59 minPelvic Floor Exercises for Women Over 40 and Menopause
With Kim Vopni
Guest on the show
Kim Vopni
Kim Vopni, known as the Vagina Coach, is a women's pelvic health expert and educator who has spent almost 19 years helping women prevent and overcome common pelvic floor challenges and created a certification course for fitness professionals.
Episodes with Kim Vopni
59 minWhat Kim talks about
Ep. 142: Pelvic Floor Exercises for Women Over 40 and Menopause
Leaking when you laugh, jump or lift is common. Kim Vopni, the Vagina Coach, says it is not something you have to accept for the rest of your life. In this conversation with Nikkiey Stott, Kim explains what the pelvic floor actually is: three layers of muscle responsible for sexual response, continence and organ support. She also covers why it is the foundation of your core and how it moves with your diaphragm every time you breathe.
Kim explains why Kegels work but most women do them wrong, usually by sucking in on the inhale when the pelvic floor should be lengthening. She walks through her ABC approach (alignment, breath, coordination) and shows how to pair the core breath with squats, lunges, bridges and bicep curls. She also explains why that pairing gets better results than resistance training or Kegels alone. She covers pregnancy and postpartum training, why six weeks is a green light for a pelvic floor physiotherapy assessment rather than a return to normal, and whether lifting heavy is really the problem.
For women in perimenopause and menopause, Kim shares her view that falling estrogen can bring on pelvic floor symptoms or make existing ones stronger. Symptoms she names include urgency, frequency, painful sex and more UTIs. That is why she wants you training your pelvic floor before there is a problem, and she says it is never too late to start.
- Kegels are effective for incontinence and prolapse, but most women do them incorrectly, so learn the right technique first and then do them consistently.
- Match your pelvic floor to your breath: as you inhale it lengthens and the belly expands, and as you exhale it contracts and lifts.
- Use Kim's ABC approach of alignment, breath and coordination, then apply progressive overload with more sets, reps and speed.
- In a squat, inhale as you lower, then exhale and engage your pelvic floor just before you stand, and later progress to exhaling as you stand.
- Pair voluntary pelvic floor activation with resistance training like squats, lunges, bridges and curls, because Kim says the research shows this works better than either alone.
In Kim's words
Common questions
Do Kegels actually work?
Kim says it is well established in the research that Kegels are an effective way to overcome pelvic floor dysfunction like prolapse and incontinence. Most people do them incorrectly, think they don't work and stop, so you need to do them correctly and consistently.
How do you do a Kegel correctly?
Kim explains that many women inhale while sucking up, but the pelvic floor naturally lengthens on the inhale and contracts and lifts on the exhale. She cues the contraction as picking up a blueberry with your vagina and anus, or sipping a smoothie through a straw with your vagina, done on the exhale.
Is strength training enough to keep your pelvic floor strong?
Kim says whole-body resistance training helps the pelvic floor somewhat, but not enough. Research comparing Kegels, resistance training and both showed exercise alone was not enough, so she recommends doing both together.
Why do pelvic floor symptoms get worse in menopause?
Kim explains that the tissues around the pelvis, vulva, vagina and bladder have estrogen receptors. When estrogen drops, symptoms can appear for the first time or become stronger, including urgency, frequency, painful sex and an increased risk of UTIs. She says over 80% of women will experience genitourinary syndrome of menopause and that it does not get better with time.
Is it too late to improve my pelvic floor?
Kim says it is never too late. She has a 92-year-old woman in her community who never had any pelvic floor education and has made changes to her incontinence and prolapse.
Is lifting heavy during pregnancy bad for your pelvic floor?
Kim says you can't make a blanket statement, because what looks heavy may be light for that person. In her view the issue is how someone manages intra-abdominal pressure, and chronic bearing down is the problem, whether it comes from a lift, constipation or chronic coughing.