
Have you been keeping the right muscles strong? I mean, we all know that for good health and fitness we need to work out to keep our muscles healthy and strong.
BUT, today’s Thin Thinking guest will argue there is a set of muscles that we are not working out and boy–life gets better when we do!
Ever used a kegel?
It is a very specific movement designed to strengthen your pelvic floor and can help improve different aspects down there, especially if you are experiencing sneeze pee, bladder prolapse, and if you are having challenges in the boudoir.
During the 86th Episode of Thin Thinking today, we are joined by The Kegel Queen, Alyce Adams, and she will share how kegel exercises helped her and 3011 other women who suffered with vaginal prolapse and urinary incontinence regain being in charge of this very important part of their body.
Also I will be Alyce’s guest this Sunday on her weekly Livestream in her Hot Healthy 50+ Facebook group. We will be discussing how to AVOID Emotional Eating Over the Holidays.
So join us! At 5pm PT November 6th. Save the link below and mark your calendar. I will also be sending out notifications.
In This Episode, You’ll Learn:
What Kegel really is
How Can Kegel exercise be therapeutically effective
How you can manage prolapse and regain health and happiness with this important part of your body
Links Mentioned in this Episode
If you’ve ever leaked when you sneeze—or felt that heavy “something’s not quite right down there” sensation—this is for you. Kegel exercises for prolapse and incontinence sound simple, but most women were never taught how to do them in a way that actually works.
In this Thin Thinking Podcast episode, I (Rita Black) talk with Alyce Adams—known as the “Kegel Queen”—who’s helped women worldwide improve pelvic floor symptoms and avoid rushing into risky, complicated surgeries. Alyce explains what a kegel really is (hint: it’s not just squeezing), why menopause changes pelvic support, and why the “I’m doing kegels right now” party joke is usually a sign you’re not doing them correctly.
You’ll also hear a powerful reframe: the goal isn’t to “fix” your body with one magic trick. It’s to build optimized pelvic floor function—strength and flexibility—so you can live your life without fear of leaks, discomfort, or losing confidence in your own body.
Let’s break it down in a way that’s practical, clear, and easy to come back to.
What exactly are kegel exercises (and what is the pelvic floor)?
A kegel is a specific, intentional contraction and relaxation of the pelvic floor muscles—not a random squeeze.
Alyce describes the pelvic floor as a “bowl of muscle” spanning from your pubic bone to your tailbone, with support across the sides as well. That muscle system helps support pelvic organs (like the bladder, uterus, rectum) and influences urinary control, sensation, and comfort.
Here’s the part most people miss: kegels are not just about tightening. A healthy pelvic floor is strong, firm, and supple—not clenched. Alyce makes a key point that applies to every muscle in your body: you wouldn’t want your jaw locked all day, and you don’t want your pelvic floor locked all day either.
That’s why a real kegel practice includes:
- A clear contraction
- A complete relaxation
- Control you can repeat consistently
- Technique that matches your goal (support, symptoms, function)
And yes—this is why “I’m doing them right now while we talk” is usually a clue that technique and focus are missing. As Alyce jokes: if you can carry on a full conversation while doing kegels, you’re probably not doing them in a therapeutically effective way.
How do you do kegels correctly so they actually work?
For kegels to be effective, they need full attention, correct mechanics, and consistent practice—not multitasking.
One of the most important messages from Alyce is that most mainstream kegel instructions are vague. A sentence here, a paragraph there. But the pelvic floor is nuanced—and if you’re trying to change symptoms (like leaking or prolapse discomfort), “kind of squeezing sometimes” won’t reliably get you there.
Alyce explains that doing kegels correctly includes details many women never learn, such as:
- Breathing
- Positioning
- Timing and pacing
- The balance of contraction and full release
- Habit-building so you actually keep doing them
She also notes a reality that’s incredibly validating: some women can connect to these muscles easily, and others need time to build the brain-to-pelvic-floor connection. For some, it’s immediate. For others, it’s a process.
If you’re struggling to “find” the muscles, don’t interpret that as failure. Interpret it as: your brain-body connection needs training, like anything else.
A practical mindset shift (especially if you’re hard on yourself):
You’re not “bad at kegels.” You’re learning a motor skill most women were never taught—because, as Alyce says, we’re trained from diapers to disconnect from this area.
Can kegel exercises help prolapse and urinary incontinence?
Kegel exercises can improve prolapse and incontinence symptoms, but results are usually about meaningful improvement—not a guaranteed “total cure.”
Let’s talk real outcomes.
Alyce shares her personal turning point after pregnancy: she had “sneeze pee,” bladder prolapse symptoms (that heavy, saggy, “gotta pee” sensation), and sex that felt mediocre instead of confident and connected. After studying the research and practicing a structured program, she experienced major changes: leaks stopped, sensations improved, and sex became “way, way, way better.”
So do kegels help? Often, yes—when they’re done correctly and consistently.
But Alyce also offers a crucial reframe for prolapse: many women ask, “Can I avoid surgery?” She calls that the wrong question—because technically, you can always avoid surgery by simply not having it. The real question is more like:
- Can my symptoms improve without surgery?
- Can I live actively and comfortably with this?
- What combination of supports will help me most?
