Do you really need to do Kegels? Physicians on five common pelvic floor myths
The pelvic floor is an essential but often overlooked and misunderstood part of the human body. Some people don't even know they have one.
'We're never really taught about it,' says Dr Sara Reardon, a board-certified pelvic floor therapist and author of Floored: A Woman's Guide to Pelvic Floor Health at Every Age and Stage. 'We don't really get any education about how these muscles work and what's normal.'
The pelvic floor is 'a basket of muscles that sits at the base of your pelvis', Reardon explains. It supports the pelvic organs: the bowel, bladder and uterus or prostate. These in turn support the spine, and play an important role in sexual health and urinary and fecal continence.
When the pelvic floor is working well, we tend to take it for granted, says Dr Ekene A Enemchukwu, a urogynecologist and director of urology at the Stanford Pelvic Health Center. But when it is not functioning correctly, 'it can significantly impact functionality and quality of life,' she says.
Common pelvic floor disorders include urinary or fecal incontinence, pelvic organ prolapse, pelvic pain and sexual dysfunction, says Enemchukwu.
We asked pelvic health experts what are the biggest myths about the pelvic floor, and how to care for yours.
'Everyone has a pelvic floor – males, females, children,' says Reardon. The three biggest risk factors for developing pelvic floor disorders – pregnancy, birth and menopause – tend to affect women, but pelvic floor disorder is still common in men, says Reardon.
Men with pelvic floor disorders can experience urinary incontinence, fecal incontinence, rectal prolapse (from chronic straining or constipation) and pelvic pain from tension in the pelvic floor muscles, says Enemchukwu.
Even in people who don't experience pregnancy or childbirth, the stress and strain of everyday life can take its toll on the pelvis, says Dr Cassandra Kisby, a urogynecologist and assistant professor at Duke University hospital. 'The pelvis can respond to our environment, our emotions, our traumas,' she explains. 'We carry stress in our pelvic floor, and that affects its function.'
One of the biggest mistakes people make when it comes to their pelvic floor health is not distinguishing between common and normal symptoms, says Kisby.
'Many things that happen to the pelvic floor are common, but don't need to be accepted as the norm,' she says.
Pelvic floor issues are extremely common. Urinary leakage, for example, affects roughly 50% of adult women, and 75% of women over the age of 65. An estimated 75% of women will experience pain during intercourse.
'I have women come in and say: 'I have three babies, and I leak sometimes when I sneeze and I have to change my clothes, but that's normal for my age.'' But it doesn't have to be, says Kisby. 'I really urge patients to think about quality of life and what we can do about it because there are treatment options.'
Patients often have to advocate for themselves when it comes to pelvic health.
'Physicians aren't screening women for these issues,' says Reardon. Because the pelvic floor affects so many systems in the body, it can also be difficult to know which doctor to ask about it.
'Our medical world is so siloed,' says Reardon. 'There's one doctor who looks at the uterus, one who looks at the colon, one who looks at the bladder – but nobody's looking at the muscles, which is the intersection of all these things.'
The people who do look at these muscles are urogynecologists. But according to Kisby, 'many women don't know what a urogynecologist is.'
'We need to find ways to improve awareness, screening and access to multi-disciplinary care,' says Enemchukwu. 'Patients do not need to suffer in silence.'
If someone has heard about the pelvic floor, they've probably heard about Kegels.
The exercise is buzzy. Gwyneth Paltrow's Goop sells multiple Kegel-related products. Celebrities boast about their Kegel routines. But according to experts, Kegels are not the be all and end all of public health. And for some, they could do more harm than good.
We don't really get any education about how these muscles work and what's normal
Dr Sara Reardon
Kegels are a pelvic floor exercise in which the muscles of the pelvic floor are contracted. 'It's closing those urinary and anal sphincters and lifting that basket of muscles up,' explains Reardon.
The exercise shortens and tightens the muscle. It can be helpful for regaining some strength after childbirth, or to address mild cases of incontinence. But for some, pelvic floor issues are a result of the muscles already being too tight, and Kegels only worsen symptoms.
For tension in the pelvis, Reardon recommends working on relaxation: 'more yoga-type stretches, breathing, massaging the muscle internally and externally to release some of that tension', she says.
But talk to an expert first.
'Ideally, care should be individualized and guided by a professional,' says Enemchukwu.
Related: Easy wins: strengthen your pelvic floor a little more every day
In some cases, pelvic floor injuries present years after they first occur.
