2 seconds per contraction—the last few drops of urine will be directed into the toilet and not your pants.

 

Stress Urinary Incontinence (for both sexes)

Stress incontinence is urinary leakage provoked by sudden increases in abdominal pressure, triggered by sneezing, coughing, bending, lifting, exercising, positional change, etc. It is a common condition in women, often resulting from the pelvic trauma of childbirth, weakening the pelvic muscles and connective tissues that support the urinary channel. Although less common in men, it can occur following radical prostatectomy for prostate cancer and sometimes after prostate surgery done for benign conditions.

In order to help control stress incontinence, you need to be attentive to the triggers that provoke it. By actively squeezing the pelvic floor muscles immediately prior to the trigger exposure, the incontinence can be improved or eliminated. For example, if standing up provokes the incontinence, do a brisk pelvic floor muscle contraction using a “long, hard flex”—contracting the pelvic floor muscles powerfully for 3-5 seconds when transitioning from sitting to standing. This long, hard flex is a means of bracing the pelvic floor muscles immediately prior to an activity that incites the problem and can be a highly effective means of managing the stress incontinence. When practiced diligently, it becomes an automatic behavior.

 

Premature Ejaculation

Weak pelvic floor muscles seem to play a role in hindering your ability to delay ejaculation. Pelvic floor muscle exercises are a promising treatment option for premature ejaculation, as they will increase the strength, tone, power, and endurance of the pelvic muscles, which can help short-circuit the premature ejaculation. Numerous scientific studies have demonstrated the effectiveness of pelvic floor muscle training in the management of premature ejaculation.

To apply your pelvic muscle facility to the real life situation you need to recognize the imminent ejaculation, slow the pace of intercourse, pause the pelvic thrusting and perform a “hold”—a pelvic floor muscle contraction lasting about 10 seconds or so, until the point that the ejaculatory urgency disappears. By actively deploying your pelvic floor muscles by using this sustained contraction of the pelvic floor muscles, the ejaculation can often be forestalled and intercourse resumed.

Bottom Line: Pelvic floor muscle training has numerous practical benefits, from the bedroom to the bathroom. Learn more about the specifics of these exercises—rapid flexes, basic flexes, long hard flexes and holds, through the Private Gym pelvic floor muscle training program, a comprehensive, interactive, follow-along exercise program that strengthens the muscles that support sexual and urinary health. (www.PrivateGym.com)

Wishing you the best of health,

2014-04-23 20:16:29

http://www.AndrewSiegelMD.com

6922

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

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

6922

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

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Man Kegels (Pelvic Floor Muscle Exercises for Men)-Part 2

March 15, 2014

Andrew Siegel MD, Blog# 145

photo

The photo above was taken by a pharmaceutical rep friend who discovered this phallic carving among the Roman ruins in Fez, Morocco.

The following is largely excerpted from my forthcoming book, Male Pelvic Fitness: Optimizing Sexual and Urinary Health, available in April 2014:

With respect to sexuality, medical publications—and more specifically the urological literature—rarely, if ever make mention of targeted exercise as a means of optimizing function or helping to treat a dysfunction. The preeminent urology textbook, Campbell’s Urology, a 4000 page, 4-volume tome, devotes precisely one paragraph to the use of pelvic floor muscle exercises in the management of male sexual dysfunction and makes no mention of its use in maximizing sexual function.

Despite numerous studies and research demonstrating the effectiveness of targeted pelvic exercises, they have been given short shrift. Part of the reason for this is simply that there has never been an easy-to-follow exercise program or well-designed means of facilitating pelvic floor muscle training in men. Instead, there is an emphasis on oral medications, urethral suppositories, penile injections, vacuum devices and penile implants. In the United States we have a pharmacology-centric medical culture—“a pill for every ill”—with aggressive prescription writing by physicians and a patient population that expects a quick fix.

It is shameful that traditionally there has been such little emphasis on lifestyle improvement—healthy diet, weight management, exercising, and avoidance of tobacco, excessive alcohol and stress—as a means of preventing and improving sexual dysfunction.

