Better sex begins with pelvic floor health.
Last month, I visited a pelvic floor therapist for the very first time. It was an eye-opening experience and following this glimpse into the world of a relatively new, but growing specialty, I left with a renewed curiosity about advances in pelvic floor health.
Who knew that back pain can be related to the pelvic floor? And why didn’t someone tell me that I shouldn’t go pee until my bladder is nearly full? There will be no more “just in case” pit stops for me. And kegels? Apparently they’re not for everyone. Instead, I should be doing squats and cat stretches to deal with my particular symptoms.
My pelvic health physiotherapist, Jessica Nargi, PT, MScPT, MCPA, agreed to answer a few questions for those who are curious about how pelvic floor health can reduce pain and improve your sex life:
What is a pelvic floor therapist?
Nargi: A pelvic floor therapist assesses and treats the whole body. An assessment includes a comprehensive external orthopedic exam and an internal vaginal or rectal exam to assess the musculature, connective tissues and neural mobility within the pelvis.
The goal of the assessment and treatment is to ensure individuals have sufficient strength and flexibility to establish optimal and functional movement patterns.
Men and Women should see a Pelvic Health Physiotherapist if they experience urinary or fecal incontinence, urinary urgency or frequency, pelvic pain, or pressure in the vagina or rectum.
A pelvic floor physiotherapist must complete post-graduate training to allow them to assess and treat vaginally or rectally. Training in Canada can be completed through Pelvic Health Solutions.
We have been told that kegels will improve your sex life, but new research suggests that this advice is incomplete. Can you help us to better understand the role of kegels in sexual pleasure?
Nargi: Providing sexual awareness and function is one of five functions of the pelvic floor. The pelvic floor muscles help support the tone in the vaginal and rectal canals and assist in blood flow for achieving orgasm.
In order for all five functions to work optimally, the pelvic floor muscles must have healthy tone (not too tight, not too weak). Kegels will improve the strength and function of the pelvic floor (if done correctly), but remember not everyone should be doing kegels, especially if their muscles are too tight or stiff.
Are there other exercises that are good for your pelvic floor?
Nargi: If the pelvic floor is tight, certain yoga poses will help lengthen the pelvic floor muscles . If it is too weak, kegels will help to strengthen them. Yoga postures like the Happy Baby pose, Lying Butterfly pose, Child’s pose and other hip opening stretches can be helpful for tension in the pelvic floor and pelvic girdle.

If I am brand new to pelvic health, where should I begin?
Nargi: If you are feeling pelvic pain, incontinence, pressure, or heaviness, you should see a trained pelvic health therapist to assess and determine if there is an asymmetry in your pelvis contributing to these particular sensations. Listen to your body. If an exercise or activity is painful, address it with your healthcare provider.
Any other thoughts or words?
Nargi: Both men and women can experience painful intercourse, but they don’t have to live with it. Pain represents a problem that can be addressed by looking carefully at the tissues of the pelvic floor, vulva, perineum and hips. Other gynecological factors need to be considered as well, including vaginal dryness and hormonal problems. Don’t be afraid to bring it up with your health care provider. Pain is not normal.