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Female Sexuality and Cancer

Pelvic Floor Physiotherapy

Pelvic Floor Exercises after Cancer Surgery or Treatment

  • The pelvic floor muscles are in the pelvis and they support the internal organs. These muscles control the opening to the vagina, the anus, and when you pass urine. Women can learn pelvic floor exercises to control the muscles to relax the pelvic floor during vaginal penetration.
  • These exercises to strengthen the pelvic floor muscles are recommended after childbirth, for women who have problems with leaking urine, or for women with tight pelvic floor muscles.
  • Once you know how to tighten these muscles, you can feel the difference between tensing the muscles and relaxing them. Then you can practice relaxing the muscles. Notice the squeezing motion you can use to stop the flow of urine. Try to do this same squeeze when you aren’t passing urine (e.g., sitting or lying comfortably). Can you feel a tensing at the opening of you​r vagina? Even after the uterus is removed (hysterectomy) or other pelvic surgery, most women can still control the pelvic floor muscles.
  • Sometimes the pelvic floor isn’t tight enough, which can cause leaking urine (incontinence). If this is a problem for you, practice the tightening part of the exercises below to strengthen these muscles.
  • Sometimes, the pelvic floor may be too tight, which may cause pain during sex. If this is a problem for you, practice the relaxing part of the exercises below.
  • If you aren’t sure how to do the exercises below or have questions, see a pelvic floor physical therapist.

How do I do pelvic floor exercises?

To find the pelvic floor muscles, follow the instructions below. The muscles for this exercise only surround the other 1 or 2 inches of the vagina. You can’t control the deeper part of the vagina. To check if you’re tensing the right muscle, follow these instructions:

  1. ​Get some lubricant. Lie on your back with your knees up and apart, or sit against pillows with your knees bent and open.
  2. ​Put some lubricant on your fingertip (or you can use a tampon and applicator). Put it at the opening of the vagina. Use a mirror to see if you’re in the right place.

  3. ​Use your hands to gently spread the inner lips (labia) apart.

  4. ​Try to squeeze the vagina and then let it go loose. When the muscles are relaxed, slip the lubricated fingertip or tampon in the vagina. Hold it there and try to squeeze again. You should feel your vagina move a little when you gently squeeze the finger or tampon. Squeeze for 3 seconds and then relax as loosely as you can. You may even feel a gentle push as you fully relax the muscles. If you have vaginal pain or tightness, the important part of this exercise is this ‘push’ or full relaxation of the muscles.

  5. Do 10 in a row every time. It only takes a few minutes and practicing can help you learn to feel the difference between tensing and relaxing.​​​

Once you’ve found these muscles and can hold and relax them, practice the exercises every day. Really focus on relaxing the muscles. Once you feel comfortable doing the exercise, you don’t need to keep inserting your finger or the applicator. You can do the exercises in the shower, while you watch TV, or during lunch. Do them 2 times a day and make them part of your daily routine.

Some clinicians and researchers believe that these exercises make the pelvic floor muscles stronger. Stronger muscles may help a woman reach orgasm more easily. They make sex better by making you more aware of good feelings in the vagina. This may also help women with low sexual desire to be more aware of the sensations in the pelvic floor and genital area. If you’re able to have full penetration without tightness or pain, you might want to try tightening and relaxing the pelvic floor muscles during intercourse.​

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