In addition to general lifestyle measures, specific exercises targeted at the pelvic floor can confer great benefits to pelvic health and fitness, an important element of overall health and fitness. The pelvic floor muscles (PFM) are critical to healthy  sexual function and achieving fitness in this domain is advantageous on many levels: to enhance sexual health; to maintain sexual health; to help prevent the occurrence of sexual dysfunction in the future; and to aid in the management of sexual dysfunction. PFM exercises should be considered first-line treatment of sexual dysfunction and a safe and natural self-improvement approach ideally suited to the male population, including the baby boomers, generation X, and generation Y.  PFM fitness can serve as an effective means to help keep the boomers “booming.”

I do not mean to downplay and disparage the role of medications and other options in managing sexual dysfunction. The availability of that magic blue pill in April 1998—Viagra—was a seminal moment in the world of male sexual dysfunction that enabled for the first time a simple and effective means of treating erectile dysfunction (ED).  On the polar opposite end of the treatment spectrum—but of no less importance—was the development and refinement of the penile implant, used in severe cases of ED unresponsive to less invasive options.

But why should we not initially try to capitalize on simpler, safer, and more natural solutions and consider, for example, using a targeted exercise program or medications in conjunction with a targeted exercise program?  Sexual function is all about blood flow to the penis and pelvis.  And what better way to enhance blood flow than to exercise?  We engage in exercise programs for virtually every other muscle group in the body.  Working out our PFM can result in a strong, robust and toned pelvic floor, capable of supporting and sustaining sexual function to the maximum.

Physical therapy is a well-accepted discipline that is commonly used for disabilities and rehabilitation after injury or surgery.  The goal of a physical therapy regimen is to promote mobility, functional restoration and quality of life. A targeted PFM exercise regimen can be considered the equivalent of genital and pelvic physical therapy with the goal of increasing the bulk, strength, power and function of the PFM.

The PFM can be thought of as a vital partner to our sexual organs, whose collaboration is an absolute necessity for optimal sexual functioning, little different than the relationship between the diaphragm muscle and the lungs. The role of the PFM in sexual function has been vastly undervalued and understated. The hard truth is that a well-conditioned pelvic floor that can be vigorously contracted and relaxed at will is often capable of improving sexual prowess and functioning as much as fitness training can enhance athletic performance and endurance.

Such targeted exercises confer advantages that go way beyond the sexual domain. These often-neglected muscles are vital to our genital-urinary health and wellness and serve an essential role in urinary function, bowel function and prostate health.  Additionally, they are important contributors to lumbar stability, spinal alignment and the prevention of back pain. Specifically, PFM exercises can be beneficial with respect to the following spectrum of issues: erectile dysfunction; orgasmic dysfunction; premature ejaculation; urinary incontinence; overactive bladder; post-void dribbling; pelvic pain due to levator muscle spasm; bowel urgency and incontinence; and in mitigating damage incurred from saddle sports including cycling, motorcycling and horseback riding.

The PFM, comprised of muscles that form a muscular shelf that spans the gap between our pelvic bones, form the base of our “core” muscles.  Our core muscles are the “barrel” of muscles in our midsection.  The top of our core is our diaphragm, the sides are our abdominal, flank, and back muscles, and the bottom of the barrel are our PFM.

The core muscles, including the PFM, are not the glitzy muscles of the body—not those muscles that are for show. Our core muscles are often ignored and do not get much respect, as opposed to the external glamour muscles of our body, including the pectorals, biceps, triceps, quadriceps, latissimus, etc.  In general, muscles that have such “mirror appeal” are not those that will help in terms of sexual and urinary function. Our core muscles are the hidden gems that work diligently behind the scenes—the muscles of major function and not so much form—muscles that have a role that goes way beyond movement, which is the cardinal task of a skeletal muscle.  On a functional basis, we would be much better off having a “chiseled” core as opposed to having “ripped” external muscles, as there is no benefit to having all “show” and no “go.”

