Pelvic Myths: True or False?

By Melinda Fontaine

Have you heard these common pelvic rumors? Can you guess which ones are true or false?

As a pelvic floor physical therapist, I’ve heard quite a few old wives tales about the pelvis. Test your Pelvic IQ with these 16 true or false statements!

1. T/F   Drinking water will make me have to pee more.
2. T/F   Everyone should do kegels to maintain continence and improve sex and orgasm.
3. T/F   You can catch venereal disease from sitting on a public toilet seat.
4. T/F   A normal bowel movement requires straining on the toilet.
5. T/F   Sex is uncomfortable after childbirth.
6. T/F   Needing lube means I am not good enough/not turned on enough.
7. T/F   Kegels are only for women.
8. T/F   I should pee, just in case.
9. T/F   Everyone will probably need adult diapers at some point.
10. T/F   Waking up to pee at night is part of getting older.
11. T/F   At some point, I will get too old for sex.
12. T/F   It’s normal to pee a little when you laugh, cough, sneeze, or jump after childbirth.
13. T/F   Everyone knows how to kegel.
14. T/F   I’m the only one with pelvic problems.
15. T/F   Pelvic PT can help.
16. T/F   Only women go to pelvic physical therapy.

1. Drinking water will make me have to pee more.

1. 1. • FALSE. Contrary to popular belief, drinking more water can actually make you have to pee less frequently because it dilutes the urine in the bladder which is less irritating to the lining of the bladder.  However, if you do drink a large amount of water in one sitting, then your bladder will stretch quickly which makes it want to empty, so you will still have to pee.  Your best bet is to drink plenty of water, but space it out evenly throughout your day.   

2. Everyone should do kegels to maintain continence and improve sex and orgasm.

1. 1. • FALSE. OK, I’m sorry. This is one of those tricky questions that is false because the statement says “Everyone”.  Kegels are a strengthening exercise for the pelvic floor muscles.  These exercises can improve incontinence if the cause is weak muscles that cannot create a good seal.  However, if the incontinence is caused because of overworked muscles or a weak abdominal wall, then kegels will not help and may even make it worse. A PT can help you figure out which category you fall into.  Kegels can also make sex and orgasm better because they strengthen the pelvic floor muscles that are involved in arousal and orgasm.  If the muscles are already strong, then strengthening will not improve function, and may even cause new problems if the muscles become too strong and tight.  Also, if there is something else impairing sex and orgasm, then strength training will not help.

3. You can catch venereal disease from sitting on a public toilet seat.

1. 1. • FALSE. Chances are extremely low that you will catch a disease from sitting on a public toilet seat.  If you still don’t believe me, then use a toilet seat cover, but pretty please sit down. Hovering over the toilet seat activates the muscles that are supposed to be relaxing in order to open the floodgates and allow you to evacuate. (As a side note, your cell phone probably has more disgusting germs than a toilet seat.)

4. A normal bowel movement requires straining on the toilet.

1. 1. • FALSE. A normal bowel movement should be soft yet formed, like toothpaste or soft serve ice cream.  It should come out easily with a deep breath with your feet up on a stool, such as the Squatty Potty.  

5. Sex is uncomfortable after childbirth.

1. 1. • FALSE. If sex feels uncomfortable, this is a clue that something else is going on in the body.  Sex could be uncomfortable due to scar tissue, too much tightness in the muscles of the pelvis, hormone imbalance, active infection, or other causes. Physical therapy can address some of these issues to make sex pleasurable.

6. Needing lube means I am not good enough/not turned on enough.

1. 1. • FALSE. Some women just need/like extra lubrication, so bring on the lube. This can be especially true for women who have low hormones level, such as women who are on birth control, postpartum, or post menopausal.  Smoking, anorexia, stress, polycystic ovarian syndrome, and pituitary or hypothalamus issues can also cause less lubrication. (Stay tuned in May 2016 for some good hints on how to pick a lube.)

7. Kegels are only for women.

1. 1. • FALSE. The kegel exercise was first described for women, but it is a strengthening exercise for the pelvic floor muscles.  Both sexes have pelvic floors, so men and women can do pelvic floor exercises.  This involves tightening the muscles used to hold back the flow of urine or the passing of gas.

