What Hollywood Didn’t Teach Me About Sex

In Pelvic Floor Physical Therapy by pelv_admin1 Comment

 

By Admin

 

Art imitates life, though Hollywood’s imitation of sex is often a crude copy. Now, don’t get me wrong, I do enjoy a good rom-com, and I may or may not be on my second viewing of True Blood, but sometimes I just don’t get it. The sex on TV is not the sex in real life, be it on Showtime or the Hallmark channel.  It’s time to set the record straight and for some sex health 101.

 

1) Vaginal penetration is not the gold-standard for orgasm

 

The history and fallacies surrounding vaginal-only orgasm could fill a novel, and have.1  If you are interested in a shortened version check out this fun musical rendition. We’ll leave the social commentary and just talk about the simple facts. The vagina is just one of many erogenous zones that can lead to orgasm.  And conventional heterosexual penetrative intercourse is not the only way to get there.  Biology can help lead us down some alternative paths. The vagina, a passageway from the outside world to the uterus, is built more for transport than sensation. The sensory map for the vagina is very vague and follows the visceral sensation back to the brain. Think about it, would you want to have precise sensation for tissue that needs to stretch >3x its normal size for birth3  I don’t think so. Now, the clitoris on the other hand, no pun intended, has the highest density and precision of receptors in the whole body.4 All bodies in fact, as the glans clitoris has almost five times the receptor density as the glans penis.5  Since the glans clitoris is on the outside of the pubic bone, it is not stimulated during penetration alone. And the clitoris is just one option on a road to orgasm. Check out this blog to get some more ideas. Or take a look here to learn how sex is more than just a P in a V.

 

2) Sex on the beach, a tasty drink, yes, an enjoyable experience, I think not, more like sandpaper in the crotch

 

Now what is more romantic than the sunset, a lover’s embrace, waves lapping at your feet, and sand…getting everywhere. For the brave who have tried, you would find that it’s not so comfortable, for either party. Genital tissue is thin and sensitive for a reason, so if anything rough is rubbed on it over and over again…well you can imagine the ramifications. Also, chemical irritants can wreak havoc on genital tissue, especially the vagina. This brings me to those hot and steamy pool scenes. The pool- fine to swim in, the labia provide a type of leak-proof seal.  Unfortunately with penetrative sex, chlorine, and other pool floaties, get a little too up close and personal. The vagina has a delicate hormonal and bacterial balance that maintains its pH at a happy 3.8. It even has its own cleaning system. Throwing chlorinated water, a strong sanitizer with a pH 7.2, or pretty much anything into the vagina, can cause problems. For a little more info about what makes for good vaginal health, take a look at our most popular blog: How your vagina is supposed to smell, 50,000 reads and counting.

 

3) The walk of shame is not the only repercussion of an unprotected one-night stand

 

The walk of shame may be enough of a deterrent for some, but there are a couple other reasons you may want to rethink unprotected stranger sex.. One is fairly obvious…pregnancy. There are few movies that broach the subject. Obvious Child and Knocked Up use this “unexpected” plot twist to show viewers the “comical” experience of unplanned pregnancy. There are also more true-to-life renditions, like Precious or this BuzzFeedYellow film. However, these seem to be more the exception than the norm. Another missed opportunity for theatrical conflict, STIs! In the top 200 films of all time (rated by IMDB), there was only one mention of condom use, and that was just in reference to birth control.6  I’m more of a rotten tomatoes fan myself, but you get the point.  This, along with the recent rejection of California’s Prop 60 condom mandate for pornographic films, exemplifies how condoms aren’t seen as sexy and STIs are not considered a serious health risk.  This is even more disparate from reality since in the US we are seeing a 20-year record high in the number of chlamydia, gonorrhea and syphilis cases.7  And these rates just keep increasing each year.  All this to say, can we please just have a movie with a dude who puts on a condom for some good clean fun…I think Ryan Gosling could make it work.

