Come Home to Your Body: Sex, Kegels, Jazz, Trauma, and Healing — A Conversation with Anaïs Salibian
Anaïs Salibian practices and teaches Rosen Method Bodywork. In Rosen work, the practitioner lays hands on the client, using gentle touch and words rather than manipulation, to help the client discover and release patterns of tension. This allows the client to experience greater emotional freedom and more joy, and often results in healing from chronic health conditions. Anaïs is also a writer, and offers classes on writing memoirs and writing to heal.
Anaïs has been my dear friend for twenty years, but I only recently began to understand the essence of her work. In both her writing and Rosen work, what Anaïs is helping people to do could be described as waking up, inhabiting their bodies, reaching embodied self-awareness, coming home to their bodies, or being fully present in their lives. My goal in this conversation was to explore what this means for women — in particular, how coming home to our bodies can affect our kegel practice and our experience of sex. Most importantly, I wanted to learn more about how to recognize, and follow, the path that leads us home to our bodies. In our culture, most of us don’t even know that such a path exists.
Anaïs has experienced great hardship in her life. She was raised by survivors of the Armenian genocide; when Anaïs was a child, atrocities and murder were everyday conversation topics at the family dinner table. As an adult, Anaïs is a two-time cancer survivor. In spite of her history, Anaïs radiates a sense of calm, love, and safety. She says it’s her ability to fully inhabit her body that allows her to live in the present moment and feel good, even in the hard times.
Anaïs lives with her husband in Rochester, New York. She may be reached at www.awareness-heals.com or 585-586-1590.
You may listen to my recorded interview with Anaïs here, or read the edited transcript of our conversation, below.
Listen to the recorded interview here:
Kegel Queen: What you’re helping people to do could be described as waking up, inhabiting their bodies, or helping them reach embodied self-awareness. You’re helping people be fully present in their lives.
Anaïs Salibian: Yes. I think when people talk about being fully present, it’s this they’re talking about.
Kegel Queen: Let me address how this is connected with my work as the Kegel Queen. You do much better kegels — any physical practice is so much more effective with awareness and with integration. We as women so often are really cut off from our bodies, in particular this part of the body. Integrating and inhabiting this part of the body is part of what I help women do. What you’re doing is so huge and so much more; [it] addresses integration on so many more levels. Also, one of the things that I love to help women with is having better sex. And it’s worlds apart, particularly something so pleasurable and so physical as sex, when you’re really in your body, really inhabiting your body, fully experiencing that moment. That’s why I wanted to bring this conversation specifically to the Kegel Queen blog.
How long have you been practicing and teaching Rosen Method Bodywork, and what is Rosen method?
Anaïs Salibian: I became a practitioner in 1996. I’ve had a private practice since then, and over the years took several steps of training to be a teacher of it, so that now I’m a senior teacher, which means I can train teachers as well as practitioners.
I have to admit that the first three years that I took Rosen training I couldn’t get it. I didn’t understand it, I didn’t get it, I was driving my teachers crazy. [Laughs.] And I didn’t realize that it was because I wasn’t embodied. I wasn’t in my body. I was forty-five when I started the training.
One day, I landed in my body — and the whole world changed. The way I describe it is that I had been living in a black and white movie, and all of a sudden the movie was technicolor. And after that I got everything I ever wanted in my life. But since that moment, which was kind of mysterious to me, there’s been a lot of neuroscience research that explains what all that is, how that happened, and what happened, and what we’re actually working with.
Kegel Queen: I want to hear about that science.
What happens on a simple material level in a Rosen session, just so people can picture what that practice is?
Anaïs Salibian: If you can remember or imagine a time that you were going to have feelings that you didn’t necessarily want to have, what do you do to stop yourself? You tense your muscles, and you hold your breath. Right? So you don’t cry, or you don’t feel your fear, or you control your anger, or whatever it is.
So holding muscles and tightening your breath becomes a chronic body posture, a chronic way you are in your body. And there’s a certain amount of tension you [are aware of]. Sometimes you realize, “Oh, my shoulders are up around my ears, I’m going to let them go.” And you can.
But there’s still a residual amount of physical tension that you can’t consciously let go. And that’s what the Rosen practitioner touches, helping the client to bring their own awareness to “Oh, I’m gripping like crazy there and I didn’t even know it.” Sometimes you know it because it hurts. Sometimes you don’t know it because it’s numb. But it’s physical tension that keeps you away from yourself — from knowing yourself, from feeling yourself, from knowing what’s actually going on inside you.
So we’re addressing the physical tension, not by forcing it to be undone, not by massage, or energy work, or anything like that, but by really, really paying attention together to… what’s happening here? Wherever “here” is, your shoulder, your head, your neck. And when you start experiencing as if you were that muscle, what your job is to hold on that tight — here’s the miracle thing — and you can name it out loud, it lets go.
I remember one experience I had was, “Oh, my shoulders are so tight, I can’t let go there.” And the more I went into that space with my attention, and my awareness, the younger and younger and younger I started to feel, until I was a little, little girl who couldn’t handle the enormity of — well, basically, genocide, which is what my family had been through. I just couldn’t deal with it. So I had to shut it down, and that’s how I did it. Tight. Hold.
Kegel Queen: Most people in our culture here in the States haven’t had the history of genocide that your family from Armenia had. But it’s still really common for people to have these patterns of tension, even if what they might have experienced is something really simple, like they got bullied, or their parents didn’t listen to them. It doesn’t have to be a profound insult in order to create these tension patterns.
Anaïs Salibian: Well, that’s the thing. I’ve come to the conclusion that we all have profound insults that don’t get recognized because they’re not so obvious as genocide. Or as racism. Or as sexism. We all have what I call trauma. Trauma is any experience you have which, at the moment you’re having it, is so overwhelming to you that you can’t neurologically process it. You have to shut it down. Now, if you had a human being helping you and supporting you through it, and allowing you to feel and think through it, it wouldn’t stay. You would resolve it then.
Kegel Queen: If that were during or shortly after the trauma.
Anaïs Salibian: But we don’t get that [support]. Some of my clients have been bullied, for instance, to the point of physical harm, and never got it processed as a child, or even as an adult. And I think things traumatize us that we don’t recognize as trauma. Ordinary things, like surgery. Women’s experience — most of us have been assaulted, abused, insulted in some way sexually. I don’t know what the statistics are, but I believe most.
Kegel Queen: If you include insulted, or have felt unsafe at some point, that would probably be 100 percent.
Anaïs Salibian: Right. So what do we do with it? We tighten up and hold our breath. And what that does is distance us from knowing our actual experience. Because the actual experience is intolerable.
Kegel Queen: So what happens is that if people tighten to a painful experience out of necessity, they then are unable to [have] a pleasurable experience because of that remaining tightness.
Anaïs Salibian: It’s the same doorway. Yes.
Kegel Queen: When you do Rosen Method Bodywork, you’re helping people to release that tension so that they can be fully present in their bodies and fully alive, and have their experiences, fully. You said [to me privately] it’s about people experiencing things instead of thinking they’re experiencing things.
Anaïs Salibian: Yes.
Kegel Queen: Is it very rare to meet someone who is actually experiencing things?
Anaïs Salibian: [Laughs.] I would say so, because it’s not just trauma that divides us from ourselves. I think we live in a culture that has a bias toward thinking. And thinking that thinking is what makes us alive. I think therefore I am.
Kegel Queen: Yes. So what’s the other way to look at things?
Anaïs Salibian: Can I do a little neuroscience here?
Kegel Queen: Yes, please!
Anaïs Salibian: You have two different parts in your brain that register your self-awareness. One part registers what you think about yourself. Another part registers all the signals you’re getting from your body — internal sensations, things like hunger, or hot or cold, or butterflies in my stomach, and things like where I am in space and what my body parts are doing in relation to each other. All these signals come from your body and register in another part of your brain. They can’t both be on at the same time.
Kegel Queen: So one system is information from the body and the other system is information about thoughts.
Anaïs Salibian: Yes. These two parts need neural connections in order to talk to each other, and for one part to be aware of the other part.
Kegel Queen: The thinking part and the body part need to be able to communicate with each other.
Anaïs Salibian: Right. And evolutionarily, they were meant to work together. But in this culture, we have idealized the one part over the other part so much that the thinking part often doesn’t even pay attention, or doesn’t even understand its language — it doesn’t speak in English, or any other language.
Kegel Queen: So the body might be sending signals all the time, and is sending signals all the time, but if our attention is cut off from that, we don’t know what’s happening.
Anaïs Salibian: Right. I’ll tell you an extreme example of what I mean by not having embodied awareness. I had a client once who was on the table and I noticed she was crying. I asked her what was bringing the tears, and she said, “I’m not crying.” And then she started wiping away, and she says, “There’s this wetness, but I’m not crying.” So her thinking mind had an idea about what was happening that was different from her actual experience.
Kegel Queen: Tell me if this is what you think is true. Our thoughts — and I think anyone sane would agree — our thoughts aren’t always correct.
Anaïs Salibian: Oh, totally.