8. I should pee, just in case.

1. 1. • FALSE. If you do not have a full bladder, then you do not need to empty it.  Doing this routinely can actually cause your body to get confused and think that it is always supposed to empty when it is partially full.  This may lead to frequent urination or urinary urgency.  

9. Everyone will probably need adult diapers at some point.

1. 1. • FALSE. Adult diapers and incontinence pads have their uses for sure, but I don’t want people thinking this is the only choice. Often the cause of urinary or fecal incontinence can be treated.  As you reach for that next pack of adult diapers, also make a resolution to speak to your physical therapist or doctor about treatment options.  Many times, people can regain control over their bowel and bladder with proper medical care and can avoid or stop using diapers.  

10. Waking up to pee at night is part of getting older.

1. 1. • TRUE, but not as much as you would expect. As we age, our bodies create less of the antidiuretic hormone as we sleep which is what tells our bodies to stop making as much urine, so we can sleep all night. A healthy older individual should be getting up 0-1 times per night.  Conditions such as diabetes, pregnancy, sleep apnea, congestive heart failure, and prostate enlargement will increase the number of times someone gets up to pee.

11. At some point, I will get too old for sex.

1. 1. • FALSE. This is a bold faced lie!  Everyone should be having pleasurable, satisfying sex for the rest of their lives. If this is not the case, there is help.

12. It’s normal to pee a little when you laugh, cough, sneeze, or jump after childbirth.

1. 1. • FALSE. Just because it is common does not mean it is normal. This is called stress urinary incontinence, and it can occur because of a change in anatomy, pelvic floor muscles that are too weak or too tight, a weak abdominal wall, or hormone changes.  

13. Everyone knows how to kegel.

1. 1. • FALSE. Oftentimes, what people think is a kegel is not, or it is not a very effective kegel. Researchers gave women verbal instructions on how to do a kegel and then checked them.  Only 49% were doing it right.  25% were actually doing something that could make incontinence worse! To find out what a kegel really is, check out Allison’s blog post.

14. I’m the only one with pelvic problems.

1. 1. • FALSE. Why else would we have so many chairs in the PHRC waiting rooms? Up to 30% of the population in the West has urogenital problems. And those are only the people we know about…

15. Pelvic PT can help.

1. 1. • TRUE. Pelvic PT can help people with pelvic pain, urinary or bowel symptoms, sexual dysfunction, and pregnancy or postpartum concerns.
   2. • Monitoring your diet and proper exercise can help too. 

16. Only women go to pelvic physical therapy.

1. • FALSE. Pelvic physical therapists treat men and women. Even gynecologists can treat men with pelvic pain. The anatomy is remarkably similar, with the one obvious exception.  Men, women, everyone who has a pelvis can go to pelvic physical therapy.

Have you heard any other pelvic myths? Post them in the comments section below!

Regards,

Melinda Fontaine, DPT

Melinda is a native of Concord, California and is part of our Berkeley team. Melinda earned her bachelor’s degree in exercise biology from UC Davis and her doctorate in physical therapy from Simmons College in Boston. When she’s not at PHRC, you’ll find her either dashing around in her running shoes or cooking up delectable meals in her kitchen. She’s famous for her killer baked chimichangas and her inability to stick to a recipe

Nilsen R. (2014) Where does natural vaginal lubrication come from? http://www.livestrong.com/article/15810-does-natural-vaginal-lubrication-come/

^[1] Kegel AH (1948) The nonsurgical treatment of genital relaxation; use of the perineometer as an aid in restoring anatomic and functional structure. Ann West Med Surg.2(5):213-6.

^[1] Bump RC, et al (1991) Assessment of Kegel pelvic muscle exercise performance after brief verbal instruction. Am J Obstet Gynecol.165(2):322-7.

^[1] Legendre G, et al (2013) Menopause hormone treatment and urinary incontinence at midlife. Maturitas 74:26-30.

^[1] Prendergast SA and Rummer EH (2016) Pelvic Pain Explained: What everyone needs to know. Lanham: Rowman & Littlefield.