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Ask Amanda

Welcome to Kegel8 - Your Destination for Pelvic Health Solutions!

Originally Published: 2024-09-03  Last Updated: 2024-10-07


Are you ready to take control of your pelvic health? At Kegel8, we understand the importance of maintaining a strong and healthy pelvic floor. Whether you're experiencing issues after childbirth, struggling with urinary incontinence, or simply looking to enhance your intimate wellness, our range of electrostimulation devices is here to support you every step of the way. This page is updated regularly so come back to read the latest Q&A's.

Meet Amanda Savage

Amanda Savage is our dedicated healthcare professional, ready to answer all your questions and provide expert guidance tailored to your individual needs. With years of experience in women's health and a passion for empowering women to live their best lives, Amanda is here to ensure you have all the information and support you need on your pelvic health journey.

Amanda Savage
Amanda Savage MCSP, MSt (Cantab) 

"Welcome to our problem-solving corner!

Here, we understand that life can present a myriad of challenges, big and small. My name is Amanda, a pelvic health specialist, and I am dedicated to empowering women by educating and offering insights into pelvic health issues.

Whether you're grappling with incontinence, seeking advice on a prolapse, or need a fresh perspective on improving sexual sensation, you're in the right place. My aim is to provide you with thoughtful responses and practical solutions to your queries.

Remember, every question is valid, so, feel free to share your concerns, and I will answer a selection of questions here on the Kegel8 website.”

Amanda

The Benefits of Kegel8
  • Expert Advice: Have questions about your pelvic health concerns or how our devices can help? Ask Amanda! Our resident healthcare professional is here to provide personalized advice and recommendations based on your specific needs.

  • Trusted Solutions: Our electrostimulation devices are designed to target and strengthen your pelvic floor muscles effectively. Backed by scientific research and user testimonials, Kegel8 devices offer a safe and proven solution for improving pelvic health.

  • Confidential Support: We understand that discussing pelvic health concerns can be sensitive. Rest assured, our platform provides a safe and confidential space for you to seek advice and support from Amanda and our community of like-minded individuals.

  • Holistic Approach: At Kegel8, we believe in taking a holistic approach to pelvic health. In addition to our devices, Amanda can provide guidance on lifestyle modifications, exercises, and other strategies to optimize your pelvic floor health and overall well-being.

The Benefits of Kegel8
  • Expert Advice: Have questions about your pelvic health concerns or how our devices can help? Ask Amanda! Our resident healthcare professional is here to provide personalized advice and recommendations based on your specific needs.

  • Trusted Solutions: Our electrostimulation devices are designed to target and strengthen your pelvic floor muscles effectively. Backed by scientific research and user testimonials, Kegel8 devices offer a safe and proven solution for improving pelvic health.

  • Confidential Support: We understand that discussing pelvic health concerns can be sensitive. Rest assured, our platform provides a safe and confidential space for you to seek advice and support from Amanda and our community of like-minded individuals.

  • Holistic Approach: At Kegel8, we believe in taking a holistic approach to pelvic health. In addition to our devices, Amanda can provide guidance on lifestyle modifications, exercises, and other strategies to optimize your pelvic floor health and overall well-being.

How It Works
  • Submit Your Questions: Whether you're curious about our devices, need advice on using them effectively, or have specific concerns about your pelvic health, simply submit your questions to Amanda through the form below.

  • Beneficial Responses: Amanda diligently examines every question, endeavoring to provide replies that not only assist the individual who posed the question but also benefit the broader audience, all while maintaining strict anonymity for the individual.

  • Ongoing Support: Our commitment to your pelvic health doesn't end with a single response. Our advisors are here to support you every step of the way, offering ongoing guidance and encouragement as you work towards your goals.

How It Works
  • Submit Your Questions: Whether you're curious about our devices, need advice on using them effectively, or have specific concerns about your pelvic health, simply submit your questions to Amanda through the form below.

  • Beneficial Responses: Amanda diligently examines every question, endeavoring to provide replies that not only assist the individual who posed the question but also benefit the broader audience, all while maintaining strict anonymity for the individual.

  • Ongoing Support: Our commitment to your pelvic health doesn't end with a single response. Our advisors are here to support you every step of the way, offering ongoing guidance and encouragement as you work towards your goals.