'Many women have a childbirth injury of some degree, and oftentimes it will temporarily get better during the initial healing that our body does,' explains Kisby. But then, patients come back 10 or 20 years later 'when their symptoms start to become more prominent'.
Fortunately, it's never too late to start working on pelvic floor health, experts say.
'Some folks feel like if they've experienced something for a long time, they're beyond help,' says Reardon. 'But at any age you can start working on this and you can get improvement.'
Hashtags
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
New York Post
a day ago
- New York Post
Unregulated chemical 13,000 times sweeter than sugar is used in most e-cigarettes: study
A little-known artificial sweetener that's up to 13,000 times sweeter than sugar is now used in most popular flavored e-cigarettes — even though it is not listed on labels and is only FDA-approved for food, a new study found. Neotame was detected in 57 of 73 flavored vaping products often marketed to kids and teens and had an average content nearly five times higher than in a mint candy, a study conducted by researchers from Yale School of Medicine and Duke University found. Little is known about the health effects of inhaling the potent, no-calorie alternative, which was created by NutraSweet and is also known as Newtame, and current regulations do not limit its use, according to the June 2 study published in the Journal of the American Medical Association. 3 Researchers at Yale detected the sweetener in a majority of flavored vaping products on the market. The researchers set out to prove, mainly to regulators and clinicians, how commonly the chemical, which is also up to 65 times sweeter than aspartame, is being used in newer products, they said. All popular disposable e-cigs introduced after 2021 that haven't yet received U.S. Food and Drug Administration marketing authorization — 27 devices across 11 different brands — contained neotame, according to the study. Among them were vapes from brands like Breeze Smoke, Elf Bar and Vapetasia, which offer flavors like Strawberry Apple, Killer Kustard and Blue Razz Ice. Products from three brands — Vuse and NJOY, which are FDA-approved, and JUUL, which is awaiting approval — that were introduced before 2021 do not contain it, the study found. The substance was likely chosen for its heat stability compared to other sweeteners, but its behavior when heated and vaporized in e-cigarettes is unknown, the scientists wrote in their findings. 3 Flavored e-cigarettes, often marketed to kids and teenagers, are rife with the artificial sweetener neotame. Vapetasia 'There are two specific concerns about the finding: How does it affect the potential for addiction to the product, and what are the product's adverse health effects when inhaled?' said Hanno Erythropel, the paper's lead author. 'Eating versus inhaling something is very different,' Erythropel, a Yale researcher, added. 'There are many examples in which chemicals are safe for eating but not for inhalation.' Neotame is approved by the FDA for use in food, but not in vaping products, according to the researchers. When eaten in foods like cakes, soft drinks and chewing gum, neotame can seriously damage gut health, a study published last year in the medical journal Frontiers found. 3 Neotame is an artificial sweetener similar to aspartame. luchschenF – 'The respiratory and systemic health effects of neotame and its potential decomposition products during heating in an e-cigarette are unknown,' the scientists said. Alarmingly, most of the 'funky' flavors used in e-cigarettes have not been evaluated for use in products other than food, Erythropel added. The team hopes its findings pave the wave for further studies on neotame toxicity and exposure once it is heated and inhaled, and how users rate the appeal of e-cigarettes that contain it.
