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Sexual Health & Menopause

Effective Treatments for Sexual Problems           

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Yoga, Kegel Exercises, Pelvic Floor Physical Therapy

About 3 in 4 women reported that their sex lives improved after completing the yoga program.

In addition to exercise of your overall body, exercises designed to ease stress or targeted to strengthen or relax your pelvic floor muscles can also benefit your sexual function.

Yoga can improve women’s sexual function, according to a 2009 study published in the Journal of Sexual Medicine. The study involved sexually active women ages 22 to 55 who followed a 12-week regimen of an hour of yoga each day followed by breathing and relaxation exercises. The women completed sexual function questionnaires at the start and end of the yoga program, which showed that their sexual function scores improved by the end of the program across all six of the areas studied—desire, arousal, lubrication, orgasm, satisfaction, and pain. The biggest improvements were in women ages 45 or older. About 3 in 4 of the women reported that their sex lives improved after completing the yoga program. However, because there was no comparison group of women who did not participate in the yoga program, this study must be interpreted with caution and more menopause information is needed.

 

Yoga’s potential sexual benefits may result from its relaxing effects, the way it focuses attention on sensation, the pelvis-strengthening effects of many yoga poses, improved self-image from engaging in exercise, or a mix of these. Yoga classes are now offered by most gyms and many other organizations, and instructional yoga DVDs are widely available at libraries and stores. While many forms of yoga are safe and appropriate for women of various fitness levels, elderly women and those with mobility issues or osteoporosis should check with their healthcare provider before giving yoga a try.

 Kegel exercises involve contracting and relaxing the muscles of your pelvic floor, which holds your uterus and bladder in place above your vagina. The aim is to improve the tone of these muscles, which can have the following benefits:

  • Increasing strength and awareness of the muscles involved in pleasurable sexual sensations, which can help some women achieve orgasm
  • Reducing vaginal or pelvic pain during sex
  • Improving some forms of urinary incontinence
  • Preventing or treating pelvic organ prolapse, in which the uterus or bladder bulges into the vagina

The key to doing Kegel exercises is identifying the right muscles to contract and relax.

The key to doing Kegel exercises is identifying the right muscles to contract and relax. One way is to try to stop the stream of urine while you’re urinating; if you can do it, you’ve identified the basic move. (But don’t start and stop your urination on a regular basis, as that might do harm.) Always try to do Kegel exercises with an empty bladder. Aim to hold your contractions for 2 to 3 seconds and then release. Once you’ve gotten the hang of the technique, try to do five sets of 10 repetitions per day while performing routine tasks such as driving or sitting at your desk. If you have trouble with the technique, you can get guidance from your healthcare provider, who might refer you for pelvic floor physical therapy (see below).

Pelvic floor physical therapy involves biofeedback and exercises to encourage relaxation and strengthening of the muscles of the lower pelvis. A physical therapist places biofeedback sensors on the vaginal wall to measure muscle tone and the strength of muscle contractions, which are then printed on a machine for you to see. After practicing your exercises at home, you can see your improvement on the machine the next time you visit the physical therapist. Sometimes the therapist will use a massage-like technique called myofascial release to help stretch and release the connective tissue between the skin and the muscles and bones in your pelvic region.

Pelvic floor physical therapy can help address sexual problems by improving chronic vaginal or pelvic pain and urinary incontinence. Typically several months of pelvic floor physical therapy are needed to achieve satisfactory results.

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