Previous Ask Amanda Questions & Answers


Intimacy Incontinence Pelvic Pain Kegel8 Ultra 20 Device General Questions Post Partum Gyneacological Surgery Prolapse Menopause Mens Pelvic Health

Intimacy
How to tighten vaginal walls?   Over the last few years sex doesn't feel very interesting and it's hard to have an orgasm.  Are there any exercises to help to tighten my vagina walls? 

Short Answer

If sex feels uninteresting and it's hard to achieve orgasm, weak pelvic floor muscles might be the issue. Strengthening these muscles through regular pelvic floor exercises, like quick squeezes and slow holds, can help improve muscle tone and enhance sexual sensation. 

 

Long Answer

Your sexual relationship with your partner and with yourself is very important for both your physical and mental health. Many women complain that it’s just not really ‘doing’ it for them.  I’ve heard women say  sex is “flat”, “a bit boring really”, “sore and uncomfortable”, or “not very satisfying”.  

You are absolutely right to wonder if lack of muscle tone in the vaginal walls could be part of the problem.  Clues that you may have lack of pelvic floor muscle tone are: 

  • you feel there is too much room inside (you might also notice this when using tampons) 
    you want to try to grip your partner or a sex toy but nothing happens
  • it just feels a bit dull and boring inside during sex
  • it takes a long time to achieve an orgasm or the orgasm is not very strong. 

Vaginal looseness and lack of sensation are closely linked.  The vaginal walls are layered with pelvic floor muscles.  These muscles need good tone and firmness to make the space feel tight and close to your partner.  Also for the pleasure nerve endings to get activated. Good news - you can exercise these muscles just like you exercise your legs and arms!  If you think weak or loose pelvic floor muscles might be a problem for you: 

  • make pelvic floor muscle training a focus for few weeks to make some impact on your muscle tone. The recommendation to get the muscles to grow and develop is to stop 3 times a day to do 10 x "quick" squeezes and 10 "slow" holds (aiming to increase your holds from a few seconds to 10 seconds).  see our videos here
  • also concentrate on good pelvic floor relaxation technique with breathing awareness. This will improve your brain connection to your vaginal sensations.
  • You might enjoy enhancing your exercises with a muscle stimulation machine like the Ultra 20 or biofeedback device like the K8 Trainer, or vaginal weighted cones. 

Download our e book - "dealing with sexual intimacy issues" for more detail on all these ideas. 

Incontinence
Why do I have to get up 3 or 4 times in the night for a wee. What is happening as I restrict my intake of liquids during the evening but it doesn't seem to make any difference?

Short Answer 

You might be experiencing nocturia, where you wake several times at night to urinate, often due to weak pelvic floor muscles that can’t fully support the bladder. Strengthening these muscles through targeted exercises can improve bladder control and reduce frequent urges, especially when cutting fluids doesn't help. 


Long Answer
 

It sounds like you might be experiencing nocturia, which is the need to wake up several times during the night to urinate. While restricting fluid intake in the evening is a common step to help, other factors may be contributing to the problem. For instance, your pelvic floor muscles might not be providing enough support for your bladder, leading to frequent urges even when the bladder isn't full. 

Weak pelvic floor muscles can affect how well your bladder holds urine, especially at night. Strengthening your pelvic floor through targeted exercises can improve bladder control and reduce nocturia. We have lots of information in our Help & Advice section on how to do the exercises and if you want faster results have a look at our medically proven Ultra 20 electronic pelvic floor exerciser. 

In addition, it’s worth considering factors such as bladder irritation (from caffeine, alcohol, or acidic foods) and checking for underlying health issues like an overactive bladder or even sleep disturbances. Working on strengthening your pelvic floor can play a key role in regaining control over these night-time trips to the bathroom. 

If the issue persists, it’s a good idea to consult a healthcare professional for further assessment. 

Pelvic Pain
I have been experiencing pain in my pelvic region for months now. I am on the waiting list to get medical help but in the meantime, I need some advice as to what I can do to try and manage the situation. I am taking pain killers but I am sure there must be other things I can do to ease the situation?

Short Answer 

Managing pelvic pain can be helped by checking your posture, habits, and breathing patterns. Often, pelvic pain causes people to sit awkwardly or tense up, which can strain muscles. Focus on maintaining good posture, take note of your body in mirrors or photos, and ensure your pelvic floor muscles aren’t being overworked. Breathing well can also relieve pelvic tension—practice mindful breathing to engage the pelvic floor muscles gently, keeping them flexible and reducing pain. Regular stretches, pelvic floor exercises, and establishing good bowel habits are essential for long-term relief. 