The pelvic floor seems to be the lowest caste of the core muscles—the musculus non grata, if you will kindly accept my term. The PFM, however, do deserve serious respect because, although concealed from view, they are responsible for some very powerful and beneficial functions, particularly so when intensified by training.  Although the PFM are not muscles of glamour, they are our muscles of “amour.”

Who Knew? Having “ripped” external glamour muscles might help get your romance going, but having a chiseled core and conditioned PFM will help keep it going…and going…and going!

The female pelvic floor muscles, exercises for which were popularized by gynecologist Dr. Arnold Kegel, have long been recognized as an important structural and functional component of the female pelvis. But who has ever heard of the male pelvic floor?  The male pelvic floor has been largely unrecognized and relegated as having far less significance than the female pelvic floor.  Yet from a functional standpoint, these muscles are of vital importance, certainly as critical to male genital-urinary health as they are to female genital-urinary health.

The PFM, as with other muscles in the body, are subject to the forces of adaptation.  Unused as they are intended, they can suffer from “disuse atrophy.” Used appropriately as designed by nature, they can remain in a healthy structural and functional state. When targeted exercise is applied to them, particularly against the forces of resistance, their structure and function, as that of any other skeletal muscle, can be enhanced.

The key responsibility of most of our skeletal muscles is for joint movement and locomotion. The core muscles in general, and the PFM in particular, are exceptions to this rule.  Although the core muscles do play a role with respect to movement, of equal importance is their contribution to support, stability, and posture. Consider that the pelvic floor muscles, particularly the superficial PFM, have an essential function in the support, stability and “posture” of the penis.  They should be considered the hidden “jewels” of the pelvis.

Who Knew? If you want your penis to have “outstanding” posture and stability, you want to make sure that your PFM are kept fit and well-conditioned.

The PFM have three main functions that can be summarized by three S’s: support, sphincter, and sex. Support refers to their important role in securing our pelvic organs—the urinary, genital and intestinal tracts—in proper anatomical position. Sphincter function allows us to interrupt our urinary stream and pucker the anus and contributes in a major way to urinary and bowel control.  These vital responsibilities are generally taken for granted until something goes awry. With regard to sexual function, the PFM are active during erection and ejaculation.  They cause a surge of penile blood flow that helps maintain a rigid penile erection throughout sexual activity and at the time of orgasm, contract rhythmically, enabling ejaculation by propelling semen through the urethra.

The PFM can become atrophied, flabby and poorly functional with aging, weight gain, a sedentary lifestyle, saddle sports and other forms of injury and trauma, chronic straining, and surgery.  Sexual inactivity can lead to their loss of tone, texture, and function.  However, PFM integrity and optimum functioning can be maintained into our golden years with attention to a healthy lifestyle, an active sex life, and PFM training, particularly when such exercises are performed against progressive resistance.  The goal of such a regimen is the attainment of broader, thicker and firmer PFM and maintenance and/or restoration of function.

The PFM may physically be the bottom of the barrel of our core, but functionally they are furthermost from the bottom of the barrel.  For those who are already functioning well, an intensive PFM training program—as with any good fitness regimen—can impart better performance, increased strength (rigidity), improved endurance (ejaculatory control), and decreased recovery time (the amount of time it takes to achieve another erection).  Keeping the PFM supple and healthy can help prevent the typical decline in function that accompanies the aging process. On so many domains, diligently practiced PFM exercises will allow one to reap tangible rewards, as they are the very essence of functional fitness—training one’s body to handle real-life situations and overcome life’s daily obstacles.

Andrew Siegel, M.D.

Author of: Male Pelvic Fitness: Optimizing Sexual and Urinary Health; in press and available in e-book and paperback formats in April 2014.

www.MalePelvicFitness.com

Author of Promiscuous Eating: Understanding and Ending Our Self-Destructive Relationship with Food: www.promiscuouseating.com

Available on Amazon in Kindle edition

Author of Finding Your Own Fountain of Youth: The Essential Guide For Maximizing Health, Wellness, Fitness & Longevity  (free electronic download) www.findyourfountainofyouth.com 

Amazon page: amazon.com/author/andrewsiegel

For more info on Dr. Siegel: http://www.about.me/asiegel913