Posts Tagged ‘resistance training’

Female Pelvic Floor Muscle Resistance Training

July 21, 2018

Andrew Siegel MD   7/21/2018


            Kim Anami started the trend of vaginal weightlifting; visit her website at


 “In the preservation or restoration of muscular function, nothing is more fundamental than the frequent repetition of correctly guided exercises instituted by the patient’s own efforts.  Exercise must be carried out against progressively increasing resistance, since muscles increase in strength in direct proportion to the demands placed upon them.”

–JV Luck, Air Surgeon’s Bulletin, 1945

“Resistance exercise is one of the most efficient ways to stimulate muscular and metabolic adaptation.”

–Mark Peterson, PhD


Resistance training is a means of strength conditioning in which work is performed against an opposing force. The premise of resistance training is that by gradually and progressively overloading the muscles working against the resistance, they will adapt by becoming bigger and stronger. Pelvic floor muscle training (PFMT) using resistance optimizes pelvic floor muscle (PFM) conditioning, resulting in more power, stability and endurance and the functional benefits to pelvic health that accrue. It also helps to rebuild as well as maintain PFM mass that tends to decrease with aging.

Applying resistance training to the pelvic floor muscles

Resistance is easy to understand with respect to external muscles, e.g., it is applied to the biceps muscles when you do arm curls with dumbbells. Resistance training can be applied to the PFM by contracting your PFM against a compressible device placed in your vagina.  Its presence gives you a physical and tangible object to squeeze against, as opposed to basic training, which exercises the PFM without resistance. Resistance PFMT is similar to weight training—in both instances, the adaptive process gradually but progressively increases the capacity to do more reps with greater PFM contractility and less difficulty completing the regimen. In time, the resistance can be dialed up, accelerating the adaptive process.

In the late 1940s, Dr. Arnold Kegel devised the perineometer that enabled resistance PFM exercises. It consisted of a pneumatic vaginal chamber connected by tubing to a pressure manometer.  This device provided both a means of resistance and visual biofeedback. The chamber was inserted into the vagina and the PFM were contracted while observing the pressure gauge (calibrated from 0-100 mm mercury). With training, the PFM strength increased in proportion to the measured PFM contractions.

PFMT resistance tools

There are many PFM resistance devices on the market and my intention is to provide information about what is available, but NOT to endorse any product in particular. What follows is by no means a comprehensive review of all products. Some are basic and simple, but many of the newer ones are “high tech” and sophisticated means of providing resistance, biofeedback and tracking, often via Bluetooth connectivity to a smartphone. I classify the devices into vaginal weights, electro-stimulation devices, simple resistance devices and sophisticated resistance devices.  Within each category, the devices are listed in order of increasing cost.

Vaginal Weights

These weighted objects are placed in the vagina and require PFM engagement in order that they stay in position. They are not intended to be used with any formal training program but do provide resistance to contract down upon.

Vaginal Cones: These are a set of cones of identical shape but variable weights.  Initially, you place a light cone in your vagina and stand and walk about, allowing gravity to come into play. PFM contractions are required to prevent the cone from falling out. The intent is to retain the weighted cone for fifteen minutes twice daily to improve the strength of the PFM.  Gradual progression to heavier cones challenges the PFM.  (Search “vaginal cones” as there are several products on the market.)

Word of advice: Be careful not to wear open-toed shoes when walking around with the weighted cones…a broken toe is a possible complication!

Ben Wa Balls:  These are similar to vaginal cones but appear more like erotic toys than medical devices. There are numerous variations on the theme of weighted balls that can be inserted in your vagina, available in a variety of different sizes and weights.  Some are attached to a string, allowing you to tug on the balls to add more resistance. Another type has a compressible elastic covering that can be squeezed down upon with PFM contractions. Still others vibrate. There are some upscale varieties that are carved into egg shapes from minerals such as jade and obsidian. (Search “Ben Wa Balls.”)