It’s also important to stay active—gentle activities like walking, yoga, or swimming increase blood flow to the pelvic region, ease tension, and strengthen muscles, reducing symptoms over time. 

 

Long Answer 

Managing pelvic pain requires addressing several key aspects of your posture, habits, and overall lifestyle. First, take a close look at how you sit and stand. When you experience pain, it’s natural to tense up or adopt awkward postures, which can worsen muscle strain in the back, legs, and pelvic area. Over time, these protective habits can lead to uneven weight distribution and muscle imbalances, which can strain your pelvic floor and surrounding muscles. One effective strategy is to check your posture regularly. Glance at yourself in mirrors or ask a friend to discreetly snap photos of you sitting and standing so you can analyse how aligned your body is. Correcting imbalances can go a long way in easing pelvic discomfort. 

Another critical factor is breathing. Many people don’t realize that their breathing patterns are closely linked to their pelvic floor muscles. If you’re unknowingly gripping or overworking your pelvic floor muscles throughout the day, this can contribute to chronic pain. Focus on mindful breathing—when you breathe deeply and evenly, your pelvic floor muscles should contract and relax gently along with your breath. This helps nourish the muscles and nerves, keeping them supple and ready for action when needed. Take short breaks throughout the day to tune into your breath and pelvic floor, using this time to release any excess tension that may have built up. 

In addition to addressing posture and breathing, it’s important to stretch and strengthen the muscles around the pelvis. Pelvic pain often leads to overworked, contracted muscles, so it’s crucial to help them relax and return to their natural length. Gentle stretches at the end of each day can help relieve tension, especially in muscles that have shortened due to prolonged pain. Remember not to force any stretch and focus on symmetry—try to even out your tighter side to match your more flexible side. Use your breath to help relax muscles as you stretch, allowing for a more mindful, effective release. 

Lastly, pay attention to your daily habits, especially when it comes to bowel health. Constipation can put pressure on the pelvic floor, exacerbating pain and discomfort. Establishing a good routine for bowel movements is essential for pelvic health. Make sure you’re drinking plenty of water and eating a fibre rich diet, which includes whole grains, fruits, vegetables, and pulses, to keep your stool soft. A morning ritual that includes movement, food, and hydration can kick-start your digestive system and prevent straining, which can worsen pelvic pain. Consider elevating your knees with a stool when using the toilet to mimic a natural squatting position, which can help the bowels empty more easily and reduce strain on the pelvic floor. 

Incorporating gentle movement into your routine is another key to managing pelvic pain. Low-impact activities like walking, swimming, or yoga improve blood flow to the pelvis, boost your mood by releasing endorphins, and help strengthen and balance the muscles around your pelvic floor. Even a few short walks each day can make a difference. Regular exercise helps keep the muscles flexible, reducing tension and improving overall function in the pelvic region. 

By addressing posture, breathing, stretching, and daily habits, you can begin to manage pelvic pain and support the health of your pelvic floor. 

Kegel8 Ultra 20 Device
When using the probe, I only feel it on one side so what is the difference is between the high and low frequency programming, specifically in program 14. Does one go deeper and one stays shallow? I feel low frequency programming on both sides of my vagina, but high frequency only on my right side. I even flipped the probe 180 degrees with feeling only on my right side during high frequency.

Short Answer 

Low-frequency stimulation targets the sensory nerves of the pelvic floor muscles, promoting blood flow, muscle awareness, and activating "slow" fibres like a warm-up phase. The higher frequency phase focuses on motor nerves, causing more intense muscle contractions and exercising the "fast" fibres, similar to a workout. Uneven sensations are common due to nerve or muscle differences, but this will balance over time with regular use. 


Long Answer
 

The low frequency stimulation has more effect on the sensory nerves of the pelvic floor muscles than on the motor (movement) nerves. This is beneficial to bring blood flow to the area, to help your brain to remember (and locate) the position of the muscles, and to bring about some activation of the "slow" type fibres. Think of this phase like a "warm up" part of a gym session, getting ready for you to perform better. It is a good phase to experience. 

In the higher frequency phase the stimulation activates more motor nerves bringing about contraction and relaxation of the "fast" muscle fibres. You will likely find the feeling more intense and many people feel their muscles "work" without them trying. This phase will exercise your muscles like the main part of a gym session. 