WebMD
2 days ago
- WebMD
The Next-Gen Sweetener You May Be Eating
June 6, 2025 – It's time to add the word "neotame" to your ingredient label watch list, especially if you vape. It's a relatively new artificial sweetener found in every disposable e-cigarette that researchers tested – and the ultra-sweet substance is increasingly being used in food and drink. You probably have heard of aspartame. But neotame is its lesser-known sibling, with just one molecular difference. It showed up in laboratory tests of 11 top disposable e-cigarette brands when researchers from Duke and Yale Universities were trying to figure out what makes the vapes, like Elf and Geek Bars, so, so sweet. Neotame is between 7,000 and 13,000 times sweeter than table sugar and up to 65 times sweeter than aspartame. The sweetened e-cig study results were published this week in The Journal of the American Medical Association, or JAMA. Neotame wasn't found in JUUL or other cartridge-based devices, which have their own checkered ingredient history, including the 2019 finding that the sucralose used in them was linked to the production of toxic aerosols. Even if you don't vape, you may already be consuming neotame, since it's found in baked goods, candy (Mentos, for example), and gum – plus salad dressing, fruit spreads, dairy desserts, and yogurt. It's also used in some flavored sparkling waters and drinks like Tampico Mango Punch. Some researchers have soured on neotame because its use makes e-cigs appealing to young people, and because lab tests show it may harm our intestines when ingested. Why You've Never Heard of Neotame Maybe you saw it on an ingredient label and passed over it sometime in the past two decades. It has zero calories, no nutritional value, and was FDA-approved as a food additive in 2002. It's not listed on disposable e-cigarette packaging. Researchers track these sweeteners. Havovi Chichger, PhD, a professor at Anglia Ruskin University in Cambridge, England, says that for more than four decades, we have been consuming "traditional" artificial sweeteners like acesulfame potassium (Ace-K), sucralose, saccharin, and aspartame. But newer substances like neotame "herald the next generation of sweet additives," she said. The substance was developed in the 1990s in a quest for a more stable sweetener for processed products, and its use has steadily grown, she said. It's even used now in some lip cosmetics that have a sweet flavor and aroma. Neotame has also become the 21st-century spoonful of sugar Mary Poppins sang about: It's used to make some pharmaceuticals more palatable. According to a website about neotame set up by Georgia-based maker NutraSweet Co., neotame has an "ability to mask the taste of supplements, vitamins, bitter food ingredients and active pharmaceuticals. Moreover, its high sweetness intensity allows formulation at very small quantities, leaving ample room for your pharmaceutical ingredients." Neotame is not, however, approved for use in products that are inhaled. Why Neotame Is Used in E-Cigarettes – and in Baked Goods The liquid vaporized by e-cigarettes is heated sometimes as hot as 800 degrees Fahrenheit, said Sven Jordt, PhD, senior author of the JAMA study and a Duke University professor who is an expert in chemical sensory biology. Heating vape liquid can chemically change its ingredients, and neotame's strong sweetness and heat stability seem to have led to its new use in vapes, he said. If a lot of a sweetener is burned up or chemically changed when heated, the desired taste profile can still be achieved if just a bit of the ultra-sweetness remains. "The FDA also has determined that neotame can be used for baking, for example, because it's more heat stable than many of the other sweeteners," Jordt said. "Sweeteners like aspartame or Ace K, they are basically burned at normal baking temperatures. However, with neotame, a large proportion survives baking and likely also survives being vaporized by e-cigarettes." His team is concerned that the sweetness makes the products particularly attractive to kids. It's not used in the few e-cigarettes that are legal to sell in the U.S. and was just found in the disposable ones that are illegal but widely available amid lack of enforcement. "We did this study specifically because this category of disposable e-cigarettes is seeing an explosive growth in sales and use," Jordt said, noting that their nicotine concentration is higher than in older products, and at a fraction of the price. "You buy this once and then you can use it a whole week. And kids are puffing on these all the time," he said. "Some have like 15,000 or 20,000 puffs [compared to a few hundred puffs in the older JUUL devices]. So if you use this continuously, you become really heavily addicted to nicotine … and now we are asking: Is it just the design or is there something else in it that makes them much more attractive to kids to use and make them taste better? And then we found this neotame." The Damage Neotame Can Cause Approval of neotame for use in food products was based on studies on mice and other animals that didn't show any adverse physical effects. But what about the effects on humans? Findings published last year suggest that neotame can damage the human intestine. "Neotame can cause previously healthy gut bacteria to become diseased and invade the gut wall – potentially leading to health issues including irritable bowel syndrome and sepsis – and also cause a breakdown of the epithelial barrier, which forms part of the gut wall," said Chichger, who is a cell and molecular biologist and senior author of the study, which was published in the journal Frontiers in Nutrition. The study showed that neotame can damage the "intestinal epithelium," or lining, by causing the death of epithelial cells. It also damages bacteria commonly found in the gut, she added. "Despite the smaller quantities used, the impact of neotame on