Vaginal video games: What to make of mobile Kegel apps

Vaginal video games: What to make of mobile Kegel apps

There are two new high-tech ways that aim to help you with Kegel exercises, both with Kickstarter campaigns. There is the Skea (Smart Kegel Exercise Aid), basically a video game that proposes controlling the avatar with a vaginal probe that uses the pelvic floor muscles and kGoal, a vaginal insert that is meant to connect wirelessly with your smart phone and measures your squeeze pressure and the number of reps etc. (kGoal has reached their funding, as of August 10, 2014 Skea has not).

I’ve been asked by numerous people what I think about these devices, so here goes.

Kegel exercises are a very low-tech no cost way to treat urinary incontinence. (Other low-tech  no-cost methods include bladder training, timed voiding, weight loss, and elimination of bladder irritants.) Many women also report stronger orgasms when keeping up with a Kegel regimen.

Kegel exercises strengthen the pelvic floor muscles, which are important not only for urinary control but are also the muscles that contract during orgasm. Squeezing the pelvic floor muscles also reflexly relaxes the bladder, so doing a quick set of Kegals (quick flicks) when you are dying to use the bathroom and it’s a block away can stop your bladder from contracting so get you to the restroom while you are still dry.

The basic way to Kegel is to contract your pelvic floor muscles for 3 seconds and then relax for 3 seconds. To practice isolating these muscles try it when you are peeing. The muscles that you use to stop your urine flow mid-stream are the right ones. Another cue is to pretend you are about to fart in public and you need to try your very best not to let it slip out. Stopping your urine flow or stopping gas both work the right muscles. Do this several times to get the hang of it and to remind your brain what the motion feels like. You should feel your vaginal muscles contract or squeeze, but your buttocks and belly shouldn’t move. If you can do this then you can Kegel without technology and it’s just a matter of doing 10 to 15 squeezes (reps) of 3 seconds 3 times a day. Need help remembering? You can set a reminder on your phone or just try to do them after brushing your teeth (that should get you twice a day) and at noon or incorporate them into your routine in the best way that works for you.

What if you can’t squeeze your pelvic floor in a way to stop your urine or gas or you can’t feel your vaginal muscles tighten? Try putting your finger in your vagina when you are squeezing. If you can feel the vaginal muscles tighten at all (and you aren’t moving your buttocks and/or belly) then you are doing it right, but are just not strong enough yet to feel it or to stop your urine flow. In this case a biofeedback tool (basically something that gives you feedback that you are doing it correctly) might be a helpful aid. The most low tech way is to use your finger, however there are low-tech devicesvaginal weights, and high-tech devices  that don’t require a smartphone. These new high-tech methods being promoted on Kickstarter are just a variation of what’s already available.

If you can’t feel your pelvic floor muscles contract with your finger or you haven’t made any progress after 4 to 6 weeks then you shouldn’t buy anything at all. In this situation it is probably best to see a pelvic floor physical therapist and get some professional help. In both these situations there is a real risk that you may be doing Kegals incorrectly (besides not treating your incontinence, using your pelvic floor muscles incorrectly can sometimes cause pelvic pain).  If your insurance covers physical therapy, then in my opinion this almost always the best way to start. Needing more than a few physical therapy visits for incontinence is uncommon. Even if you don’t have insurance, the cash price for a single in office consult from a great pelvic floor PT may be similar than the price of many of the high-tech home devices.

Personally, I would hold off spending too much money on home devices until consulting with an experienced physical therapist because they can figure out what you really need and can tell you from their experience what works at home and what doesn’t. Some people can benefit from a special kind of electrical stimulation to help the muscles and the therapist can do some tests in the office to help figure out what device and settings will work best for you.

If your incontinence hasn’t improved after two months of doing Kegal exercises on your own or after 3 physical therapy sessions then you should probably see a doctor for further evaluation.

What’s the verdict on the wireless device/video game concept? They’re just variations of what’s already available. Since very few devices are ever formally studied it’s really a matter of considering these 3 issues:

  1. Deciding if you want to try the no cost/no tech home approach first before you spend money on the problem.
  2. If you decide the no cost approach isn’t working, thinking about where you want to spend your money (physical therapist versus do-it-yourself equipment).
  3. Asking yourself if these high-tech devices (or really any medical device you are planning to purchase) will outlast their novelty phase. Many people have high-tech bathroom scales that measure body fat percentage or exercise bikes gathering dust. After all, no device will do the exercises for you.

What I can tell you from my long experience treating this issue is that most women do well without buying anything, it’s really the dedication to doing it that is a challenge (like every exercise regimen). However, if you aren’t getting anywhere with Kegels on your own it might be an idea to see a physical therapist (PT) and go from there. Many women who fail home Kegals do make progress with devices that give biofeedback and/or electrical stimulation and the PT can tell you which device might work best. Its possible down the road one of these devices might be on the recommended list, but without data (never mind handling the device) it’s hard to say any more. Also, if you aren’t well on your way after 2 to 3 visits with a pelvic floor PT seeing a urogynecologist (gynecologist who specializes in incontinence) may also be a good idea.

However, if the idea of playing video games with your vagina simply appeals to you, well, you don’t need to have incontinence to give it a try.

Jennifer Gunter is an obstetrician-gynecologist and author of The Preemie Primer. She blogs at her self-titled site, Dr. Jen Gunter.

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