It is common to not feel an even sensation. This can be because your nerves have been affected in some way by events (eg childbirth or surgery) so that you have more feeling (or less feeling depending which way you look at it!) on one side than the other. Or it may be that the muscle responds better on one side than the other. Over time using the stim machine this should become more even but don't worry if it does not. If you can feel it on one side it means the machine is working correctly, even if you cannot feel it on the other side. Only turn up as far is as comfortable on the side you can feel. Turning the probe around will not make any difference. But you may find some positions give more closure on to the probe than others (eg keeping legs tight together or lying on one of your sides). 

General Questions
I need help. Why would you recommend seeing a pelvic floor physiotherapist and what is involved in a proper assessment of the pelvic floor?

Short Answer 

A specialist pelvic floor physiotherapist can assess your muscles through an internal examination, identifying issues like muscle spasms, scar tissue, or pelvic organ displacement, and help you progress in your pelvic floor training. Acting like a personal trainer, they use tailored exercises, muscle stimulation, and holistic treatments to improve function, core strength, and alignment, while addressing bladder or bowel concerns and working with healthcare professionals for a full recovery plan. To find a specialist, you can self-refer through your local maternity unit, ask your GP for a referral, or search for a private physiotherapist who is a full member of POGP. If you need help locating a physiotherapist, you can email POGP with your postcode for recommendations. 

 

Long Answer  

A specialist pelvic floor physiotherapist will internally examine your muscles to be really certain about their condition and function. This examination will be so useful for you. When somebody shows you exactly where your muscles are on the inside it can be very enlightening - a few tips and you could be straight onto the next level with your pelvic floor training. The examination will also show up any of those other common problems such as muscle spasm (where the pelvic floor muscles are too tense even when you may think they are relaxed), scar tissue, or change in the position of the pelvic organs. The examination doesn’t take long, and your physiotherapist will be gentle and informative. Most women say how helpful it is when somebody checks exactly what they have been doing and explains how all the parts work together. 

With a clear diagnosis your physiotherapist will help you plan a swift path to recovery. 

How can a specialist pelvic floor physiotherapist help if doing exercises myself didn’t? 

Imagine you have used a phone app to follow a programme to build your running fitness from couch to 5km. You would be really pleased with how much you have achieved alone. But now you want to do your first half marathon. Suddenly you realise that there is quite a lot more to learn about the body, nutrition, running and technique for this much more complex goal. You know you have will start reading blogs from experienced runners and you might have some sessions with a personal trainer to find out the next steps to take to more your running to this more advanced level.

Your physiotherapist will be like your experienced personal trainer for your pelvic floor. Just like a personal trainer, physiotherapists also have a lot of other exercises up our sleeves to train muscle reaction times, co-ordination with complex movements, improve endurance,  the amount of time you can hold your muscles for symmetry = the right and left balance and work on muscle symmetry (explain) and alignment. If the muscles are very weak, we can help you use of a muscle stimulator, biofeedback and other hands-on therapy techniques to wake the muscles up. We will help you correct other Musculo-skeletal issues such as pelvic and spine alignment and symmetry issues. We think holistically and will help you tackle a weak core or diastasis rectus abdominis (DRA) which is poor closure of the abdominal muscles after pregnancy. Most mums leave physiotherapy with more than just one problem sorted out! 

We also give advice on other aspects of bladder and bowel function that could be contributing to your symptoms. Very importantly we will also ask questions to know when we should talk to your GP about other investigations that might be needed for your problem. Physiotherapists work closely with gynaecologists, urologists and local maternity departments so can liaise with other team members to help your situation too. 

How to organise further assessment and treatment 

In many places in the UK you can self-refer to a specialist physiotherapist, usually associated with the maternity unit where you gave birth. If this service isn’t available in your area your GP will be able to make a referral. There are many private physiotherapists too, look for a physiotherapist who is a full member of POGP (www.pogp.csp.org.uk) as they have passed post-graduate exams to treat pelvic floor dysfunction. If you need help to find a specialist physiotherapist, NHS or private, you can email POGP with your postcode and they will put you in contact with your nearest specialist. 