 

4) Not all good sex is easy sex

 

Hopefully this isn’t too surprising. Not all holes are created equal. Sometimes it takes a little maneuvering to get the angle right. I chuckle every time someone just slips in during penetrative sex- especially if it’s a first-time kind of deal. In the real world, it’s normal to have to recalibrate to match your partner. That’s part of what makes sex fun. Also if you need something to grease the wheels a bit, which is normal too, try some lubrication. Young and old alike, lube is your friend.  But before you reach for the KY, check out some better recommendations for a good time. Also, sex is messy, so sex requires clean up. If I chuckle at the slip-in, I LOL at the roll over and go to sleep when it’s all done. Umm, does every starlet have a UTI and a wet spot she curls up in?  And does every hero have a split stream? It’s not that unreasonable to add a little girl-sitting-on-the-toilet pee scene, à la Girls, or if that is too crude, how about a shower scene to get everything spic and span and sexy. Remember, we’re talking just water here, no soap in the nether regions, please.  

 

5) Sex is not just for the young, beautiful and belly-free

    This is more of a comment on Hollywood as a whole. I’m sure we can all agree that what we see on TV does not match what we see on real bodies. And, no, Gwyenth’s egg is not going to get you there (you know I had to fit that in somewhere 😉 ). But I just want to remind everyone that sex is for everyone. It looks different for everyone. Whether we’re talking intercourse, or outercourse….uppercourse or lowercourse, let it be consensual, let be fun and let it be real. So go get yours!

 

Bibliography:

 

  1. Gerhard J. Revisiting “the myth of the vaginal orgasm”: The female orgasm in American sexual thought and Second wave feminism. Feminist Studies. 2000;26(2):449. doi:10.2307/3178545
  2. Munarriz R, Kim N, Goldstein I, Traish A. Biology of female sexual function. Boston University School of Medicine. http://www.bumc.bu.edu/sexualmedicine/physicianinformation/biology-of-female-sexual-function/. Accessed January 10, 2017.
  3. Ashton-Miller JA, DeLancey JOL. On the Biomechanics of vaginal birth and common Sequelae. Annual Review of Biomedical Engineering. 2009;11(1):163–176. doi:10.1146/annurev-bioeng-061008-124823.
  4. Winkelmann R. The Erogenous Zones: Their Nerve Supply and Significance. Proceedings of the Staff Meetings of the Mayo Clinic. 1959;34(2):39–47.
  5. Shih C, Cold CJ, Yang CC. Cutaneous corpuscular receptors of the human Glans Clitoris: Descriptive characteristics and comparison with the Glans Penis. The Journal of Sexual Medicine. 2013;10(7):1783–1789. doi:10.1111/jsm.12191.
  6. Boseley S. Sex, lies and celluloid: Doctors hit out at Hollywood. The Guardian. October 3, 2005. https://www.theguardian.com/society/2005/oct/03/health.aids1. Accessed January 12, 2017.
  7. Tello M. Sexually transmitted infections on the rise. Harvard Health Publications. http://www.health.harvard.edu/blog/sexually-transmitted-infections-on-the-rise-2016112810653. Accessed January 12, 2017.

FAQ

What are pelvic floor muscles?

The pelvic floor muscles are a group of muscles that run from the coccyx to the pubic bone. They are part of the core, helping to support our entire body as well as providing support for the bowel, bladder and uterus. These muscles help us maintain bowel and bladder control and are involved in sexual pleasure and orgasm. The technical name of the pelvic floor muscles is the Levator Ani muscle group. The pudendal nerve, the levator ani nerve, and branches from the S2 – S4 nerve roots innervate the pelvic floor muscles. They are under voluntary and autonomic control, which is a unique feature only they possess compared to other muscle groups.

What is pelvic floor physical therapy?

Pelvic floor physical therapy is a specialized area of physical therapy. Currently, physical therapists need advanced post-graduate education to be able to help people with pelvic floor dysfunction because pelvic floor disorders are not yet being taught in standard physical therapy curricula. The Pelvic Health and Rehabilitation Center provides extensive training for our staff because we recognize the limitations of physical therapy education in this unique area.

What happens at pelvic floor therapy?