the epithelium-microbiota relationship has the potential to cause poor gut health, which in turn could lead to metabolic and inflammatory diseases." The findings were the latest in a line of studies showing the effects of artificial sweeteners on gut health. Another recent study led by Los Angeles-based endocrinologist Ruchi Mathur, MD, linked artificial sweeteners to changes in the microbial composition and diversity in stool and the small intestine. That research, which was published in the journal Cell, didn't include neotame. Changes observed in the gut microbiome's biochemical activity "raise concerns regarding the potential impacts of non-sugar sweeteners on metabolic and gastrointestinal health," said Mathur, who is director of the Diabetes Outpatient Teaching Education Center and a professor of medicine at Cedars-Sinai in California. All the experts interviewed for this article said that while there's not enough data to say for sure that inhaling neotame is bad for you, the existing research suggests reasons to be cautious. When you vape, some of the "smoke" can mix with saliva and get swallowed – so neotame could reach your gut, Chichger said. "In fact, there are other studies which show that e-cigarette fluid can cause the same level of damage that we noted from neotame." Unanswered Questions About Neotame Big questions about neotame: How does it affect the lungs? How can we keep track of how much we've consumed (eating, drinking, or inhaling)? And how much is too much? "These sweeteners are only approved for use in food, but not for inhalation," Jordt said. "We don't know how safe they are if you inhale them every day." Mathur noted that the lungs have their own microbiome, and past studies have shown that vaping alters saliva as well as the nasal cavity microbiome. A large study published in March showed a significant link between exclusive e-cigarette use and development of COPD. The FDA has set daily intake limits for neotame, which is sometimes referred to by the brand name Newtame, and other sweeteners. But experts say there is no labeling requirement that shows consumers how much is included in a product, whether it's food, drink, or vape liquid. Jordt said it's unlikely someone would reach that limit by vaping alone. But if you also eat products with the sweetener, then exceeding that limit becomes more likely. "I do think it is reasonable to assume that there should be consumer awareness and caution, as there is little if any data on what happens when this substance is inhaled," Mathur said. You should also be aware of artificial sweeteners in food and drink, Mathur said. Make a plan with your doctor, especially if eating artificially sweetened foods is part of how you manage your body weight or diabetes. "There is enough data to suggest it is safe to use these non-sugar sweeteners in moderation," Mathur said. "If someone uses artificial sweeteners in non-traditional ways, such as inhaling it through an e-cigarette, they are doing so without the benefit of any good information on the potential long-term consequences of taking in the substance through their airways and down into their lungs or what byproducts may be created in the process."
New York Post
5 days ago
- New York Post
‘Exciting' new non-opioid painkiller shows promising results — and doesn't build up tolerance
A real ache-ievement! Duke University researchers have devised a promising, potent pain reliever — seemingly without the harmful side effects and addictive highs of opioids. While opioids interact with numerous cellular pathways, the experimental drug is more selective. SBI-810 targets a receptor in the brain and spinal cord, activating a single pain-relief signal while steering clear of other signals that could trigger troublesome consequences. Advertisement 3 Ru-Rong Ji, an anesthesiology and neurobiology researcher who directs the Duke Anesthesiology Center for Translational Pain Medicine, led the team in developing the painkiller SBI-810. Duke University School of Medicine 'What makes this compound exciting is that it is both analgesic and non-opioid,' said senior study author Ru-Rong Ji, an anesthesiology and neurobiology researcher who directs the Duke Anesthesiology Center for Translational Pain Medicine. '[The receptor] is a promising target for treating acute and chronic pain,' Ji added. Advertisement Chronic pain is a persistent problem in the US. Nearly a quarter of adults, about 62 million, experienced it in 2023. Chronic pain has helped fuel the opioid crisis. About 8.6 million Americans 12 years and older reported misusing prescription opioids in 2023. And almost 70% of the 107,000-plus US drug overdose deaths that year were attributed to opioids such as fentanyl. 3 Chronic pain is a persistent problem in the US, with about 62 million adults experiencing it in 2023. AS/ – Advertisement The good news is that there has been recent progress on this front, with more treatment options and fewer opioid-related deaths. It's too early to tell if SBI-810 can help the cause. The drug has not been thoroughly tested in humans, but the results in mice have been encouraging. Opioids like morphine often lead to tolerance with repeated use, requiring higher or more frequent doses to maintain the same level of pain control. Advertisement SBI-810 relieved pain from surgical incisions, bone fractures and nerve injuries without a buildup of tolerance or constipation, another common opioid side effect. 3 The experimental drug SBI-810 targets a receptor in the brain and spinal cord, activating a single pain-relief signal. mybox – When coupled with small doses of opioids, SBI-810 made them more effective at lower doses. And it's said to work better than the painkillers oliceridine and gabapentin in certain situations. The findings were published recently in the journal Cell. Ji's team has secured several patents for SBI-810 and hopes to start human trials soon.
