Last updated: Mar 02, 2016
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Im at the front door, grocery bag on one hip, toddler on the other, fishing for my keys and thinking, “Im not going to make it.” The bathroom is a mere 6 feet away. Plunking my son and groceries on the floor, I run but cant unzip in time. And I cant help thinking: “Do we both need diapers?”


Two years after giving birth, I still cant control my bladder. Im one of 25 million Americans, the majority of them women, with incontinence. More than half of healthy women ages 42 to 50—Im 45—have some form of chronic-peeing problem, usually linked to pregnancy and childbirth, coughing, constipation, heavy lifting, or hormonal changes. Yet, incredibly, 90 percent of us never seek treatment.

I decide Ive got to do something. I dont seem to have any muscle tone in my pelvic floor, and my OB-GYN thinks Ill need surgery. When I ask about alternatives, she suggests physical therapy: my own personal Kegel trainer.

Ive known about, and done, Kegels for years—but not the right way, apparently. Arnold Kegel, a University of Southern California gynecologist, developed the exercise in the 1940s to help women with postpartum incontinence. Experts say a good Kegel program can reduce weekly incontinence episodes by 50 to 60%.

So, I figured, why not give therapy a try? And, like a woman on a mission at the gym, I decide to track my progress with a diary.


Month 1: Anatomy lesson
Im the only patient under 60 in the Urinary Incontinence and Pelvic Pain Clinic of the Alta Bates–Summit Medical Center in Berkeley, California. Am I in the right place?

“It sounds like you had a traumatic labor,” Esther, a certified physical therapist, says when I relate my 2-day back labor, hours of pushing, and near C-section. She assures me that she sees patients of all ages, not just the elderly. Using a plastic model of a female pelvis, she shows how the pelvic floor supports the reproductive, urinary, and digestive organs. But if this sling of muscles were on a beach, mine would be the one getting sand kicked in its face.

Thankfully, because I dont have a painful medical problem, Esther thinks strengthening my pelvic muscles can solve my incontinence. My insurance company apparently agrees, having authorized eight sessions. Esther does a pelvic exam to test my strength. She feels a little something when I squeeze. For homework, Im to do five 3-second Kegels twice a day. Real Kegels.

Esther shows me that I had been just clenching my thigh and butt muscles, not squeezing the ones that make up my pelvic floor. Ill work up to 30 per day with 10-second holds, she promises. Esther also asks me to track my fluid intake and urine out-put. I tell her that my son has just started potty training. “Good,” she says. “The two of you can train your bladders together.”

I see Esther twice the first week to make sure Im doing Kegels correctly. We talk about the best positions and techniques (like exhaling while on my back with pillows under my butt), my history, and my worries. Then I come back once a week, then every 2 weeks, and then every 3. Within a month, accidents are becoming few and far between.

Month 2: Re-education
Im amazed at how often I pee: 12 times a day. Normal is six to eight. To control this urge, I distract myself, breathe deeply, then walk casually to the bathroom. My goal: to gradually decrease bathroom visits from every hour to every 2, then 3. “Hey!” I tell my bladder. “Im in control now.”

Month 3: Going places
“Take your pelvic floor with you,” Esther reminds me. In other words, do Kegels whenever you can, and practice relaxation techniques to avoid accidents. Now I do a Kegel every time I lift my son.

Month 4: Benefits galore!
Ive been doing Kegels every day for months. The benefits? No accidents—and amazingly better sex. My orgasms are stronger, longer, and more intense. I tell Esther, but her reaction surprises me. “Orgasm is a great workout for the pelvic floor,” she says.

Wait. I thought it was the other way around: Pelvic-floor exercises give you great orgasms. Turns out thats true. But Esther just wants me to do any exercise that makes those muscles stronger—orgasm included. Hmm. Why didnt she say so at the beginning?

By our last session. Im no longer afraid of having an accident. “Just think,” Esther says, “youve learned a lot about a part of your anatomy that most women dont even consider.” Its true. For the rest of my life, Im taking my pelvic floor with me.