Kegel Queen: Our thoughts might be completely out of range. They might have nothing to do with reality, actually.
Anaïs Salibian: You’re totally right.
Kegel Queen: And that other input network from the body, is that always real information? Or can that be mistaken sometimes? Certainly we could receive information from the body and add an incorrect thought on it, we could misinterpret it, but is that information from the body always true?
After the interview, Anaïs added these comments (italics):
I guess the short answer has to do with, true for when? If you’re living with an unprocessed trauma experience, the memory of it is not encoded in your brain the way ordinary memories are. The sensations and emotions of the trauma are all over your body, and in imagery instead of language. So people can have “relives” where their bodies are experiencing something that is not actually going on in the present moment. Then one might say that information from the body is not true — but it is true about the past.
When your present-day consciousness knows something isn’t true now, but your body is experiencing something else, you can’t simply change your mind. This is what drives me nuts about affirmations or Cognitive Behavioral Therapy or positive thinking. The reason these things often don’t work is that the body is not experiencing anything different than the old trauma, so why should you believe something different? Thoughts can’t change thoughts unless they’re accompanied by an actual experience.
With my clients, say they’re feeling unsafe but know that they “should” feel safe now. They feel stupid because they can’t just relax in my office. They know (in their heads) they’re not in danger of getting abused, but something in them won’t obey. So I make it clear that their body has to experience the safety for them to believe it. We direct their attention to present-time, concrete experience: Do you feel supported by the table? How do my hands feel? What are the outlines of your body? How big are you?
Experience is how the brain gets wired and rewired. In other words, the body gives rise to the mind. So that’s why the two parts (thinking and body awareness) have to talk to each other.
Anaïs Salibian: This is a good example of why they need to talk to each other. Let’s say you were walking in the forest one day and a snake fell on you, and scared the hell out of you. So your adrenaline pumps up, your breathing speeds up. Your amygdala, which is the fear center in your brain, is turned on — it’s fight or flight. Right? And you don’t have the opportunity to have someone come along and see you through it.
Two years later, you’re walking in the woods and there’s this curvy piece of stick on the ground. And your amygdala goes, “Aah! Snake! Snake!” Your body responds as if you were actually seeing danger. Your conscious brain is the one that has to say, “It’s just a stick, okay, it’s just a stick,” and calm down the fear center part. [Anaïs added the following after the interview (italics): Look at the stick, hold the stick, break the stick — anything so your body can really experience that it’s a stick and not a snake.]
The other thing I love about Rosen work is that there’s a connection between what your diaphragm is doing and what the amygdala is doing. Because if you’re holding your breath, if your breathing is tight (which [for] most of us it is), it automatically sends a signal to the amygdala that there’s danger around, when there isn’t. So to loosen the diaphragm means to ratchet down our level of stress and fear that we’re feeling even when we’re not naming it.
But naming it — this is why I love to teach writing also. Naming what’s actually going on calms down the whole system. Even if you don’t change it, naming it calms down the whole system. And that means that you’re conscious, and your body and your mind are together. That’s what integration is.
When your body-centered awareness and your thinking mind are talking to each other and aware of each other, and you’re using the pieces of information that each side has to think logically, you think clearly about what’s going on. ‘What do I need to do, to get what I want and need?’
Kegel Queen: [This is] very rare, I think.
Anaïs Salibian: Yes.
Kegel Queen: I want to come back to the term, “embodied self-awareness.” And I used the phrase I’ve heard from you before: “inhabiting the body.” What is that? And what is the difference between inhabiting and not? Is the difference that communication between those two parts of the brain is not happening? What is embodied self-awareness, and how can you tell whether you’re experiencing that, or whether someone else is experiencing that?
Anaïs Salibian: I can describe different states of the nervous system that we’re in, a range from completely relaxed to completely freaking out and stressed out. And there’s an ideal place in between where it would be nice to be living [laughs], where your nervous system is aroused just enough so that you’re really engaged and you’re really interacting with whatever it is that you’re doing. It could be running a business or it could be painting a painting, or whatever it is that’s your passion that you’re doing.
And [when] things get in the way of doing that, of achieving your goals, [when] you have problems, they don’t feel like they’re going to defeat you. They feel like challenges you can really grapple with and actually have fun grappling with, and then you get so involved in doing…
Have you ever had this experience, that you’ve just spent five hours and you thought it was half an hour? You’re engaged, you’re alive, you’re present, you’re thinking, you’re feeling what you’re feeling when you’re doing it. When you’re not in that state, you’re probably shut down in some way, or you’re simply in a relaxed, open, restful, rest-and-relax and repair state.
But when we get to the other extreme end of stress and freakout, and tightness and tension and vigilance and not feeling like you trust anything, that is not an embodied self awareness state. Because actually I have found that when I am really… you can call it inside my body, but you can also say when I’m checking in and tracking what I’m actually experiencing in my body. When I turn my attention inward and say, “What am I experiencing right now?” a lot of the time it’s very different than what my brain thought I was experiencing. My brain could be busy worrying about something; my body is like, “Ah, we’re fine. We’re good. Things aren’t desperate. And by the way, there’s power in here to trust.” It’s a very different experience than just the mind. And if you’re a person who’s in worry mode a lot, it probably means you’re not embodied.
Kegel Queen: That must be what you were here to say to me. [Both laugh.]
Anaïs Salibian: Yes, because the body is more grounding. You know the difference between feeling grounded and not grounded?
Kegel Queen: I think so. In my own way. It’s hard to talk about it objectively; it’s inherently subjective.
Anaïs Salibian: So to get grounded I tell people to do things like walk barefoot, have someone touch your feet, really sit and feel the chair under your butt.
Kegel Queen: So tuning in to physical sensations is one of the easiest ways to wake up our connection?
Anaïs Salibian: I would say that’s step one. Physical sensations. Step two or three is what difference does it make that you’re having these sensations? They need to matter to you in some way. So what?
Kegel Queen: Why should they matter?
Anaïs Salibian: Because sometimes I ask people, “Okay, what are you feeling here?”
“I feel a sleeve on my arm, I feel an itch on my hand.” You can name everything you feel, and if you don’t have a subjective response to it, you’re like a robot.
Kegel Queen: What does that subjective response look like?
Anaïs Salibian: It could be, “I have an itch there, I’d like to rub my back against the chair. Oh, that feels good.” Or it could be, “Wow, that chair is pressing hard on the bottom of my thigh there, I might want to move.”
Kegel Queen: So it has something to do with what feels good and what doesn’t feel good. It’s about sensing what’s happening and recognizing what you want to do about it.
Anaïs Salibian: Yes. To enhance your well-being. For instance, this teacher screams at the class all the time. How does that feel to me inside? Am I going to stay with it? Or am I going to move away from it? Or am I going to act in some way to change what doesn’t feel right to me?
Kegel Queen: In that situation, you could ask your body, “What do I want to do about this?”
Anaïs Salibian: Instead of sitting and taking it because that’s what you’re supposed to do. I think if you really, truly register your actual experience of certain things, you don’t put up with the bullshit. [Laughs.] Pardon my language! And we put up with it when we numb out of how we actually feel about something.
Kegel Queen: This idea of inhabiting your body, or embodied self awareness, is fundamentally about taking care of yourself, in a way.
Anaïs Salibian: Yes. On a basic survival level. But it’s also about having a sense of your own being. This is where it gets into what I call the spiritual level, because you can’t know who you are if you don’t even know how you react to things. Right? But the more inside the body I go, the more I feel a presence of a being, who is me, who is greater than my thoughts, my sensations, my emotions, my perceptions. All of those things aren’t that being.
Kegel Queen: So this part of you that is part of, or connected with, something divine and universal…
Anaïs Salibian: I can’t even know about her if I’m not in my body. And I think that’s where I used to not even understand why people meditate, because I used to think all you did was zone out. And maybe for years that’s what people thought meditation was. But I’ve heard that in more recent years, meditation teachers themselves have said no, it’s about noticing your bodily experiences and really being present to your actual experience.
Kegel Queen: It’s interesting. When I initially had a lightbulb [go on] about what your work was really about, helping people to connect with themselves and wake up in this way, suddenly I saw it everywhere. This is why people meditate. This is why people love their pets, because animals don’t have that disconnect that humans do. This is why it feels so good to be around babies and little kids because they’re really integrated. There’s no separation or disconnection. What you see is what you get, and they know what’s going on. They know what feels good, and they don’t need to tell themselves a story about why they should talk themselves out of feeling how they feel; they just feel it. And they’ll tell you.
Anaïs Salibian: Right. Exactly.
Kegel Queen: And I started to wonder about so many other things. Is this what makes the difference between an artist who is working on the surface and creating something mediocre, versus an artist who is creating something phenomenal? Is this the difference between someone we see on stage who is interesting, versus someone who is incredibly captivating? Or a leader who really inspires people?
Do you think that being connected and aware in this way is a requirement for expressing real genius? I mean operating at a really outstanding, inspiring — some people would say inspired or divinely inspired — really, really high level in whatever your work might be. Is it a requirement to have this kind of internal awareness and connection?