Post Partum
Why aren’t pelvic floor exercises working for me? I’m 6 months post-birth and things 'down there' still haven’t improved—whether it’s leaking when I cough or run, constantly needing the loo at night, or dealing with painful, unsatisfying sex. What advice would you give me because at this rate I won’t be having another child?

Short Answer 

Postnatal issues like pain, pelvic organ prolapse, incontinence, urgency, or bowel problems should improve with time and pelvic floor exercises, but if symptoms persist after 8-12 weeks, it’s essential to seek help from a GP or pelvic floor specialist. Factors such as incorrect exercise technique, muscle spasms, scar tissue, or misalignment could be affecting your recovery, and a professional assessment can identify the root cause and offer more advanced treatment options. 

 

Long Answer 

Common postnatal problems which should be getting better with both time and pelvic floor exercises are: 

  • pain in the vaginal or anal area,
  • painful or dissatisfying sex,
  • pelvic organ prolapse (feeling of bulging, gaping or discomfort below)
  • urinary stress incontinence (leaks with cough, sneeze, laugh, run),
  • urgency (struggling to get to the toilet on time),
  • nocturia (needing more than 2 wees in the night) or
  • bowel leakage or constipation

Fortunately, a large percentage of women will find that their post-baby symptoms improve with home pelvic floor exercises to improve the strength, endurance and reaction time of the muscles which support the organs and help with continence function. BUT if after 8-12 weeks of regularly practicing pelvic floor exercises, with or without a muscle stimulator, you find that are still having one or more of these problems it is definitely time to seek further help from your GP and ideally, a specialist pelvic floor physiotherapist. Please don’t delay. If the exercises you have tried are not helping your symptoms, we don’t want you to struggle along alone. 

There are several reasons that exercising the muscles by yourself may not have had the outcome you hoped for: 

  • It is really difficult to be sure if you are doing the exercises correctly - these muscles can’t be seen from the outside and are tricky to reach and test what they are doing
  • It is also common to find muscles that are not actually weak at all, rather stuck in a spasm and overworking. This can make them appear weak and is the also a common reason for pain in the vagina. 
  • Sometimes scar tissue from your delivery can be interfering with the the muscles and even though your brain is sending the right signals to the area the muscles can’t react correctly. 
  • Or the bladder or bowel position may be being distorted by problems with the back and pelvic alignment, a weak core or a caesarean scar. 
  • The muscles could be coming along well from a very weak starting point, but they may need to further development and skills to cope with the more complex activities of life like running, jumping, sneezing without laughing and managing a full bladder. More advanced and specialised exercises will help this. 
  • There could be other things going on, like hormone imbalances, haemorrhoids, an infection, a rogue stitch, or something completely new, not even necessarily connected with your delivery, like a fibroid, polyp or cyst. 

What comes next if DIY pelvic floor exercises are not working for you 

Though you will be feeling disappointed and frustrated at the moment, you should be proud to have given pelvic floor exercises by yourself a proper trial. Your GP will have expected you to try exercises first and will only send you off with that job if you can’t look them in the eye and tell them you have already had a good go at them by yourself! 

If the DIY exercise approach is not working, it is the time to have a proper assessment of the pelvic floor muscles and the surrounding structures that could be influencing the muscles ability to work properly or the function of the bladder or bowel. Some of these problems can also be caused by other issues, not just pelvic floor dysfunction, and should be investigated properly if they are not getting better. 

 

Gynaecological Surgery
Is the Kegel8 machine recommended/safe for women who’ve had a hysterectomy? Even if they have had their cervix removed? How soon after surgery is it safe to use it?

Short Answer 

Yes, the Kegel8 Ultra 20 Electronic Pelvic Toner & Muscle Stimulator is safe and recommended for women who have had a hysterectomy, including those with their cervix removed. It should be used after 12 weeks post-surgery, allowing for initial recovery. For those with a prolapse, it can be beneficial, but consult with a specialist physiotherapist for personalized guidance. 

 

Long Answer 

There are many reasons why a woman may need a hysterectomy. Often it is part of the management of a bladder, bowel or prolapse issue, but it could also be due to bleeding or a cancer. In the UK most women having a hysterectomy to help with prolapse will have already been working on her pelvic floor muscle exercises before an operation as part of our NICE guidelines pathway of care.
 
 

Even so women can be surprised how long it can take to get back to their normal level of activity after their op. Gynaecological surgery can have an incredible impact on pelvic floor muscles, with women often finding that they feel weak, unsupported or de- conditioned in the weeks following their operation This is partly because the surgical work in the area affects the blood flow, nerves, and surrounding tissues; women will also be a bit sore and less active for a few weeks during recovery.  

