Weight Lifting to Fight Incontinence

Are vaginal weights a safe and effective therapy for stress incontinence or prolapsed uterus?

— L.S.

[Have a question about women’s health? Ask Dr. Gunter yourself.]

Using vaginal weights to strengthen the muscles of the pelvic floor is no more effective in treating incontinence than exercises that do not use weights — known as Kegel exercises.

The pelvic floor muscles are a group of muscles that wrap around the vagina, bladder and rectum. They help support these pelvic structures, they are the muscles that contract during orgasm, and they are involved in control of both the bladder and bowel.

A weakening of these muscles can lead to stress urinary incontinence (S.U.I.), a leakage of urine that occurs with physical exertion, or pelvic organ prolapse (P.O.P.), a weakening or tearing of the pelvic floor muscles that can cause the pelvic organs or even the vagina itself to fall downward. About 40 to 50 percent of women have mild pelvic organ prolapse, but do not have symptoms. This means that some laxity of the tissues is normal for many women. However, bothersome symptoms of prolapse may develop, the most common being a vaginal bulge.

Pelvic floor muscle training is exactly what it sounds like — exercises that strengthen the pelvic floor muscles. These exercises can be very effective therapy for stress urinary incontinence and can also treat the symptoms of pelvic organ prolapse. They can be done without weights (called Kegel exercises) or with weights.

Kegel exercises can be done essentially anywhere as no one knows you are doing them. There are two types of Kegel exercises:

Sustained contractions: Squeezing the pelvic floor for 5 to 10 seconds and then relaxing completely between.

Quick flicks: A simple contraction and release of the muscles that takes 1 to 2 seconds.

Pelvic floor weights involve inserting a set of increasingly heavier objects inside the vagina. The weight works by forcing the pelvic muscles to contract to keep the object inside the vagina while you are standing. They are generally recommended to be used for 15 minutes, twice a day. Once the wearer can keep the weight in for 15 minutes without much effort, the next heaviest weight is used, and so on.

Here are other women’s health questions posed by our readers and answered by Dr. Jen Gunter.

A review of the data tells us that pelvic floor weights are no more effective that simply doing Kegel exercises for strengthening the pelvic floor muscles. If the idea of weights appeals to you (some women love tools and devices), then they are fine to try. Be sure to use a medical grade set that can be cleaned appropriately. Note: This does not include the so-called vaginal or yoni jade eggs, which were never designed for vaginal or pelvic floor use.

If you are doing Kegel exercises and are not making progress, weights are unlikely to be the answer. It can be hard for many women to do Kegel exercises correctly and some women may even have muscles tears that prevent them from doing the exercises appropriately. I recommend finding a doctor who understands the pelvic floor as well as incontinence and pelvic organ prolapse (typically a urogynecologist), as well as a physical therapist who specializes in pelvic floor disorders.

Dr. Jen Gunter, often called Twitter’s resident gynecologist, is teaming up with our editors to answer your questions about all things women’s health. From what’s normal for your anatomy to healthy sex and clearing up the truth behind strange wellness claims, Dr. Gunter, who also writes a column called The Cycle, promises to handle your questions with respect, forthrightness and honesty.

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