Anaïs Salibian: I think the great artists worked hard to get their technical skills, but without this other human presence… somehow they have transmitted that through the paint and the paintbrush on the canvas, and they did it well because they knew the technical skills. But the technical skills without that, you might as well just snap a picture.
I just came back from France. My husband is a trained painter. We’re standing in front of this Braque painting. I don’t particularly love cubism, but I’m standing in front of this painting ready to cry. I’m so thrilled, and I’m having all these bodily reactions, and he’s going, “What?” because his training taught him what intellectually these people were trying to achieve with this kind of painting, and he’s looking at it through his mind. And I’m just reacting to it. We’re having different experiences. [Laughs.]
I have this trick. Here’s another way. Anytime you do anything, whether it’s a walk in the woods, or stand in front of an abstract expressionist painting, or listen to loud “headache jazz,” instead of letting it in through your eyes, let it in through your gut. And your entire experience will change. I’ve written about this. I can look at abstract art and go, “Oh my God, my kindergartener could throw those colors on, what is it?” and then drop the mind, go to the body, take it in through your heart and your gut, and you’re seeing somebody’s soul. You’re seeing their struggle. You’re seeing them naked.
It’s the same with certain kinds of jazz. I remember being in a jazz club in New York and getting a headache — McCoy Tyner. All of a sudden I said, let me try the belly trick. In two seconds I was ready to worship these guys as shamans of some sort. They were doing something phenomenal. It was spiritual. And they were doing it together, without rehearsing. Ah! So the body has a whole other kind of knowing than the mind. And I think to be truly creative you’re including that.
Kegel Queen: What else can being embodied do for us?
Anaïs Salibian: It can make you happy.
[Both laugh.] It can make you happy no matter what’s happening. I remember, in the recovery room after a bilateral mastectomy, waking up and feeling so much full of love and full of light that it was… nothing is ever wrong. [Both laugh.] It’s not about denying what’s not right.
Kegel Queen: I know when you had cancer, not every moment was a picnic like that. How did your ability to be connected and embodied inform your experience during the more difficult times?
Anaïs Salibian: I think that early on when I had cancer, I got so scared, so terrified, that I left my body. So the process is how do you come back? You may have to cling to people. That’s primary. For some reason, we evolved to need another person’s presence. Actually, our nervous system regulates toward theirs. If someone has a calm nervous system, our nervous system will get calmer.
Kegel Queen: I find that fascinating, that we have this electromagnetic field coming out from our bodies. This is the energy that’s picked up by an EKG. Your heart is putting out electrical energy that can be sensed on a machine. This is common, everyday medicine, like an EEG, where they put the little electrodes on your head, and they’re sensing the electrical activity of the brain. The electrical activity of your brain extends out, I think, three feet or something from your body. The electrical activity from your heart can be sensed at something like thirty feet. I’m just making those numbers up, I don’t remember them. I’d like to know what they are. But we are constantly putting out, surrounded by, this electrical field that we create, ourselves, and it makes perfect sense that we are sensitive to each other’s. And newborns literally need regulating. They need to be held because their immature little nervous system can’t take care of itself by itself, they need to be physically close to an adult, and getting loved.
Anaïs Salibian: And getting loved, as part of their physiological development. And an adult — say you’re really stressed about something, or scared, your heart’s beating fast. If you sit next to someone whose heart is slower, the slower heart always slows down the speeding heart.
Kegel Queen: So this was a tool that helped you when you had cancer?
Anaïs Salibian: Yes, just cling to people.
Kegel Queen: What were the tools that helped you effectively come back, besides that, when you felt scared?
Anaïs Salibian: Actually, I remember a Rosen session where I couldn’t feel, couldn’t feel, I was so numbed out and gone, and my practitioner simply put her hands on my feet. And it felt like, you know when you let go of a helium balloon, it rises? It felt like she tugged on the string and brought me back down, and I kind of landed back in my body.
I am very curious about finding out exactly what works for people to bring them back.
You know what else I think? I think we move too fast. I think slowing way down is a requirement to even notice what our bodies are telling us we feel, because our minds will override it really fast.
Also, by the way, the signals from the body aren’t myelinated, meaning the actual nerve signal travels more slowly than thought to thought. You can think thoughts in an instant, but it takes more time to really register some of these internal signals.
Kegel Queen: Part of staying aware and waking up and staying connected has to include not plugging yourself into media input 24/7. You’ve got to turn the TV off and put your phone down, and not have sensory inputs and verbal inputs happening all the time.
Anaïs Salibian: Right.
Kegel Queen: Let’s talk about kegel exercises for a minute and how this relates. Just a couple nights ago, I was doing one of my Q & A sessions that I do with my members. It’s a topic that I’ve covered many times over the years, but I thought about it in an entirely new way based on some of what I’ve been learning from you. The topic was kegels and stress reduction. In the Kegel Queen Program, we make the kegel workout inherently relaxing, so that it feels good. It will be like candy that you keep coming back to, because if it’s not fun you’re not going to stick with it. And the easiest way to make it fun is to make it relaxing.
Looking at that through the lens of tuning into the body… I’m talking on the call about how we breathe. We do this nice, relaxing deep breathing and focus on the sensations in the pelvic floor as you contract it and relax it. What I’ve been attempting to do without even realizing it, all this time, is to help women, during their kegel workout, achieve moments of embodied self-awareness.
How powerful that is, particularly for women. Particularly regarding this body part, this whole area of the body [where] so many women have experienced physical abuse, sexual abuse. So many women have experienced cultural abuse around their sexuality, or their sexuality isn’t free, or it’s shameful.
Even as kids, toilet training, or being punished for not toilet training properly. We start when we’re in diapers, we start cutting off the feedback loop. Traditionally for thousands of years people didn’t use diapers, because they’re an invention of our modern world. Now that we have diapers, the kid is supposed to pee or poop and just go on living as if it never happened. And we start with this “diaper training” that begins to cut people off. For any of you who have children or grandchildren, or nieces or nephews on the way, I highly recommend going diaper-free. This is something we did with my daughter, and you can find out more at diaperfreebaby.org…staying aware of what’s happening in that part of the body.
Anyway, for most of us, we grew up in diapers, and we grew up in an atmosphere where it wasn’t safe to have sexuality as women — at all, really, so what we’re doing with kegels… It’s interesting how I didn’t even realize this whole side of it about waking up those neural connections in that way. How do you think women can women maximize the ability of their kegel practice to help them wake up?
Anaïs Salibian: Well, I haven’t learned them, and I don’t know what the exercises are, but it’s making me want to do them, to get my whole self back. I think that pelvic area is where we have our connection to our soul and to the whole life force of what’s in everything in the universe. And if we do the kegel practice as, okay, first of all really noticing what I’m feeling when I do it, and then noticing how I feel because I’m noticing what I’m feeling.
Kegel Queen: Noticing how you feel physically, and then how you feel emotionally about the physical sensations?
Anaïs Salibian: Right. My image is the deeper in you go into the body, there’s a space there. The pelvis is a room. and if you go into that room, and deeply go into it, the broader your connection to the universe, to the planet. So I think kegel exercises, I would approach them as a spiritual exercise. [Both laugh.] It’s all inclusive, it’s not just so you’re not incontinent when you’re older. It’s so you have your whole self back. And that self is pretty damn huge.
Kegel Queen: It is. What would you suggest for a woman who is in my program, and she’s beginning to wake up a connection with the pelvic floor, but it becomes frightening because maybe there are some memories there, or there’s some fear there that she needs help addressing? People who are in Rochester, New York can come and see you for a Rosen session. People who are elsewhere, what would you recommend that they do to get help? Rosen practitioners everywhere, surely, could help them.
Anaïs Salibian: I have a client who this exactly happened to. She was sexually abused as a child and came to the last intensive we did, and a whole section of it was about the pelvic floor, which really woke things up for her. I just saw her again, and she said it’s kind of scary, because now she’s feeling horny! [Laughs.] What do you do with that? And I said that I think she needs to really practice, take time to spend with the feelings themselves.
Kegel Queen: Instead of just acting on them.
Anaïs Salibian: You don’t have to act — you have to get used to the fact that they exist. And when you feel them, you have to take in that you’re safe now. Because you’re so associated with abuse. But you have to live again and again and again: I feel this, and I’m safe. I feel this, and I’m safe. Whatever way you can achieve that… it can be with your friends. It doesn’t have to be a practitioner of some sort. It can be with your partner. To get used to the feeling of being alive in your pelvis, and that you own it and it’s yours and nobody has the right to it. And that you know that. Then you can share it. It’s yours.
Kegel Queen: Yes. That’s great advice.
Anaïs Salibian: I had this dream the other night. We were outdoors, it was a group of people and everybody was horny as hell, and we were all so happy. Also, it was springtime. It was like, juicy life! Yaay! This is a gift. It’s about life, and being alive, and everybody in the dream was for everybody else’s life force to be expressed.