Immediately post-op, once the catheter is removed, women will be encouraged to do regular pelvic floor exercise sessions several times a day. Even baby pulses of the muscles will help the healing process by improving blood circulation to the area, reducing swelling, and strengthening the muscles. Then over the next few weeks the aim is to build up good muscle strength and endurance again which we need for secure bladder and bowel control. 
 

Exercises will also improve the muscle tone which we need to prevent further pelvic organ prolapse, and to feel supported. Pelvic floor exercises are particularly important after surgery for prolapse as this type of problem can re-occur. It’s important to build up a strong area of muscles to support all the lifting and carrying and impact of normal life. We often relate preparing and recovering from gynaecological surgery to how one would expect to prepare to have a new knee or hip joint. You know that if you do the "pre-hab" and post op "re-hab" you can expect to get better results than the person who only relies on the surgery for their "fix".  

In the first 12 weeks after your surgery you should do classic pelvic floor exercises, but independently - using your brain and muscles only. As the body is healing and sensations can be altered, it is not advised to use a muscle STIM device in this early phase. However, after 12 weeks post-op, the Kegel8® Ultra 20 can be used to exercise the pelvic floor muscles. This can be particularly helpful for people who find it difficult to feel the area, want support to do the exercises correctly and those who get distracted easily or need a bit of extra focus and motivation each day! 

You can use a stimulation machine to help your muscles to work after all types of hysterectomy, including removal of the cervix. However, if you have had pelvic surgery for a cancer related issue you should get guidance from your doctor. The Kegel8 Ultra 20 comes with our Let’s Get Started Guide, which includes a step by step 12 week guided pathway for Rehabilitation after Gynaecological Surgery, devised by a specialist physiotherapist. In the first phase you allow the electrical impulses to come and go in cycles of stimulation and rest periods. This will help you "find and feel" your muscles again and improve blood flow to the area. Then you start to join in with the contractions to teach your brain how to squeeze the muscles correctly, but as you get tired the machine continues to do this for you. The programmes build the intensity and range of patterns until you have developed strong and co-ordinated muscles again.  

Prolapse
I have a uterine prolapse (stage 2) and recently developed a stage 3 bladder prolapse. I've been using the Kegel 8 Ultra 20 but reduced it to once a week and have had less sexual activity. Should I be following a specific program? I’ve been using programs 5 and 20 over the past year. Will I need surgery?

Uterus prolapse level 2 and bladder prolapse level 3 will likely need more support than pelvic floor muscles can achieve alone. A pessary is definitely the first approach with few side effects. These can be used as a long-term solution. In the UK there are some excellent resources for women trying to decide about different types of surgery available from The British Society of Urogynaecology.

If you still have some prolapse after your surgery, or prior to surgery you can still use a Kegel8 stimulation machine as part of your package of things you are doing to improve your pelvic floor support. As the prolapse can push downwards on to the pelvic floor area many women find it easiest to get the internal probe into a good position by lying down for 5-10 mins first to tip things literally (!) back out of the way and to do their Kegel8 programme in this position. Stimulation can be helpful if the prolapse is making it hard to tell where your muscles are or putting a lot of pressure on the muscles. As prolapse can be a complicated system it would be best to get a full assessment of your personal situation from a specialist physiotherapist and they will guide you on making modifications to get the best results.

I haven’t tried a pessary yet, but I have an appointment in October to get one fitted—can I still use the Kegel 8 Ultra 20 with a pessary?

Yes, you can if it is a "ring" type (which can also stay in place for sex) but if it is a cube or space occupying pessary only if you remove it first. 

Vaginal pessaries are commonly fitted for women of all ages to help support the pelvic organs from within the vagina. They can be ring or diaphragm shaped sitting up at the top of the vagina or cube shaped taking up space. A pessary can be fitted by a doctor or nurse with 6 monthly changes. Or some women learn to put their pessary in and out themselves to give great flexibility when they use it (for example just for sport or long days on their feet) and to enable a full active sex life. If a pessary suits you, it can be a long term way to manage your prolapse. Or a pessary might be a temporary solution while you work on improving your pelvic floor muscles, sorting out constipation, losing weight or while waiting for surgery. 