Kim Anami is the queen of vaginal kung fu, a life and sex coach who advocates vaginal “weightlifting” to help women physically and emotionally “reconnect” to their vaginas and become more in tune with their sexual energy. Her weightlifting has included coconuts, statues, conch shells, etc.  According to her, vaginal weightlifting increases libido, lubrication, orgasm potential and sexual pleasure for both partners.                                                                                                                       

Electro-Stimulation Devices

These devices work by passive electrical stimulation of the PFM.  Electrical impulses trigger PFM contractions without the necessity for active engagement.  Many clinical studies have shown that electro-stimulation in conjunction with PFMT offers no real advantages over PFMT alone. Like the electrical abdominal belts that claim to tone and shape your abdominal muscles with no actual work on your part, these devices seem much better in theory than in actual performance.

Intensity: This is a battery-powered erotic device that looks like the popular “rabbit” vibrator sex toy.  It consists of an inflatable vaginal probe that has an external handle. It has contact points on the probe that electro-stimulate the PFM and vibrators for both clitoral and “G-spot” stimulation. It has 5 speeds and 10 levels of stimulation. Cost is $199 (

ApexM:  This device is intended for use by patients with stress urinary incontinence.  It consists of an inflatable vaginal probe and control handle. It is inserted inside the vagina, inflated it for a snug fit and powered on.  Electric current is used to induce PFM contractions. The intensity is increased until a PFM contraction occurs, after which the device is used 5-10 minutes daily. Cost is $299 (

Simple PFMT Resistance Devices

These are basic model, inexpensive resistance devices. They consist of varying physical elements that you place in your vagina to give you a tangible object to contract your PFM upon. They provide biofeedback to ensure that you are contracting the proper muscles. Some offer progressive resistance while others only a single resistance level.

These devices can be used in conjunction with the specific programs that were specified in a previous blog entry.  To do so, repeat the 4-week program for your specific pelvic floor dysfunction while incorporating these devices into the regimen. You may discover that the 4-week programs using the devices that offer progressive resistance become too challenging as you dial up the resistance level. If this is the case, you can continue with the first week’s program while increasing the resistance over time. Customize and modify the programs to make them work for you, as was recommended for the tailored programs without using resistance.

Educator Pelvic Floor Exercise Indicator:  This is a tampon-shaped device that you insert into your vagina. It is attached to an external arm that moves when you are contracting the PFM properly, giving you positive feedback. Cost is $32.99 on Amazon (

Gyneflex: This is a flexible V-shaped plastic device that is available in different resistances. You insert it in your vagina (apex of the V first) and when you squeeze your PFM properly, the external handles on each limb of the V close down, the goal being to get them to touch. Cost is $39.95 ( The Gyneflex is similar in form and function to hand grippers that increase grip strength. 

Pelvic Toner:  Manufactured in the UK, this is a spring-based resistance device that you insert into your vagina.  It has an external handle and two internal arms that remain separated, so the device must be held closed and inserted. When your hold is released the device springs open and, by contracting your PFM, you can close the device. It offers five different levels of resistance. Cost is 29.99 British pounds (

Magic Banana: This is a PFM exerciser that consists of a loop of plastic and silicone tubing joined on a handle end. The loop is inserted in the vagina and squeezed against.  When the PFM are contracted properly, the two arms of the loop squeeze together. Cost is $49.99 (

KegelMaster: This is a spring-loaded device that you insert in your vagina and is squeezed upon. It has an external handle with a knob that can be tightened or loosened to provide resistance by clamping down or separating the two arms of the internal component. Four springs offer different levels of resistance. Cost is $98.95 (

Kegel Pelvic Muscle Thigh ExerciserThis is a Y-shaped plastic device that fits between your inner thighs.  When you squeeze your thighs together, the gadget squeezes closed. This exerciser has NOTHING to do with the PFM as it strengthens the adductor muscles of the thigh, serving only to reinforce doing the wrong exercise and it is shameful that the manufacturer mentions the terms “Kegel” and “pelvic muscle” in the description of this product.

To be continued next week, with a review of sophisticated PFMT resistance devices.

Wishing you the best of health,

2014-04-23 20:16:29

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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

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.