Kegel Queen: This is something we don’t experience on a daily basis in our culture. I believe that we have a cultural mandate not to be aware of our bodies, and by extension, not to celebrate our sexuality. Who knows, it’s a chicken and egg situation, but it’s very threatening to the thoughts… The cultural idea that thoughts are everything translates to a whole lot of different beliefs — about nature being something we can use instead of something that is a source for us. Women’s sexuality in particular being something that needs to be kept in a tiny little box and tightly controlled, instead of being something that women own and celebrate. I think if we were all really embodied and comfortable and at peace with our bodies, and when a feeling came up whether it was a sexual feeling or anything else, we could accept it without judgment, notice it, learn from it perhaps, maybe enjoy it or maybe move away from it or whatever it might be, but if we can have a dialogue with ourselves without so much judgment, we would live in a very different world.
Anaïs Salibian: You remind me of a story I heard [about] a little boy whose parents were being open and teaching him. Grandma was over for dinner and he said at the dinner table, “Grandma! I have a boner!” He was really pleased. [Laughs] “How nice, dear.” If we had that kind of freedom without threat of any sort…
Kegel Queen: Perhaps our sexuality, or it would extend to elimination, even — this whole region of the body is the center of so much in our lives. Understanding what’s happening with your chest or your elbows could be really powerful, but there’s something that happens about the whole pelvic region that’s connected with sex and elimination and birth…
Anaïs Salibian: Not just elimination, but absorption, actually being nourished.
Kegel Queen: Yes. It affects us at an identity level, in a way that other body parts don’t. We say, where are you? Where are you going? If your pelvis is there, that’s where you are. You can reach forward to something, lean forward, but if your pelvis is there, that’s where you are.
I wanted to say one more thing about sex. For me personally, it’s been a really interesting arena from which to explore what it’s like to really be in my body. Because it’s so physical, and it’s so pleasurable, and it’s sort of an easy avenue to get in. If I’m just sitting in a chair by myself, I might need to try a little bit harder to tune in to what the sensations are of my body, what my feet are experiencing.
But sex is so powerful and compelling, and with so many intense sensations. For years and years I’ve tried to catch myself if my attention wanders during sex, I can bring my attention back: no, I’m here, this is what I’m doing, I’m not thinking about what I’m going to make for dinner or whatever it is. What I’ve been working with more recently that I would highly recommend to any woman is to really try to bring awareness into your body in a different way during sex.
I’ve been experimenting with this. If I’m taking a walk outdoors barefoot in the summer, which I like to do — in fact, I have a stone driveway, and I’ll often walk to the mailbox. I’m walking barefoot on my stone driveway and it hurts a little, but there’s a lot going on there and I like noticing what that feels like. And if I really pay attention to what’s happening with my feet, not just receiving information through my feet but if I really use my feet as a thing that can feel, the same way you would reach out with your hand to feel something, to find out about it… If I use my feet while I’m walking to really find out about what’s there, it’s great. Then if I use my body that way during sex, it’s amazing. So I might be not even moving, but let’s say my clitoris is receiving some pleasurable attention, if I can imagine reaching with it — what is the consciousness there? — really reaching with it to feel. I might not be physically reaching in any way, but if I’m reaching with my attention, it’s a completely different experience.
Anaïs Salibian: Right. Yeah, that sounds embodied. That’s what I mean by embodied. You’re actually in there.
Kegel Queen: And it’s a practice. It’s the work of a lifetime, I think, to get good at becoming embodied from moment to moment and to remind myself to notice and to be there.
Anaïs Salibian: Because actually, the brain was programmed to think about plans all the time. So it’s part of the natural function. It’s not like we’re doing something wrong.
Kegel Queen: When we go out of our body and think about the future, or our to do list.
Anaïs Salibian: Right. What’s off balance is when we don’t have an ease with the embodied awareness that, say, we did when we were evolving, or that tribal people did, or children do. We lose that, and then — one of my favorite jokes lately is “Did you hear about the time Descartes walked into a bar, and the bartender asked him if he wanted a beer? He said, ‘I think not,’ and poof! He disappeared.” [Both laugh.] Go ahead, try to exist if all you are is thoughts.
Kegel Queen: Yes, we are so much more.
Anaïs Salibian: I have a friend, a Rosen practitioner, who says — I love her phrase — “I feel safe because I am myself.” So when you asked, ‘What good does it do to be embodied?’ and I said it makes you happy, it also lets you know when you’re actually safe and when you’re actually in danger, and what you can actually do about it. And that even applies to sex, I think. In the moment. And here’s the thing with sex, though. It’s different than being in the moment by yourself. It’s because you’re actually there to experience the other person as well.
I remember a moment when things really shifted with me and my husband. When I was just not turned on, not turned on, not turned on, and I didn’t know what to say to him.
Kegel Queen: It wasn’t a long-time pattern, it was just in one moment?
Anaïs Salibian: Well, it had begun to be a pattern. So I finally just said, I give up trying to tell you, you figure it out. [Laughs.] And in the next instant the way he was touching me was… I’m swooning and I’m yours forever. [Laughs.] Do that! Whatever it is. I don’t know what it is. And his response was, “Well, I kind of imagined that my hands had eyes, and I was looking for you.” And I went, oh my God! His hands were about connecting, and my body found that a total turn-on.
Kegel Queen: He was really present in his hands.
Anaïs Salibian: Yes. And in relation to me.
I think that what he had been trying to do before was something around doing it right.
Kegel Queen: That’s a great lesson too. Something I need to learn over and over and over is the difference between trying to do it right and having a curious experience: what can happen here?
Anaïs Salibian: Exactly. What can happen here?
Kegel Queen: And that applies to everything.
Anaïs Salibian: Every moment of your life!
Kegel Queen: Sex, work, cooking, relationships.
Anaïs Salibian: Yeah. When I was in France, I had these moments. I’m standing in front of a painting in a museum, and I’m weeping and I don’t know why. I’m on top of a mountain at a glacier and I’m weeping and I don’t know why. I’m not Catholic and I’m hearing a mass in French at Notre Dame, and I’m weeping and I don’t know why.
I was trying to figure out what all those things had in common. And when I went into my body with what experience that was, it was as if each one of them was being present in a moment of creation. That each moment, something emerges that wasn’t, before. And that for instance, if I come back home, I can have that experience every time I touch a client. I can have the awe and I can have the mystery. Then, like you said, it expands to everything. If we don’t already know, we get to find out.
Kegel Queen: Yes. And how often do we think we know? ‘I’ve done all this before.’
Anaïs Salibian: And how often do people feel not safe thinking they don’t know, and what they must know? That’s another practice, getting comfortable with not knowing.
Kegel Queen: Thank you so much. This was fascinating. Wonderful!
Anaïs Salibian: This was fun!
Your Childbirth Teacher Was Wrong! Kegels During Pregnancy
If you’ve ever attended a childbirth class, you’ve heard a lot about kegels. But what if most of what your teacher told you was wrong?
You might have had the smartest, nicest, most caring, most conscientious childbirth teacher in the world. But if she was like 99 percent of childbirth teachers out there, she was wrong about kegels — when to do them, how to do them, and why.
What Are Kegels, and What Is the Pelvic Floor?
A “kegel” is not a body part. It’s an exercise. What you might think of as your “kegel muscles” are the muscles of the pelvic floor, a bowl of muscle between your legs at the outlet (the base) of your pelvis.
The pelvic floor supports your pelvic organs, including your great big pregnant uterus, and stabilizes the base of your spine. It’s responsible for when you pee and poo and, more importantly, when you don’t. And the pelvic floor is part of your sexual anatomy. It gives the vagina its structure, includes tiny muscles connected directly to the clitoris, and contracts rhythmically during orgasm. A small gap in the pelvic floor stretches enormously to let your baby out when you give birth, then regains its usual size after your baby is born — especially if you give it a little help by doing kegels correctly.
What Your Childbirth Teacher Said: Is It True?
Most childbirth classes present a mix of facts, myths, and rumors about kegels during pregnancy. Let’s set the record straight!
Your childbirth teacher said…
Doing kegels during pregnancy prevents incontinence.
Is it true?
Yes. Research shows that you are 30% less likely to develop urinary incontinence postpartum if you’ve done an intensive kegel program during your pregnancy. Note: you must be doing kegels intensively and correctly to achieve this effect.
Your childbirth teacher said…
Doing kegels during pregnancy will make your birth faster and easier.
Is it true?
No. But kegels won’t make your birth longer and harder, either. One study found an itsy bitsy positive effect, with the kegels-in-pregnancy group being less likely to push for over an hour when compared with women who didn’t do kegels while pregnant. But in that same study, the second (pushing) stage of labor was, on average, only five minutes shorter for women who did kegels while pregnant. Other studies — including one that tracked over 18,000 women — have shown absolutely no effect, positive or negative, on length of labor, complication rates, or other birth outcomes. Overall, the research says the effect of prenatal kegels on labor and birth is… meh.
Your childbirth teacher said…
Doing kegels during pregnancy helps your postpartum recovery.
Is it true?
Maybe. I can find zero research data about this. I believe it’s probably true, however. Here are my reasons.