Is there anything else I can do to manage the bladder prolapse, as I only have the bulge and no other symptoms like leakage or urgency?

Short Answer 

Establish good bowel habits by creating a morning routine to prevent constipation, sitting with knees higher than hips for easier bowel movements, and supporting your perineum when passing stool. Combine this with a healthy diet rich in fibre, maintaining a healthy weight, and incorporating pelvic floor-safe exercises to manage and prevent worsening of pelvic organ prolapse. 


Long Answer
 

Establish Good Bowel Habits 

  • Bowels love a routine and you can train a “bowel habit”. Try to establish a morning ritual that your body can get used to and lets you empty your bowel regularly before you become constipated. Move about as you get up. Have something to eat and drink to help kick-start your gut peristalsis. Listen for the messages telling you to go.  
  • Research has shown that the best way to sit on the toilet is with your knees higher than your hips. This straightens the bowel and relaxes the pelvic floor muscles. 
  • Be patient! Emptying the bowel is a natural thing that the body does best on automatic pilot. It is not something that ‘we’ do. Give your body time. Many women finding reading a book a good way to stay still!  
  • Many women find it helpful to support their perineum and pelvic floor as they pass a stool. Take a pad of toilet tissue and press it over the whole of your perineum, just leaving the small anal sphincter free. Press upwards to support your soft bits as the poo is coming down. This will also direct the poo backwards to come out the anal passage easily, rather than the pressure coming forward into the vagina area.  
  • Treat your bottom skin with love and care. Wipe gently from front to back. Don’t scrub at your skin with dry tissue. Dampen some cotton wool or use a non-alcoholic wet wipe. Wait for your skin to dry and then apply a baby-bottom cream for you too. This helps your skin heal and acts as a thin barrier from rubbing against your underwear.  


Eat a Healthy Diet 
 

A high BMI is a risk factor for developing prolapse. Keeping a healthy weight for your height will be beneficial to reduce pressure on the pelvic area. A diet rich in fibre will keep your stool soft and easier to pass. A useful and helpful YouTube Video can be found here: The Link Between Bowel Health and Your Pelvic Floor Muscles


Enjoy exercising
  

With some modifications as well as exercises to strengthen your pelvic floor (independently or using a Kegel8 pelvic toner) you will also benefit from exercise that is pelvic floor safe, this means that the exercise you do to strengthen your pelvic floor will not overload it and not put you in danger of further prolapse damage. Physiotherapists recommend paying attention to your exercise activities to notice how your body feels during and after the things you enjoy doing. No symptoms, no worry! But if you find an exercise, class or activity feels it increases vaginal bulge, heaviness or other symptoms as you take part or in the 24 hours afterwards you will benefit by making modifications to reduce the load on your pelvic floor muscles. You could reduce the repetitions; make sure you breathe out when you exert pressure; change the leg position and swap out any exercise that creates too much downward pressure on your pelvic floor for a different one. It may be compression shorts, this clever underwear helps activate the pelvic floor muscles, strengthening them for long lasting results. 

Pelvic Organ Prolapse can be a long-term condition. The important thing to remember is be proactive, there are things you can do now to manage your prolapse and stop it getting worse. 

Menopause
Hello. I am 56 years old. I’m definitely in the menopause time. I’m noticing that I have to be much more careful when I cough or sneeze to stop leaks and I am getting up at night more often for a wee. Could a muscle stimulation machine help me with my menopause bladder symptoms?

Short Answer 

The peri-menopause, lasting 5-10 years, brings hormonal changes that can also affect pelvic floor muscles, leading to bladder or bowel control issues, vaginal support concerns, or altered sexual enjoyment. Traditional pelvic floor exercises, enhanced with a stimulation machine like the Ultra20, can help strengthen both quick and slow muscle fibres, targeting symptoms such as stress incontinence, pelvic organ prolapse, and urgency, while also improving sexual sensations and overall pelvic health. 

Long Answer 

The peri-menopause is a 5-10 year phase of gradually changing hormones. There is a lot of media attention to hot flushes, mood changes and vaginal dryness. As you move through this time you may also notice symptoms which suggest that your pelvic floor muscles need some attention. This could be bladder or bowel control issues, or feeling unsupported in the vagina, or a change in your enjoyment of sex. 

