Kegel v. Reverse Kegel

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    Hi all. Much has been written about the topic of Kegels. In the past, one member posted about a reverse kegel, writing:

    “I learned very specific things about my vaginismus from my physical therapist. One of the most important ones I learned was that I should absolutely not be doing kegels, but reverse kegels! My sex therapist had told me to do kegels, but my physical therapist told me that was very wrong, and to do reverse kegels. And man am I glad she told me to do that! They help so much! Doing a reverse kegel during dilator insertion makes it painless, and doing reverse kegels while holding in the dilator also helps take away any pain!”

    Do you guys recommend doing kegels or reverse kegels? What has worked for you?


    I’ve never heard of reverse kegel. How is that done?


    Hi Christine. This is a great question. I found an excellent post describing what it is and how to do it.

    “A reverse kegel is loosening those pelvic muscles. You know how most people will explain how to do a kegel for you by telling you it’s the muscle movement of stopping yourself from peeing, while you’re in the middle of peeing? My physical therapist told me that to do a reverse kegel, you make the muscle movement you would do as if you were about to make a bowel movement. The first time she had me try it, she made me hold up a hand mirror so that I could observe my genitals while I did it. When I did the reverse kegel (moved my muscles as if to make a bowel movement), I could see the area expand outward a little (loosening up).

    She told me to do reverse kegels instead of regular kegels because, as she explained it, “Your pelvic muscles are already chronically tightened up; the last thing you want to do is practice making them even tighter. Instead, you want to practice loosening them up.”


    Alright. I’m actually trying that now on my 4th dilator. I think it’s going to take a few times because the further I push it in, it burns. Is that how it worked for you?

    Dr. Pacik

    Both Kegels and reverse Kegels work to make dilation easier. Some women find that doing a series of 4-5 strong Kegels, holding the Kegel for a few seconds then completely releasing makes dilator insertion easier. Conversely, inserting a dilator when doing a strong Kegel (reverse Kegel) also works. It just depends on which approach makes dilation easier.
    Kegels are over-rated for achieving intercourse without using dilators first.
    I agree that using a vibrator can be very helpful in that it relaxes the pelvic floor. An orgasm in association with the use of a vibrator relaxes the pelvic floor even more. This was taught to me by my patients. Dr. Pacik


    This is so true Dr. P. I felt like each time I had an orgasm prior to dilating or while dilating or using a vibrator, it made it feel so much more comfortable. Hi Christine. I wanted to share another earlier post that Dr. P wrote regarding tips to fight discomfort with the dilators. I hope this helps so much.

    Specifically, he wrote:

    “Early in the process dilation may be uncomfortable and create soreness. Sometimes it starts off being comfortable and then it is hard to find a position that allows for pain free insertion. This may cause distress (because the dilation was going so well) but needn’t be because most women do experience discomfort with dilation at some time. Sometimes the lube dries up and extraction of the dilator is uncomfortable. By simply twisting the dilator first this loosens it so that it can be removed more comfortably. Most dilators are too long and it is important to avoid inserting the dilator so far that it hits the cervix which can create discomfort. This discomfort of hitting the cervix is also true for intercourse when the penis is too long. When using the Pure Romance dilators the pink #5 dilator needs to stick out about one inch and the blue #6 about two inches. For painful extraction, experiment with the different lubes including silicone lubes. The water based lube gets absorbed overnight and dries out. One may be sore from the dilation process because the vagina is not used to this new frequency and duration of using dilators. This gets better with time. It is OK to use ibuprofen or Tylenol at this time. The correct dose of ibuprofen is three 200mg tabs (over the counter) three times a day. This can be used for about a week if needed. If you find a position of comfort, this may be your position for transitioning to intercourse. One should therefore experiment with different positions including squatting for dilation and then intercourse. Most women with vaginismus have spasm involving the entry muscle. The higher muscles may be tight but usually not in spasm. Therefore once one gets past the entry muscle, about one inch (2.5cm), the dilator practically “falls in” and the rest of the dilation process becomes easy. It is also helpful to do a series of Kegels, with complete relaxation of the pelvis on the 5th Kegel, and then insert. Also the use of a vibrator has been shown to help relaxation when dilating. Always use lots of lube.”

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