• Better circulation. Kegels increase circulation to the pelvic floor, and better circulation generally leads to faster healing. Therapeutic, correctly performed kegels increase muscle mass in the pelvic floor, which increases circulation 24/7, not just while you’re doing kegels. Theoretically, a woman who enters the postpartum period with greater pelvic floor muscle mass and better circulation could heal any (large or small) pelvic floor injury faster.
• Pregnancy may be a better time to learn than postpartum. If you find out how to do kegels correctly while you’re pregnant, you don’t have to learn how when you’re busy recovering from birth and caring for your baby. You’re ready — you can simply do them.
Your childbirth teacher said…
Do 200 kegels a day. Do elevator kegels. When you’re driving, do kegels at every red light.
Is it true?
NO! 200 a day is an outrageously high number that could even be harmful, unless you’re doing short, pulsing kegels, which are basically useless. Current kegel research recommends a completely different approach. Elevator kegels: Somebody simply made that up. It has nothing to do with the kegel techniques shown by research to actually help women. Kegels at a red light? This is the biggest kegel mega-myth out there. Here’s why kegels at a red light don’t work.
The Kegel Queen’s Kegel Recommendations for Pregnancy
• Do kegels, intensively and correctly as in the Kegel Queen Program, if you want to minimize your chances of having urinary incontinence postpartum.
• You might heal faster postpartum if you do kegels correctly while you’re pregnant.
• Doing kegels postpartum can be tremendously valuable (I’ll plan to cover that in a future post). If you’re going to do kegels after your baby is born, pregnancy might be the best time to find out how and get started with practice, because it may be far more convenient than when you’re busy with a new baby.
• If you’re going to do kegels, the correct technique is essential. Doing kegels wrong is at best a waste of time, and at worst, dangerous. This webinar shows you how to do one perfect kegel, the first step toward doing kegels right.
Pregnant women, take note! In this webinar you’ll also find out how to protect your pelvic floor when you give birth, reducing your chance of pelvic floor injury that can lead to incontinence, pelvic organ prolapse, and problems with sex.
7 Shocking Mistakes Destroying Your Vagina
How can this be such a huge secret?
Millions of women suffer with vaginal prolapse: up to half of all women over 50 years old. One in five U.S. women will have dangerous surgery to treat this condition. (One in five! This could be you, or someone you love, if you don’t take action to avoid it.) In spite of these enormous numbers of women affected, most women have never heard about prolapse, or how to prevent it, until they themselves become victims. And once prolapse strikes, women don’t get the information they need to care for prolapse safely.
Vaginal prolapse means that part of your body that doesn’t belong in your vagina is bulging or sagging into (or in severe cases, bulging out from) your vagina.
“If only I knew then what I know now, I would have done things differently!”
Today’s post is my attempt to help you, dear reader, to avoid that regret so you and your vagina can live happily ever after, without the needless pain and suffering so many women endure.
To get even more valuable information, see my webinar: How to Beat Prolapse Surgery and Stay Out of Adult Diapers: These 11 Tricks May Surprise You (and Amaze Your Doctor!)
Vagina Mistake #1: Prolapse Repair Surgery
Some women get lucky and have satisfactory results. But this surgery fails up to 50 percent of the time. And up to one in six women have complications, some of which can lead to a lifetime of pain. Here’s the ultimate irony: even if your surgery works, all pelvic surgery increases your risk for prolapse. You may actually be at greater risk because you’ve had surgery, and you can develop a new prolapse after you’ve had surgery for prolapse of a different organ. This info can help you avoid prolapse surgery.
Vagina Mistake #2: Unnecessary Hysterectomy
Doctors often say to women, “You’re done having babies. What do you need your uterus for?” Answer: besides the fact that you might like to keep your body parts just because you happen to like your body parts, you need your uterus to help keep everything else in your pelvis where it belongs. Hysterectomy puts you at risk for bladder prolapse (the bladder bulges into, and sometimes hangs out of, the vagina) and vaginal vault prolapse (the top part of the vagina itself falls down into, or out of, the vagina). If your doctor recommends a hysterectomy because you have a non-life-threatening condition such as prolapse or fibroids, get informed about alternatives to surgery.
Vagina Mistake #3: Crunches
Sit-ups? Hurting your vagina? Absolutely. Not just sit-ups or crunches, but many core training moves, as well as high-impact exercises (yes, that includes your trampoline or rebounder), can lead to prolapse. I can’t quote a research study on this one, only the words of many very unhappy women who later joined the Kegel Queen Program to help with prolapse after “something went wrong down there when I started going to the gym.”
Vagina Mistake #4: Constipation
Constipation is more than just discomfort and inconvenience. Pushing hard on the toilet can literally pop a prolapse out. Get 2 new & natural constipation cures…
Vagina Mistake #5: Standard Birth Practices
Many common childbirth practices can lead to damage of the pelvic floor. (The pelvic floor is the bowl of muscle that helps your pelvic organs stay in place). Epidural, episiotomy, pushing and breathing when others tell you to instead of as your body directs you, pushing as soon as you’re fully dilated instead of waiting for the urge to push… all these can lead to pelvic floor damage that increases your risk for prolapse. And all are usually avoidable, if you choose a midwife or doctor who uses those strategies only as a last resort. (Tip: ask what percent of patients have certain procedures. It’s the only way to know what your odds are with that midwife or doctor. Answers like “only when necessary” don’t tell you anything — insist on a number.)
Vagina Mistake #6: Not Knowing You Have Prolapse
If you have mild prolapse, you might not realize that you have it. Amazingly, many health care providers don’t mention this to patients when they find a mild prolapse during a vaginal exam. If you know you have a mild prolapse, you can take steps to heal your prolapse, or at least to prevent it from getting worse. The next time you have a vaginal exam, ask, “Do you see any signs of prolapse?” If the provider wants to know why you’re asking, just say you know it’s very common and you’re curious.
Vagina Mistake #7: Bad Kegels
Kegel exercises can actually relieve symptoms and even reverse prolapse, when you do them correctly. But many women (and doctors) think kegel exercises don’t work — because over 99 percent of women are doing kegels wrong. Find out how to do one perfect kegel, the first step to doing kegels right.
For extra detail and more women’s health tips like these, check out my easy new webinar: How to Beat Prolapse Surgery and Stay Out of Adult Diapers: These 11 Tricks May Surprise You (and Amaze Your Doctor!)
Rectocele vs Anal Prolapse: Different Types of Rectal Prolapse
Women often ask me about rectal prolapse: do kegels help? There are two types of rectal prolapse, and the answer is different for each one.
First, let’s look at some definitions.
The rectum is part of your large intestine. It’s the last part of the large intestine that feces (a.k.a. poop) moves through before it gets to the anus. The anus is the opening. I’ve noticed that people seem to really hate using the word “anus,” so they often refer to the anus (the opening) incorrectly as the rectum.
Prolapse means that part of the body has shifted, or literally fallen, out of its normal position.
Two Kinds of Rectal Prolapse
The rectum can prolapse in two different ways: vaginally or anally.
Vaginal rectal prolapse is called rectocele. With a rectocele, the rectum has prolapsed so that it protrudes into the rear wall of the vagina. The rectum, covered by the vaginal wall, creates a bulge in the vagina. Depending on how severe a rectocele is, the bulge can be invisible inside the vagina, or extend down to the opening of the vagina, or if it’s severe, it can protrude out from the vaginal opening.
Anal rectal prolapse is sometimes, confusingly, referred to simply as “rectal prolapse.” For the sake of clarity, we’ll call it anal prolapse. With anal prolapse, the rectum itself turns inside-out and protrudes out from the anus.
Can Kegel Exercises Help?
Kegel exercises are exercises for the pelvic floor. The pelvic floor is a bowl of muscle that helps to support the pelvic organs, one of which is the rectum.
Can kegels help with rectocele? Yes. There’s research evidence showing that kegels can improve all types of vaginal prolapse, and many women in the Kegel Queen Program have seen improvement with rectocele. You can see some of their stories here.
Can kegels help with anal prolapse? Maybe. There’s no clear data one way or the other, either from research studies, or from the very few Kegel Queen members who have talked with me about this condition.
It’s possible that kegels could help with anal prolapse by increasing strength and muscle tone in the anal sphincter. The anal sphincter is part of the pelvic floor, and it’s among the muscles that get worked out when you do kegels correctly. The anal sphincter’s job is to keep the anus closed most of the time, and to open only when you want it open (to let out gas or poo). If you have anal prolapse, a malfunctioning anal sphincter might be contributing to the problem, although the root of the problem is the failure of other structures that hold the rectum itself in place.
If you suffer with anal prolapse and you decide to try the Kegel Queen Program, please stay in touch with me and share your results.
What Else Can I Do?
If you have rectocele, my webinar shares tips and strategies for how to care for all types of vaginal prolapse without surgery. It also shows you how to do one perfect kegel, the first step to doing kegels right.
If you have anal rectal prolapse, what can you try besides kegels? Acupuncture could help. You can also try Arvigo Therapy — speak with a practitioner in your area.