Dr. Siegel is co-creator of the male pelvic floor exercise instructional DVD (female version is in the works): PelvicRx

New video on female pelvic floor exercises:  Learn about your pelvic floor



Exercise Your Penis…REALLY?

September 2, 2014

Andrew Siegel M.D.   Blog # 170


Your penis is an organ that wears many hats. It directs your urinary stream with sometimes laser-like precision (although this precision goes to pot as you age); when erect it allows for vaginal penetration; and at the time of climax, it permits passage of sperm to reproduce the species. Pretty remarkable in terms of its multi-functionality and handiness, similar to a Swiss Army knife, but really so much better! In terms of sexuality and fertility, the ability to achieve an erection is a must, and this is predicated on an adequate penile blood flow, which is the “rocket fuel” of penile erections.

Your ability to obtain penile rigidity is a matter of hydraulics—maximizing inflow of blood while minimizing outflow. I need to get a bit medical to explain this: Your penis contains 3 erection chambers that fill with blood. They are composed of sinuses, virtually identical to our nasal sinuses, and an erection occurs when the sinuses become congested with blood. Blood inflow is caused by smooth muscle relaxation in the penile arteries and in the sinuses. As the sinuses fill up, they compress the penile veins to block the outflow of blood. And hence you have a tumescent penis, plump, but not yet rigid.

So how do you go from plump to rigid? The pelvic floor muscles are the key players in the transformation from a tumescent penis to a rigid penis. They compress the deep, inner part of your penis, creating rigidity by aiding closure of veins and by elevating the blood pressure within your penis so that it is well above systolic blood pressure. An erect penis is a hypertensive penis (really a very good thing), and it is this tremendous pressure that causes bone-like rigidity. If this penile blood pressure at the time of a rigid erection were experienced in the arteries of your body, it would be considered a hypertensive crisis! So, the only organ in the body in which high blood pressure is not only healthy, but also desirable, is your penis.

With aging, the smooth muscle of all of our arteries tends to become stiffer and less able to relax, resulting in high blood pressure (a very bad thing) for many of us. The penis is not spared, as the smooth muscle of the penile arteries and sinuses stiffens and is less able to relax. Unfortunately, stiff smooth muscle in the penis does not lead to a stiff penis…in fact, quite the opposite. Additionally, our pelvic floor muscles weaken with age, like many of our skeletal muscles. Between the smooth muscle stiffening and the weakened pelvic floor muscles, we have the perfect storm for ED.

Where are your pelvic floor muscles? They are located between the scrotal sac and the anus, the saddle region where your body is in contact with a bicycle seat. In the 1940s, gynecologist Dr. Arnold Kegel popularized pelvic floor muscle exercises (“Kegels”) in women to improve their sexual and urinary health. Men have similar pelvic floor muscles and an equivalent capacity for exercising them, with parallel benefits to sexual and urinary health. It’s high time that we demand equal pelvic rights!

Male pelvic floor muscle exercises date back to ancient times, having been described in ancient Greece and Rome by Hippocrates and Galen respectively. Performed in the baths and gymnasiums, these exercises were thought to promote general and sexual health, spirituality and longevity.

Most men are unfamiliar with pelvic floor muscles exercises, let alone with their pelvic floor muscles. Unfortunately, many physicians are not very knowledgeable regarding the pelvic floor and the benefits of fitness in this area, and do not see themselves as instructors of pelvic floor muscle training. Regrettably, our medical culture—heavy on prescription writing and surgery—does not typically promote lifestyle improvement and exercise programs such as pelvic floor training. I would like to explain to you why such exercises are well worth your time and effort.

There is exercise and then there is EXERCISE; for example, there is walking (moving is good) and then there is running with interval training (a great workout). When it comes to exercising your skeletal muscles, using resistance training—working against an opposing force—stresses your muscles to enhance strength, tone, power, durability and responsiveness. By gradually and progressively overloading the muscles working against the resistance, they will adapt by getting bigger and stronger. Imagine repetitively doing arm curls without weights as compared to doing curls with weights, in which case the added resistance will rapidly and effectively create muscle growth and accelerated strength.

