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Sexual Health

How Pelvic Floor Therapy Can Improve Your Health — And Your Pleasure

by Michaela d'Artois

@eva_abe

• By Michaela d'Artois

Regardless of the phase of life you are in, it’s possible that at some point during your journey you’ve been told to do your kegels. Turns out those are actually incredibly important. Those pelvic floor muscles — aka the ones that you can contract to stop your stream of pee — can play a huge part in your overall health and have the power to make even your sex life more pleasurable. To learn more about these magic muscles, we engaged Carine Carmy, co-founder and CEO of Origin, a physical therapy destination by women, for women. We talked about pelvic floor health, aging gracefully down there, providing all women with sexual health resources (because it’s a GD human right!), and so much more. Read on for the full interview.

MD

Can you tell us a little bit about your background?

CC

I’ve always been passionate about women’s health, but I’m actually a tech startup exec turned pelvic floor warrior.  I began my career as a management consultant (think George Clooney, Up in the Air). Then came the 2008 recession, which for all its challenges, fueled a lot of young people myself included to rethink business norms and big company mindsets. I always had an entrepreneurial drive thanks to my immigrant parents, so I decided to join an early stage tech company in NY and went on to help launch and grow several venture-backed businesses. I worked in everything from 3D printing to digital healthcare, all with the common thread of the question: how can we use technology to unblock and unlock human potential? When I learned that 40 million women every year experience commonly overlooked health issues and are told to “just deal with it,” I knew there had to be a better way.

MD

What brought you to co-founding Origin?

CC

After I left my last company, I took some time off (what a gift!) and reconnected with an old friend and now my co-founder, Nona Farahnik Yadegar. She had recently had her first son Elio, and even five months after giving birth, she had yet to recover. No one had prepared her for what she should expect postpartum, and she discovered physical therapy after desperately asking her friends for advice. I connected the dots of Nona’s experience to my own experience of enduring painful sex throughout my 20s. I sought care from nearly a dozen doctors but was told again and again that my pain would hopefully go away over time. Most of us aren’t aware of this (yet), but from painful sex to postpartum recovery, physical therapy is the first line treatment for pelvic floor dysfunction. Unfortunately in most parts of the United States, this kind of expert care isn’t the norm. We started Origin because we believe every woman should have access to the care they need to feel good in their bodies, through every stage of life.

MD

What have you learned about the importance of pelvic floor health and strength?

CC

I’m obsessed with pelvic health, and this is coming from someone who didn’t even know they had a pelvic floor until their 20s. Your pelvic floor is, quite literally, the center of your body’s universe. More specifically, the pelvic floor is a group of muscles and connective tissue that makes up the floor of the pelvis. In addition to being responsible for your reproductive health, it holds up your organs, enables you to control your bladder and bowel, gives you core stability, and actually acts as a pump for blood and lymph flow. These muscles work together with your abdominals, diaphragm, and hip muscles. And like any other group of muscles, your pelvic floor can be strong or weak, tight or loose. A strong and healthy pelvic floor can lead to more pleasurable sex, prevent leaking during exercise, and help prevent unnecessary surgeries as we age. I’m so passionate about pelvic floor PT because it’s the clinically proven, noninvasive way to help treat issues that arise and build strength over the long term.

MD

How can a strong pelvic floor better a woman’s sex life and overall health?

CC

1 in 6 women have chronic painful sex. Frankly, this is probably underreported because they are 5 times the number of research studies about erectile dysfunction in men compared with dyspareunia, or painful sex, in women. There are multiple causes for painful sex. Often, pelvic pain or discomfort is exacerbated by pelvic floor muscles that are tight and weak. Evidence shows that pelvic floor physical therapy should be considered an integral component of a multidisciplinary approach to treating painful sex. Pelvic floor PTs can help your mind connect with these muscles and bring them to a state of balance to improve your symptoms, reduce pain and achieve your goals.

MD

What would you tell women who experience painful sex about the possibilities of finding solutions and a future of pleasurable sex?