If you have either rectocele or anal prolapse, there’s one strategy that is absolutely, totally, and completely essential: prevent constipation.
Constipation, and the hard pushing that goes with it, could be a major reason you’re suffering with rectocele or anal prolapse now. If you want to stop your prolapse from getting worse, and give your body a chance to heal, you must avoid constipation at all costs.
You’re probably aware of the standard advice for preventing constipation, and it’s great advice: drink plenty of fluids, eat plenty of fiber, exercise. What you might not know is to pay attention to two key elements of gut health — food intolerance, and gut flora.
Gut flora, a.k.a. the gut biome, is the living colony of bacteria living in your digestive tract. Your gut flora can have a huge impact on how regularly and easily your bowels move. Healthy gut flora is not only about using probiotics (such as the acidophilus bacteria in yogurt), it’s about eating in a way that supports healthy flora. Details are beyond the scope of this post, but get your internet-searching game on and get some info! Here’s a sneak preview: eat a lot of vegetables.
Food intolerance is another often-overlooked cause of constipation. There may be certain foods that don’t trigger constipation for everyone, but do trigger it for you. Keep a journal that lists what you eat and when your constipation flares up, and see if you can find a connection. Or take a more proactive approach and try a short-term exclusion diet. You completely avoid certain foods for a while and see how your body responds as you add them back into your diet; it’s a great way to discover how specific foods are affecting your body.
One More Tip
If you suffer from rectal prolapse — either rectocele or anal prolapse — please take care of yourself emotionally. You may feel terrified, as if your body has gone out of control, or as if you’ll never feel confident, attractive, or even normal, again. It’s important to get emotional support from a trusted friend or counselor, so you take care of the emotional aspects of prolapse while you’re taking steps to heal physically.
4 Life-Changing Reasons to Talk to Your Friends about Vaginal Prolapse
The term “prolapse” in this article refers to pelvic organ prolapse, or vaginal prolapse: prolapsed bladder (cystocele), prolapsed rectum (rectocele), prolapsed small intestine (enterocele), or prolapsed uterus.
I know two sisters. They’re real people, but I won’t use their real names. Let’s call them Deena and Lydia. They both live in their hometown, and they’re good friends. They work together to take care of their aging parents and spend holidays together. When Lydia was going through cancer treatment (don’t worry, she’s fine now), Deena went with her to medical appointments. They’re part of each other’s lives, and they know what’s going on with each other’s health.
But Deena and Lydia both have prolapse. They both have rectocele. And decades — literally, decades — went by before they ever talked about it. All those years, those two sisters had no idea that they both were suffering.
Many women who suffer with prolapse (cystocele, rectocele, enterocele, or uterine prolapse) keep prolapse a secret. They don’t tell their friends, their family members, or if they can avoid it, even their sex partner.
But keeping prolapse a secret might not be the most beneficial choice. Talking about prolapse with the women close to you could make a significant positive difference for you, and for them.
Here are four life-changing reasons to talk with women about prolapse.
1. Sharing your problem could change your life by lifting your burden of shame, fear, and feeling alone.
As bad as the physical symptoms and discomfort of prolapse can be, the emotional pain can be far worse. You can feel broken, alone, afraid of your own body, out of control, terrified the problem might get worse. Very often, women with prolapse feel a deep sense of shame and embarrassment. The best (some would say, the only) remedy for these feelings is reassurance and love. Choose a close, caring friend. Talk to her about what’s happening with your body and how you feel about it. Simply getting your problems, and your feelings, out in the open can begin to heal your feelings of shame. Ask for the emotional support you need, and a true friend will do her best to provide it.
2. Your friend might have prolapse, and talking about it could change her life.
Research shows that up to half of women over age fifty suffer with some degree of vaginal prolapse. Yes, you read that right: up to half of women. Having prolapse can make you feel completely and utterly alone, but in reality, millions and millions of women around the world are suffering too. There’s a good chance that your friend might be suffering, or might develop prolapse in the future. When you open the conversation, you can help her.
• You can provide emotional support to your friend. She will feel less alone, and you can offer her the love and reassurance she needs.
• You can share information that might help your friend. Since you’re here on the Kegel Queen blog, you have access to powerful information that can help women care for prolapse without surgery. Share this article about what to do if your doctor recommends surgery, and share this webinar, that shows you exactly what to do about no-surgery approaches for prolapse.
• When your friend sees that you’re reaching out to talk about your prolapse, she may feel inspired to talk with the women in her life, creating a ripple effect of help for them, too.
3. If your friend doesn’t have prolapse, you could change her life by helping her prevent it.
For many women, the first time they ever hear of prolapse happens when they, themselves, experience it. Even though — here’s that statistic again — up to half of women over age 50 (and many younger women) suffer, most women have no idea what prolapse is, what puts them at risk, or how to help prevent prolapse. My webinar includes several strategies for preventing prolapse or keeping a mild prolapse mild, including information about how to exercise safely, how to give birth in a way that’s safest for the pelvic floor, and more.
4. Increasing public awareness about prolapse can change millions of lives, and it’s up to women to do it.
In the U.S. alone, one in five women will have surgery to treat vaginal prolapse. One in five. Surgery is not only the most expensive prolapse treatment, it’s the most dangerous. Up to one in six women have complications. For up to half of women, the procedure fails. Yet doctors continue to offer surgery as the first, or only, treatment option for women with prolapse, ignoring safer and more affordable approaches. Women continue to allow this insanity because they’re uninformed — because they’ve never even heard of prolapse until they have it themselves.
Women need to know how common prolapse is. Women who have prolapse need to know that they’re not alone. Women need to know about the dangers of surgery, and what the alternatives are. Women need to know how to prevent prolapse. We need to support each other emotionally, and by sharing information.
Talk with your friends. Bring them to this site. Together, we can bring this secret epidemic out of the shadows and give women the tools they need to handle this frightening condition safely, and begin to heal.
You may also be interested in this additional information…
How Buff Is Your Vagina?
Are your muscles saggy, or toned? That’s a question you can easily answer about your arms, your abs, or your thighs. But what about your vagina? Did you know you even have muscles there? Or that they can be just as saggy — or just as fit — as any other muscle in your body?
What Are the Vagina Muscles?
The muscles around your vagina are part of the pelvic floor. The pelvic floor is a bowl of muscle between your legs. It’s a hammock of muscle and connective tissue that does many different jobs in your body, including holding your insides where they belong (i.e., inside you). The pelvic floor muscles surround the vagina, giving the vagina its tone, structure, and firmness.
What Do the Pelvic Floor Muscles Do?
The pelvic floor is something most women don’t think about, or even know about, until something goes wrong. When it’s not working right, the pelvic floor can cause big trouble, because the jobs it does in your body are so important.
Here’s some of what the pelvic floor does for you, every day:
The pelvic floor controls your bladder and bowel release. These muscles decide when you pee and poo — and this one is really important — when you don’t pee and poo.
The pelvic floor stabilizes the base of your spine. Care for a little back pain, anyone? No? I didn’t think so. The very end of your spine, the sacrum and tailbone, are connected to your pelvic floor. Pelvic floor problems can affect the tailbone and sacrum, and move like dominoes up the bones of your spine.
The pelvic floor holds your organs in place. Who knew this was such an important job? Don’t organs just stay where they’re supposed to be? Not always. Your bladder, uterus and rectum (your pelvic organs) sit inside the pelvic floor “bowl.” They’re supported from the top and sides by ligaments that help hold them up, and they’re supported from behind and below by the pelvic floor. For a surprising number of women, those pelvic organs don’t stay in place… more on that in a moment.
The pelvic floor makes sex awesome. “Awesome” is a highly technical term used to describe great sex. You already know that the vagina gets its structure from the pelvic floor. You may not know that there are pelvic floor muscles specifically attached to the clitoris (and that your clitoris can actually move back and forth when you learn to control these muscles). A healthy pelvic floor helps with good circulation to your sex organs, which is essential for arousal, lubrication, and orgasm. And one of the major sensations you feel during orgasm is contractions of the pelvic floor.
What Happens When the Vagina Muscles Aren’t Working Right?
If your pelvic floor isn’t working right, here’s some of what can happen:
- You can’t control your pee and/or poo (a.k.a. you need pads or diapers).
- Your back hurts.
- Your pelvic organs fall out of place into your vagina (you have pelvic organ prolapse).
- You have mediocre sex. (Okay, I realize there could be a lot of other reasons for mediocre sex, but that’s a whole different discussion.)
Hear these words, my friends: If the pelvic floor ain’t happy, ain’t nobody happy.
How Can I Tell if My Vagina Muscles Are Strong?
Pelvic floor problems can happen because your pelvic floor is too tight, or too lax. Either way, the muscles aren’t strong and aren’t working properly.
If everything seems to be working right “down there,” and you don’t have any of the problems I listed above, your pelvic floor is probably just fine.
But if you do have one or more of those problems, maybe your pelvic floor ain’t happy.
How Can I Make My Vagina Muscles Stronger?
That’s a really important question, but strength is only part of the equation. The happiest pelvic floor muscles are not just strong, but have the right tone — not too tense and not too slack. Having great control of those muscles is the other piece of the puzzle.