Traditional pelvic floor exercises will improve the health of the pelvic floor tissues. Our e-book shows you how. You can also use a stimulation machine to enhance your practice, or help you feel more connected and focused. The machine makes the muscle fibres repeatedly contract and release to encourage the muscle fibres to grow and have a better blood and nerve supply. Machine exercises need to target both the quick and slow muscle fibres, just like you need to do when you practice the exercises without a machine (which you need to do as well!). 

Take a moment to consider which symptoms you have developed or worry you. There are different programmes on the Ultra20. You can choose a programme to focus on the symptoms bothering you the most at the moment.

  • Stress Incontinence: the leakage women experience when the bladder is under pressure or high impact - like when you cough, sneeze, laugh or jump. Exercising to strengthen & tone the pelvic floor muscles helps improve closure of the bladder tube to prevent leakage. 
  • Pelvic Organ Prolapse,  the movement of internal organs downwards in the pelvis. Exercising to strengthen & tone the pelvic floor muscles helps improve the support shelf for the organs and improves your core muscle strength to help with lifting and carrying activities. 
  • Urgency (when you don't feel you can get to the toilet in time) , frequency (needing to wee more than you used to) and urge incontinence (having an accident before you reach the toilet) or nocturia (getting up more often for a wee at night). First exercise to strengthen & tone your pelvic floor muscles (as you can’t “hang on” if you have nothing to hang on with) - then if you know your bladder itself is also “jumpy” or “irritable” you can use your stimulation machine to "calm" the nerves to the bladder muscle. There is an extra programme to use for this which you could introduce once you have established your muscle training routine. 
  • Sexual Sensations in women are felt in the muscular vaginal walls. Exercising to strengthen & tone the pelvic floor muscles helps improve the movement you can create and feel during sex. You can also use a stimulation machine to help learn to relax and encourage blood flow and pleasant sensations in the vagina. 
Mens Pelvic Health
I've started using the Kegel 8 for men and have questions about the anal probe. When inserted shallowly, the sensation feels too low, but when deeper, I don’t get the same contraction as manual Kegels (where my penis lifts at the base). How deep should the probe be inserted, and should I feel the same contraction as with manual Kegels? Also, is P05 the best program to start for erection strength and ejaculation control, and should I transition to P07 and P08 over time?

Short Answer 

It sounds like you’re already activating your pelvic floor muscles well with traditional exercises, and using the V for Men stimulation can enhance your training by reaching muscles your brain may not fully engage. The probe works at different depths, so experiment to find the most effective position, and over time, the machine should feel similar to manual exercises with muscle contractions. Programs like PO3 or PO4 can help with erection strength and endurance, while P05 is great for long-term maintenance. 

Long Answer 

 It sounds like you have been getting on well already with the traditional pelvic floor exercises; the feeling you describe between the anus and scrotum and the penis "lift" are good clues that you are activating pelvic floor muscle fibres well with your own brain.  You can now enhance your pelvic floor exercise by using the V for Men stimulation to reach parts your brain may not be reaching and to help stay focused and intentional with your training. 

The probe supplied has two points it can make contact with your body. The bar near the hilt is designed to exercise the anal sphincter (the ring of muscles you can see from the outside), the slightly deeper bar is to stimulate the levator plate (the pelvic floor muscles) further in. A few cm difference doesn't change the effectiveness but there will likely be a "sweet spot" for you where it feels just "right".  The hilt moves to help you mark the most comfortable position once you have worked that out.  You might also like to explore different positions for comfort, such as lying on your side or your back?  

Allow several sessions to get used to the electrical sensations.  You may not feel a muscle contraction until the intensity is higher, but your brain will need you to get used to the sensations bit by bit.  In time I would expect the work with the machine to feel very similar to when you do the exercises by yourself (the same area and the penile lift feeling).  However, some people do only ever feel a "warmth" or "tingle" sensation. Do be reassured that there will still be changes taking place in the blood supply, the nerve pathways and the muscle fibre cells even if you don't have a strong sense of movement. 

I am glad you are using our Let's Get Started Guide.  This has 12-week guided pathways for common male situations.  For improving erection strength and endurance you could work with either no 1 (see page p25 ) "more effective pelvic floor exercises" or "erectile dysfunction" (see page 64).  We use PO3 and PO4 to activate both fast and slow twitch fibres with tips to enhance working with the machine given along the way.  We recommend P05 as a good long term maintenance work out once you have achieved your goals. 


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