CC

I would tell these women my former self included there’s hope! Your recovery might not be linear, the pain may come and go, and you may have doctors or partners who don’t make you feel heard. But know that you’re not alone and keep knocking down doors until you find a provider who truly listens to you and gives you a clear plan of action. Also, check out dilators if you haven’t heard about ‘em yet!

I hope that we can shift the conversation from ‘women shouldn’t be in pain’ to ‘women should expect pleasure.’

MD

 Let’s talk about aging! Just like our faces, our vulvas age as well. How can implementing an exercise routine set us up for success as our bodies age?

CC

YES! This is such an important topic. When you hear menopause, you may think about symptoms like hot flashes or difficulty sleeping. But other symptoms with potentially severe implications are often overlooked or ignored entirely, such as painful intercourse, vaginal atrophy, increased incontinence and frequent urination, and increased risk of osteoporosis. To ignore these symptoms is to ignore the truth that you can do something about it. Evidence shows that addressing pelvic floor muscle function, in conjunction with improving overall muscle strength and physical wellbeing, can help to reduce and even prevent many symptoms related to menopause. Simply put: working with a PT to understand your baseline today will help you know how to set yourself up for success. In some cases, that might be kegels, but if you are experiencing painful sex or other symptoms, you’ll start with a different routine.

MD

It feels like everyone is having babies right now! What can moms-to-be know about the importance of being in shape down there that could benefit their birth stories?

CC

Exercising your whole body including your pelvic floor can lead to better labor and delivery outcomes. Research shows building strength and endurance in muscles that assist with delivery is key for shortening labor times, and improving labor outcomes. Working with an expert, you can strengthen your pelvic floor muscles and learn how to push correctly, hopefully creating a smoother postpartum recovery. PT can also help you manage pregnancy pain, and stay active with safe, pregnancy-approved fitness exercises. Our co-founder Nona gave birth to twins in 12 minutes of active labor, in a textbook labor and delivery. She also avoided the postpartum challenges that she experienced after her first pregnancy. The difference between her two journeys? Physical therapy throughout her second. It’s the real deal!

MD

And for postpartum?

CC

In France, the healthcare system focuses on “the fourth trimester” — every person who delivers gets at least 10 sessions of pelvic floor PT afterwards. In the US, we send new moms home with a couple print outs and a 15 minute appointment 6 weeks later. Whether you deliver vaginally or via C-section, there’s so much you can do to recover, address common issues such as incontinence or ab separation, and safely regain strength. We make it a point to offer both in-person and virtual care so everyone can have the access that they need.

MD

Why is it important to you to create educational opportunities and provide resources about sexual health for every woman?

CC

For millennia, women have been told that they are hysterical, emotional, exaggerating their pain, or that “it’s all in your head.” Gender bias in medicine is pervasive and entrenched. Women are more likely to be misdiagnosed, ignored, or denied by doctors, causing well-documented harm. Unfortunately, these perverse cultural norms can get internalized. As one research team explained, “For women whose pain is invalidated, chronic pain might serve as a nagging buzz of shame and discomfort: an implicit backdrop to their ongoing perceptions, thoughts and feelings.” We need to break the cycles of intergenerational pain and empower women with the information and care they need to feel good in their bodies.

MD

What are some stigmas about women’s sexual health you hope we can leave behind?

CC

All the things! But seriously, I’m still shocked by what other people find taboo. I recently wrote this piece called ‘Dear Tech Giants, please stop banning women’s bodies.’ It’s in regards to the countless times that our educational imagery surrounding the pelvic floor and women’s bodies has been rejected by Facebook, Instagram and Google. Why does our content with women’s anatomy get banned for ‘unacceptable business practices’ (true story!) yet phallic imagery used by an erectile dysfunction company gets the green light to be posted throughout the NYC subway system? It’s time to change the narrative once and for all. Big tech aside, there’s a laundry list of incredibly common health issues society has normalized: Leaking when running or laughing. Painful sex. Expectations that you can just “bounce back” after giving birth and there’s no need for rehab. Menopausal symptoms that no one talks about but impact so many. F that. I hope that we can shift the conversation from “women shouldn’t be in pain” to ‘women should expect pleasure.’ Let’s normalize pleasure and feeling good through every stage of life!

Photos courtesy of Origin.