How do you get all that? Kegel exercises — but not just any kegel exercises. Most women are doing kegels completely wrong, even if they learned how from a doctor, midwife, or childbirth teacher. Real kegels that really work are the only kegels that can make your pelvic floor happy, and make you happy too. Check out my webinar for your first easy step toward doing kegels right!
How Not to Be a Victim of Your Doctor (or Feel Like One)
It’s all over the news right now: Michigan oncologist Dr. Farid Fata, who gave unnecessary cancer treatments to 533 patients as a moneymaking scheme, will be sentenced tomorrow. Dr. Fata’s patients were injured, disfigured, disabled, even killed by his brutal and violent behavior, and prosecutors are asking for 175 years behind bars.
Dr. Fata is, of course, an exception. The vast majority — let me say that again — the VAST majority of doctors are good people who care deeply about their mission to relieve suffering, and work hard to give patients the best possible care.
Here’s the problem: even the very best doctors work within an imperfect system.
Even when our doctors truly want to help us, the medical system can leave us, as patients, feeling confused, unheard, and powerless. Too often, we feel like victims.
What if you could walk out of your doctor’s office feeling supported, informed, and in control?
You can’t singlehandedly reinvent the entire health care system before your next medical appointment. But by using the six steps below, you can make your next experience the best it can be.
6 Ways Not to Feel Like a Victim When You See Your Doctor
1. Get centered.
Before your appointment, take a moment to consciously center yourself. Take a few deep, calming breaths. Think of a time you felt confident and strong, stand tall, and picture yourself feeling strong and secure during the appointment you’re about to have. Before, and even during, your appointment, you can repeat this simple exercise as often as you like.
2. Choose the right doctor.
Use both your intellect and your instinct. What is this doctor’s reputation? Does she care about getting the little things right, or does she let the details slide? Does she speak respectfully to you? Does she listen? Does she answer your questions? If you don’t have confidence in your doctor’s judgment, or you don’t like the way your doctor treats you, move on and find somebody else.
3. Write down your questions in advance.
When you’re sitting on the edge of the exam table, wearing nothing but a paper gown and feeling terrified that something might be wrong with you, is your mind working at your intelligent, logical best? Of course not! When you’re in the patient role, it’s nearly impossible to think clearly and remember the questions you want to ask. Write down your questions in advance. Over the days or weeks before your appointment, keep a notebook handy or make a list in your phone, so you can add a question whenever you think of it. Then bring it to the exam table with you — don’t leave it across the room in your pocket or bag.
4. Bring a friend.
Even better than bringing your list of questions: bring your list of questions and a friend. If you have a friend who works in health care, that’s great. If not, bring someone who is confident, calm, supportive, and not afraid to speak up. I’ve attended medical visits countless times with friends and family members, and it makes a huge difference. Here’s what you want to ask your friend to do: Ask questions (lots). Take notes (try to catch everything). Ask the doctor to explain things again, or in more detail, if there’s anything you don’t seem to understand. Most importantly, ask your friend to show you love and support.
5. Don’t rush into treatment; get information first.
True emergencies are rare. Nearly always, you’ll have plenty of time to gather information before you decide what treatment to choose, or whether to choose any treatment at all. Ask to see your lab results and radiology images, and get help understanding them. Get a second opinion. Ask about alternatives, including the alternative of doing nothing or delaying a procedure. And be sure to get the name — and the correct spelling — of any body part, medical condition, drug, test, or procedure being discussed, so you can research it on your own.
6. After your visit, call the office if you have questions.
After you leave the office, new questions might come up (or you’ll remember one that, in spite of your pre-written question list, you forgot to ask). You don’t need to wait for your next appointment — just call and ask. In many offices, the receptionist will connect you with a nurse, who will either answer your question on the spot, or talk with the doctor and get back to you. Many patients are hesitant to “bother” the staff with questions by phone, but the job of doctors and their staff is to give you the information you need.
Please share this post with others who can benefit from these tips. I wish I could have personally delivered this information to every single one of Dr. Fata’s patients before they became his victims. Even if your doctor is highly skilled as a practitioner and the soul of kindness as a human being, these tips will help you make the most of your medical visits. Responsibility for your health, and for your health care, rests with you!
How Long Should I Leave a Pessary in Place?
How long should you leave a pessary in place between cleanings? There is no single correct answer. Some women wear a pessary only occasionally, or wear it during the day but take it out every night. At the other extreme, some women leave a pessary in place for weeks or months. Pessaries are designed to stay in place for weeks on end, allowing fluids to flow around them — even your menstrual flow — but frequent removal and reinsertion is perfectly safe and acceptable.
The good news: you have options! And you can work with your care provider to create a pessary care plan that works for you.
What Is a Pessary?
A pessary is a silicone device that you can wear at the top of your vagina to hold your pelvic organs in place. If you have pelvic organ prolapse (bladder prolapse, or cystocele; rectal prolapse, or rectocele; or a prolapsed uterus), a pessary can allow you to be active and comfortable without the pain and danger of surgery. If you have urinary incontinence, some pessary styles can help you get control.
Your Individual Preferences: Questions to Consider
How long do you want to wear your pessary? It’s a matter of personal preference.
Do you want your pessary to be only for especially active days, or every day? If you wear your pessary only occasionally, simply clean and store it between uses. If you want to wear your pessary every day, you have the option to remove and clean it daily, every few days, weekly, or only when you feel the need, leaving it in place the rest of the time (except at GYN visits for pessary care).
Does your pessary interfere with sex? If you’re sexually active, you can probably have sex — yes, including intercourse — with your pessary in place. Some pessary shapes will not allow this, but most will.
Can you remove and insert your pessary on your own? Some women don’t have the strength or flexibility in their hands to insert and remove a pessary, especially as they get older. Also, certain pessary shapes may be difficult for you to remove on your own. In that case, it’s perfectly OK to leave it in place 100% of the time between appointments with your health care provider.
What Health Care Providers Recommend
Health care providers will have different recommendations based on the way they were trained, and on their own observations. Ideally, your health care provider will use scientific evidence to guide your care. However, regarding the question of the ideal length of time to leave a pessary in place between cleanings, there is no scientific evidence. No-one has conducted a scientific study on this topic. (There’s no study I can find, anyway. If you know of one, please contact me!)
No matter how often you remove and clean your pessary at home, it’s important to have regular office visits with your health care provider so the vaginal lining can be examined. If you don’t remove your pessary yourself, but leave it in place except at health care appointments, these appointments may be especially important. Your pessary must be removed and cleaned at least as often as every few months.
Some providers want women to come to the office every month for pessary care. Others recommend an office visit every three months. I’ve even heard of one doctor who told one of my Kegel Queen members to leave her pessary in place and visit his office every five months. (Please note: that length of time is way outside my comfort zone and far longer than most practitioners recommend.)
What Pessary Manufacturers Recommend
Here are recommendations from two leading pessary manufacturers, Milex and Bioteque. Bioteque recommends daily cleaning, but also says it’s fine to leave the pessary in place for 4 to 12 weeks. Milex does not address home care, but recommends a followup visit with your health care provider every 4 to 6 weeks, noting that the schedule can be adjusted based on patient and physician preference.
So… How Often Should I Remove and Clean My Pessary, After All?
It’s up to you. You can remove and clean your pessary every day, or you can leave it in place as long as three months. Any pessary care schedule within those parameters can work well, as long as it works for you with the support of your health care provider.
What Is Pelvic Organ Prolapse?
Millions of women suffer with pelvic organ prolapse, and millions more are at risk — but few women understand what prolapse really is.
What is cystocele? What is rectocele? What does it mean that my uterus is prolapsed? What does pelvic organ prolapse mean for my health? What does prolapse mean for my sex life?
What’s happening in your body when you have prolapse? When you feel that “something’s not right down there,” what are you feeling? If your doctor has told you that you have prolapse, but you feel normal, what’s going on?
The word “prolapse” means that something in the body has moved out of its proper position. Pelvic organ prolapse means that one (or more) of your pelvic organs — your bladder, uterus, or rectum — has literally fallen out of its proper place in your body. Sometimes people describe prolapse as a “fallen” or “dropped” bladder, uterus, or rectum.
Prolapse happens when your pelvic organs lose support. Your pelvic organs are supported in two ways.
They’re held up from the sides and the top by ligaments. The ligaments are like ropes and sheets attached to your pelvic organs, connecting them to each other and to other parts of your body to hold them in place.
Your pelvic organs are also supported, from behind and below, by the bowl of muscle called the pelvic floor. If the ligaments, or pelvic floor, or both, are not doing their job of supporting the pelvic organs, pelvic organ prolapse is the result.
Three Types of Pelvic Organ Prolapse
There are three types of pelvic organ prolapse, because there are three pelvic organs that can be involved. Bladder prolapse is called cystocele. A prolapsed rectum is called rectocele. A prolapsed uterus is simply called a prolapsed uterus, or uterine prolapse.
