There Are Muscles Down There?
As a pelvic floor physical therapist, I have taught many people about their pelvic floor! One theme that I’ve noticed is that most of us don’t even realize that we have a pelvic floor and we don’t know what it does. Here is a brief lesson about these muscles and their role in pleasure.
If you’ve ever held back gas, stopped yourself from peeing, or done a kegel, then you’ve activated your pelvic floor muscles! They are a complex group stretching across the bottom of your pelvis, like a hammock, and serve as the bottom of your muscular “core.” The pelvic floor is made up of 21 muscles that comprise three different layers. They go around the urethra, anus, and vagina in those who have one. When you activate these muscles, you effectively close those holes. These muscles help in preventing leakage of pee and poop, supporting the pelvic organs (bladder, uterus, rectum), and achieving orgasm! The pelvic floor is under-appreciated for all that it does to improve your quality of life. Regardless of your sex assigned at birth, you have a pelvic floor and it helps with you with all these everyday functions. However, the pelvic floor has some different roles based on the genitals it surrounds.
PFM in Vulvar Pleasure
The superficial pelvic floor muscles surround the clitoris and the vaginal opening. With arousal, blood flow to these muscles increases and the ischiocavernosus contracts, moving the clitoral hood to make the clitoris more accessible. The pelvic floor muscles play a vital role in orgasm and studies have shown that the muscles contract between 3-15 times during orgasm in those with a vulva.1 Having a stronger pelvic floor muscles can increase the intensity of orgasms.2
The pelvic floor muscles also surround the opening of the vagina and tightening these muscles during penetrative intimacy can increase sensation and pleasure for you and your partner. Strengthening the pelvic floor muscles can improve sensation during intimacy as you have better awareness of the muscles and when they are tensing versus when they are relaxing. However, in some people, increased pelvic floor tension can lead to difficulties engaging in receptive penetrative intercourse and pain during intimacy. If pain limits you from engaging in any type of intimacy that you desire, I recommend you talk to your doctor or physical therapist about treatment options.
PFM in Penile Pleasure
The first layer of the pelvic floor muscles is where most of the muscle differences between each sex can be seen. The image provided shows how the anatomy that each muscle covers differs depending on the genitals. However, regardless of sex, the superficial pelvic floor muscles play a vital role in pleasure and orgasm. In those with a penis, two muscles—the bulbospongiosis and ischiocavernosus—are crucial for ejaculation.3 These muscles are located at the base of the penis and, when orgasm is achieved, contract to allow for ejaculation.3
The pelvic floor muscles, like any other muscle in the body, can be trained. Having strong pelvic floor muscles and good awareness of these muscles can certainly increase pleasure during intimacy. Strengthening these muscles has been shown to improve erectile dysfunction and pre-mature ejaculation.3 For an erection to be achieved, blood fills the chambers of the penis to extend and harden it. In order to maintain an erection, the pressure in those chambers must be sustained.3 Contracting the pelvic floor muscles can also help maintain that pressure which is why having strong pelvic floor muscles can help you keep it up! Not all causes of erectile dysfunction will be receptive to pelvic floor strengthening so it’s important to discuss treatment and causes with your provider.
Squeeze Baby, Squeeze
Since we cannot see the pelvic floor muscles and they don’t move a joint, it can be challenging to know if you are actually squeezing the right muscles when we try to engage them. Here are a few cues that I find helpful when trying to teach patients how to engage these muscles.
If you have a vulva (try these sitting up straight, lying down, or standing):
- Try to draw your underwear into the vagina
- Imagine your pelvic floor is like an elevator and try to move the elevator up toward your head
- Try to squeeze to hold back urine
- Try to squeeze to hold back gas
If you have a penis (try these sitting up straight, lying down, or standing):
- Try to draw your scrotum upward or your testicles into your abdomen
- Try to shorten your penis
- Try to squeeze to hold back urine
- Try to squeeze to hold back gas
A few important tips:
- Don’t hold your breath!
- Don’t squeeze your butt muscles or squeeze your legs together while you do this.
- Make sure you completely relax between each squeeze.
- Stop doing these exercises if you have any pain or discomfort.
One important note that I like to make here is that it’s just as important to relax your muscles as it is to squeeze them when you’re working on training your pelvic floor! Imagine you were doing a bicep curl, you wouldn’t just keeping bending your elbow, eventually you would have to straighten your elbow. The same goes for the pelvic floor, after you tighten the pelvic floor muscles focus on relaxing them by taking in a big breath into your belly.
Disclaimer: This information provided is not medical advice, consult your doctor with any questions or concerns regarding your pelvic floor health. if you are interested in finding a pelvic floor physical therapist you can search for one here.
References:
- The Vagina Bible by Jen Gunter, MD
- https://www.elvie.com/en-us/blog/pelvic-floor-orgasms-and-health
- The Penis Book by Aaron Spitz, MD
Images:
1.https://en.wikipedia.org/wiki/Pelvic_floor_dysfunction#/media/File:1116_Muscle_of_the_Perineum.jpg