Kegels 101 involves repetitions of pelvic floor contractions without resistance. How do you accelerate to Kegels 401—pelvic floor muscles with resistance? Dr. Kegel designed a resistance device for women called a “perineometer” that was inserted into the vagina to provide a means of squeezing against something and a way to measure the strength of the squeeze. Men don’t have a vagina, but they do have a rectum, and one way to do resistance training is to use a perineometer placed in the rectum. Not a very appetizing thought though, is it?

Remember that your pelvic floor muscles engage when you have an erection. When you contract these muscles, your penis magically lifts up towards the heavens with each contraction. Since the pelvic floor muscles govern this upward deflection, they can be challenged to lift up more than just the weight of your penis.

And thus was born the concept of the Private Gym resistance workout for men. Whereas the Private Gym’s Basic Training program strengthens the pelvic floor muscles with a series of progressive male Kegel exercises without resistance.


The Resistance Program uses resistance equipment to maximize pelvic floor muscle strengthening. The equipment consists of an ergonomic weighted base and magnetic weights that attach to the base. It is placed on your erect penis, which is raised up and down by contracting the pelvic floor muscles in accordance with the follow-along DVD program, subjecting the pelvic floor muscles to resistance. Your muscles will gradually and progressively adapt to the load placed upon them and will strengthen in accordance with the resistance



When one first hears about progressive resistance training for the penis, their reflex reaction is often: Are you kidding? Really? Seriously? REALLY? Weights for the penis? You must be joking! No way. When Dr. Arnold Kegel in the late 1940’s first proposed his concept of the perineometer that gets placed in the vagina in order to do progressive resistance exercises, he likely received many similar responses from both his patients as well as his medical colleagues. What, shove that up my vagina and squeeze? And this was the 1940’s, decades before the sexual revolution!

If one can discard their conservative prejudices and carefully consider the principle of resistance training for skeletal muscle adaptation, they will realize that resistance training for the pelvic muscles is no different than resistance training for any other skeletal muscle, a bona fide means of creating strength and endurance. Resistance training is a “boner-fide” (sorry—I couldn’t help myself) means of maximizing your pelvic floor muscle growth.

In terms of resistance training of the penis, the Private Gym clearly is superior and more user friendly and less invasive than using a rectal resistance device, with the limitation that it can only be used in those men who can obtain a sufficiently rigid erection, whether naturally, or with the help of pills such as Viagra, Levitra, Cialis and Stendra.

The Private Gym Company was established after recognizing that there was an unmet need for a means by which a pelvic floor muscle-conditioning program could be made accessible and available in the home setting. The premise behind the Private Gym is to help achieve pelvic floor fitness and optimize sexual and urinary health.

Adaptation of skeletal muscle is an accepted scientific precept and if you have ever had your arm or leg in a cast, you can understand the detrimental effect of disuse on muscle tone and strength. The corollary is that if you have ever done weight training, you understand the beneficial effect of resistance training on muscle tone and strength.

Elston Howard was a New York Yankee who invented the batting “donut,” a circular lead weight that slides onto baseball bats and is used by on-deck batters. This added weight during practice swings makes the bat feel very light once it comes time to step up to the plate and remove the weight. Howard employed the resistance principle to heighten power—use the weighted bat in practice and when it comes time to step up to the plate, you’re going to perform better. This principle will work on your “bat,” too—utilize resistance training in practice and when it comes time to “step up to the plate,” you’re going to perform better. The Private Gym resistance turns conditioning into a weapon that is capable of producing “outstanding” erections, maximizing stamina, and tremendously boosting one’s confidence.

Bottom Line: Resistance training is utilized for creating strength and endurance for every group of skeletal muscles in the body, and the pelvic floor muscles should be no exception. The pelvic floor muscles are skeletal muscles and, just like the biceps and pectorals, they will adapt in a positive way to the resistance (load) placed upon them.


Wishing you the best of health,

2014-04-23 20:16:29

Andrew Siegel, M.D.

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Author of Male Pelvic Fitness: Optimizing Sexual and Urinary Health:

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