A woman may have just one type of pelvic organ prolapse, or more than one. With each type of prolapse, whether it’s the bladder, rectum, or uterus that has prolapsed, the organ falls out of place and takes up space inside the vagina. With uterine prolapse, the cervix (the “neck” of the uterus) is lower in the vagina than normal, or the uterus itself can descend into the vagina. With bladder prolapse or rectal prolapse, the bladder or rectum creates a bulge in the vagina, but the organ itself is covered by the vaginal wall.
What Does Pelvic Organ Prolapse Feel Like?
With all types of pelvic organ prolapse, women often describe a heavy, aching, sagging, or “dragging” feeling in the pelvis. Some women with more severe prolapse have the sensation of something coming out of the vagina, or feel “like I’m sitting on something.”
If you have a cystocele (prolapsed bladder), you might have trouble emptying your bladder completely. Try shifting your position on the toilet after you urinate to empty the bladder more. You can also try “double voiding”: After you pee, wait a few minutes, and try to pee again. You’ll often be able to empty your bladder more completely that way.
With a rectocele, you may have trouble moving your bowels. “Splinting” can help. While you’re moving your bowels, use two fingers to push on your perineum (the skin between your vagina and your anus), or place two fingers inside your vagina to hold the rectum in place. I know, you’d rather not have to do that, but it can help you avoid constipation. And besides the obvious discomfort, constipation can be a real problem for prolapse. Pushing hard on the toilet can actually cause prolapse, or worsen the prolapse you already have.
Problems with sex are common too. A lot of women, or their partners, are afraid to have sex. Sometimes prolapse can make sex physically or psychologically uncomfortable, but as long as partners keep communication open and follow a few basic safety and comfort guidelines, you can still have safe, satisfying sex even when you suffer with prolapse. For most couples, the fear of having prolapse-related problems with sex is worse than any actual physical problems the prolapse may cause.
How Bad Is My Prolapse?
Prolapse can be mild or severe. With mild prolapse, you might not even realize you have prolapse at all. When prolapse is mild, the cervix, or the bulge of cystocele or rectocele, is smaller and farther up inside the vagina. When prolapse is more severe, the bulge or cervix goes all the way to the opening of the vagina. In the most severe cases, the cervix or bulge protrudes out from the vaginal opening — not only taking up space in your vagina, but taking up space in your underwear.
Will your prolapse get worse? If you have prolapse, this can be a terrifying question. The good news is that there’s a lot you can do to stabilize your prolapse. You may even be able to reverse your prolapse and relieve your symptoms — all without the dangers and pain of surgery.
What Do I Do Now? Do I Have to Have Surgery for My Prolapse?
Your doctor may tell you that surgery is your only option. In reality, surgery is by far the most dangerous, and the most expensive, option for treating prolapse — and for up to half of women who have the surgery, the surgery fails. If your doctor says you need surgery, this quick article is a must-read.
Prolapse can be a terrifying problem. You may wonder if it’s possible to ever feel normal again. But many women can relieve prolapse symptoms, or even reverse prolapse partially or entirely. Even if you’re afraid now that you can never again be physically active, or enjoy sex, or just feel comfortable and normal, there is hope. Join this webinar to find out more about non-surgical prolapse care that can work for you.
6 Reasons NOT to Buy a Kegel Exercise Device
In this post: Why kegel products are not the correct way to do kegel exercises for your pelvic floor muscles, and how kegel weights and other kegel devices can do more harm than good.
Kegel exercisers. Kegel eggs. Ben wa balls. Vaginal cones. Electrical stimulation devices. Biofeedback devices. Kegel weights for your vagina.
Kegel devices come in every shape, size, and style imaginable. There are plastic kegel devices, metal kegel devices, inflatable kegel devices, kegel devices made of jade, kegel devices that deliver electrical current to your most sensitive body parts, kegel devices with wires and electronic displays, kegel devices with springs, gears, and levers. Some look like medical equipment. Some look like sex toys. And some look like torture devices the aliens want to use on you once they get you back to the mother ship.
What do all these kegel exercise devices have in common? They’re a waste of your time and money. Your pelvic floor muscle workout is easier, more effective, and way more fun when you go natural — without any devices at all. Here’s why.
1. Kegel Devices Train Your Muscles to Do the Wrong Things
Healthy, effective kegel exercises train your muscles to contract and release. Relaxing the pelvic floor muscles is just as important as contracting them. A healthy muscle that works well and feels good is a muscle that is relaxed and supple, not tight and clenched.
But many kegel devices train your pelvic floor muscles to clench. All devices in the “vaginal weights” or “kegel weights” category create this problem. Kegel “eggs,” physician-prescribed vaginal cones, and other weight-based devices are all used the same way. You put it in your vagina and try to hold it in while the pull of gravity tries to make it fall out.
While you’re trying to hold that kegel weight in your vagina, what are your muscles doing? Tightening and clenching — for 10 or 20 minutes at a time. Here’s what happens to tight, clenched vaginal muscles: they hurt. They can make sex intensely painful. Even worse, they won’t function as well, because while you do the big clench they’re not getting the blood supply they need, and because tight, clenched muscles simply aren’t as strong as stretchy, relaxed muscles. Don’t buy kegel weights! And if you already have some, either find a way to repurpose them (paperweights?) or throw them away.
2. Kegel Devices Make Your Muscles Stupid
We’ll talk about problems with other types of devices in Reasons 3 through 6, but here’s one more huge problem with kegel weights. They don’t help you gain muscle control. That’s why the research shows that kegels done without a device work better than kegels done with weights.
Let’s imagine that you’re in a public place, having a conversation with someone you want to impress, and you suddenly need to sneeze. Doing a good, strong kegel as you sneeze will help keep your undies dry by stopping the “sneeze pee.” Which muscles will respond more quickly and effectively — muscles that have been practicing contracting and releasing on cue? Or muscles that have been practicing nothing but one long hard squeeze around a kegel weight?
And here’s the fun part. The pelvic floor muscles are directly attached to your vagina and clitoris. They’re your sex muscles. When you get good at pelvic floor muscle control, you open the door for way more pleasure in bed for you and your partner. If you’re not building muscle control while you do kegels, you are missing out, bigtime. Details are beyond the scope of this article, but hear this: once you find out what better pelvic floor muscle control can do for you (and your partner) in bed, you’ll never go back.
3. Kegel Devices Insist on Resistance, but Resistance Is B.S.
A lot of people out there — namely, the ones who want to sell you a kegel device — will tell you that kegel exercises must be done against resistance. They say that if you’re not squeezing some object inside your vagina, especially the one they’re trying to sell you (which might look like a dildo, a garlic press, or a shoehorn), kegels won’t work.
Why do the kegel device people insist on this? Because it’s what Dr. Arnold Kegel used to say. Dr. Kegel did some very important work in helping people discover the awesome results pelvic floor exercise can provide. (Thank you, Arnie!) But Dr. Kegel released his landmark research paper in 1948, and he’s been dead since 1981. Since then, scores of brilliant modern researchers, most of them women, have shown us how to do far easier, faster, more effective kegels, with no devices at all.
The very best kegel techniques are based on the very best up-to-date research studies. Any dinosaur who insists on resistance devices is either misinformed, or simply trying to make a buck, or both.
4. Kegel Devices Are a Pain in the Butt Because You Need Privacy
Kegels with a device: you have to have your pants off. No kegels on your lunch break at work, no kegels when your kids might walk in on you, no kegels anywhere except at home behind a closed door, alone.
Kegels without a device: your pants are on. To do kegels right, you will need to give kegels your full attention (no driving, please), but you can do them in your parked car, during a break at your desk at work, in your living room while the kids are playing nearby, at the gym during your warm-down, on a park bench during a break in your daily walk… anywhere you can take a few minutes to focus on doing the exercise.
Which way is simpler? Easier? More likely to actually make its way into your schedule? It’s a no-brainer! Keep your pants on.
5. You Will Not Like Explaining the Kegel Device to Your Kids, or to Airport Security Agents
Let’s say you do manage a kegel device exercise session behind the closed door of your bedroom. Then you need to wash the device, and store it somewhere. “Mom, what’s that thing in the bathroom?” “Mom, what’s this I found in your drawer?” “What do you do with this thing again?”
Even more fun would be answering questions like that in the airport security line when you’re trying to catch a plane. “Well, sir, it’s for my vagina…”
6. You Will Give Up on Kegels if You Use a Kegel Device
When you do kegels the easy, effective way without a kegel device, it’s like brushing your teeth: a few minutes a day that you hardly think about. But using a kegel device is a recipe for failure, for two reasons.
First, if you’re just getting started and you don’t have much pelvic floor muscle strength and control, you’ll fail right away with most kegel devices. You can’t hold the weights in, or you can’t squeeze the lever thingy, so you give up.
The other big reason to give up on kegel devices is the inconvenience. This is what kegels look like with a device: Get the kegel device out of its storage place. Take off your pants. Use the device. Put your pants back on. Wash the device. Dry the device. Put it back into its storage place.
Compare that do doing kegels the easy way, without a device, which looks like this: You simply do your kegels.