During an evaluation for pelvic floor dysfunction the physical therapist will take a detailed history. Following the history the physical therapist will leave the room to allow the patient to change and drape themselves. The physical therapist will return to the room and using gloved hands will perform an external and internal manual assessment of the pelvic floor and girdle muscles. The physical therapist will once again leave the room and allow the patient to dress. Following the manual examination there may also be an examination of strength, motor control, and overall biomechanics and neuromuscular control. The physical therapist will then communicate the findings to the patient and together with their patient they establish an assessment, short term and long term goals and a treatment plan. Typically people with pelvic floor dysfunction are seen one time per week for one hour for varying amounts of time based on the severity and chronicity of the disease. A home exercise program will be established and the physical therapist will help coordinate other providers on the treatment team. Typically patients are seen for 3 months to a year.

What is pudendal neuralgia and how is it treated?

Pudendal Neuralgia is a clinical diagnosis that means pain in the sensory distribution of the pudendal nerve. The pudendal nerve is a mixed nerve that exits the S2 – S4 sacral nerve roots, we have a right and left pudendal nerve and each side has three main trunks: the dorsal branch, the perineal branch, and the inferior rectal branch. The branches supply sensation to the clitoris/penis, labia/scrotum, perineum, anus, the distal ⅓ of the urethra and rectum, and the vulva and vestibule. The nerve branches also control the pelvic floor muscles. The pudendal nerve follows a tortuous path through the pelvic floor and girdle, leaving it vulnerable to compression and tension injuries at various points along its path.

Pudendal Neuralgia occurs when the nerve is unable to slide, glide and move normally and as a result, people experience pain in some or all of the above-mentioned areas. Pelvic floor physical therapy plays a crucial role in identifying the mechanical impairments that are affecting the nerve. The physical therapy treatment plan is designed to restore normal neural function. Patients with pudendal neuralgia require pelvic floor physical therapy and may also benefit from medical management that includes pharmaceuticals and procedures such as pudendal nerve blocks or botox injections.

What is interstitial cystitis and how is it treated?

Interstitial Cystitis is a clinical diagnosis characterized by irritative bladder symptoms such as urinary urgency, frequency, and hesitancy in the absence of infection. Research has shown the majority of patients who meet the clinical definition have pelvic floor dysfunction and myalgia. Therefore, the American Urologic Association recommends pelvic floor physical therapy as first-line treatment for Interstitial Cystitis. Patients will benefit from pelvic floor physical therapy and may also benefit from pharmacologic management or medical procedures such as bladder instillations.

Who is the Pelvic Health and Rehabilitation Team?

The Pelvic Health and Rehabilitation Center was founded by Elizabeth Akincilar and Stephanie Prendergast in 2006, they have been treating people with pelvic floor disorders since 2001. They were trained and mentored by a medical doctor and quickly became experts in treating pelvic floor disorders. They began creating courses and sharing their knowledge around the world. They expanded to 11 locations in the United States and developed a residency style training program for their employees with ongoing weekly mentoring. The physical therapists who work at PHRC have undergone more training than the majority of pelvic floor physical therapists and as a result offer efficient and high quality care.

How many years of experience do we have?

Stephanie and Liz have 24 years of experience and help each and every team member become an expert in the field through their training and mentoring program.

Why PHRC versus anyone else?

PHRC is unique because of the specific focus on pelvic floor disorders and the leadership at our company. We are constantly lecturing, teaching, and staying ahead of the curve with our connections to medical experts and emerging experts. As a result, we are able to efficiently and effectively help our patients restore their pelvic health.

Do we treat men for pelvic floor therapy?

The Pelvic Health and Rehabilitation Center is unique in that the Cofounders have always treated people of all genders and therefore have trained the team members and staff the same way. Many pelvic floor physical therapists focus solely on people with vulvas, this is not the case here.

Do I need pelvic floor therapy forever?

The majority of people with pelvic floor dysfunction will undergo pelvic floor physical therapy for a set amount of time based on their goals. Every 6 -8 weeks goals will be re-established based on the physical improvements and remaining physical impairments. Most patients will achieve their goals in 3 – 6 months. If there are complicating medical or untreated comorbidities some patients will be in therapy longer.

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