That’s where kegels come in as one important layer. For many women, benefits may include:
- Less leaking with sneezing, coughing, exercise (stress urinary incontinence)
- Reduced heaviness or bulging sensation
- Better pelvic support over time
- Improved circulation and sensation (which can support sexual function)
- More confidence and “ownership” of your body
And Alyce is honest: there are outliers. Some women improve dramatically. Some improve modestly. Some don’t see the change they hoped for. That’s why the goal is a multi-layer plan, not a single trick.
Important note: this is educational content, not medical advice. If you have severe symptoms, pain, bleeding, or sudden changes, see a qualified clinician (often a urogynecologist or pelvic floor PT).
How does menopause affect prolapse and pelvic floor health?
Menopause can increase prolapse risk because connective tissue becomes more brittle—similar to how skin becomes less bouncy over time.
This section matters because it explains why symptoms can show up even if you never gave birth vaginally.
Alyce explains that menopause affects connective tissue especially—ligaments and supportive structures that help keep pelvic organs in place. As estrogen declines and tissues change, the body’s ability to “bounce back” from pressure and strain can decrease.
That means:
- Pelvic organ prolapse can become more likely after menopause
- Support changes can happen even in women who have not had children
- The same physical stress that felt manageable at 20 may feel different at 60
The hopeful piece: Alyce emphasizes that overall health habits still matter—sleep, movement, strength, and nutrition all support tissue function and resilience. She also points to a specific benefit of pelvic floor strengthening: improved circulation. With better muscle tone and blood flow, you’re supporting genital tissue health and function 24/7—not just during a “set” of exercises.
And she adds a strong caution about certain strain-heavy patterns (like chronic pressure from coughing, vomiting, and poorly managed mechanics during exertion). The pelvic floor isn’t fragile—but it does respond to repeated downward pressure.
What is a pessary, and when does it make sense?
A pessary is a silicone device worn inside the vagina to help support organs that have dropped out of position.
In simple terms: it’s a support tool. Alyce describes it as something that can hold up pelvic organs and reduce symptoms—especially during activity.
A pessary may be worth discussing with a clinician if:
- You feel heaviness or bulging that limits movement
- You want a non-surgical way to improve daily comfort
- You’re building pelvic floor strength but want support in the meantime
Many women use it as part of a layered plan:
- Pelvic floor strengthening (correct technique)
- Body mechanics and alignment support
- Symptom management tools like a pessary
- Medical oversight when needed
If you’ve never heard of a pessary, you’re not alone—this is one of those “why does nobody talk about this?” topics. Which brings us to the next section.
Are prolapse surgeries effective, and why do some fail?
Pelvic organ prolapse surgeries can have significant complication and failure rates, so decisions should be careful, informed, and individualized.
In the conversation, Alyce shares a striking statistic: in the U.S., the risk of having surgery for prolapse or incontinence by age 80 is about 1 in 5—and yet it’s rarely discussed openly.
She also shares an insight from a gynecologist friend: there are many different surgical techniques, and when a condition has a huge menu of procedures, it can be a clue that no single approach is a perfect solution for everyone.
Key takeaways from Alyce’s perspective:
- If surgery is on the table, consider seeing a urogynecologist (a specialist in pelvic floor disorders)
- Ask about options that preserve support when possible
- Be cautious about “one-and-done” thinking—both surgical and nonsurgical paths may require ongoing management
This isn’t anti-surgery. It’s pro-informed-consent.
The goal is not to be scared into doing nothing. The goal is to make a decision from power, not panic.
Should you use kegel devices or avoid them?
If you’re leaking or dealing with prolapse, the worst first step is often buying a kegel device before learning correct technique.
Alyce is very direct here: don’t rush out and buy a device as your first move. Her reasoning is practical:
- Many devices don’t teach proper technique
- Some may be ineffective for your real issue
- Many people abandon them quickly because they don’t fit real life
- Without skill + consistency, tools don’t solve the root problem
If you’re tempted by a device because you want certainty (“Am I doing this right?”), that desire makes sense. But Alyce’s approach is to build the skill first—then decide what supports are truly useful.
A smarter “first investment” is education + a structured plan, especially if you’re trying to change symptoms (not just check a box).
What’s the best “first step” if you have prolapse or leaks?
The most powerful first step is reclaiming ownership: you are in charge of your body and your health decisions—even in a doctor’s office.
Alyce closes with something bigger than kegels. She talks about self-leadership. That moment where you say:
“This scares me, but I’m going to show up for myself.”
Because pelvic floor issues can create a quiet kind of fear:
- Fear of leaks in public
- Fear of exercise
- Fear of intimacy changing
- Fear that your body is “broken”
This episode flips the script. You’re not broken. You’re in a body that responds to training, support, and informed choices.
If you want a simple, practical first-step checklist:
- Start by learning what a kegel actually is (contract + relax)
- Don’t multitask your practice—give it focus
- Consider a pelvic floor PT or urogynecologist if symptoms are significant
- Explore layered support (like a pessary) if you need daily comfort now
- Avoid impulse-buying devices as your first move
And above all: choose your next step from power.
For a broader conversation about caring for your body with confidence and intention—especially when navigating physical changes—listen to Episode 124 — Essential Self-Care with Dr. Z, which reinforces the self-leadership mindset behind informed pelvic health decisions.
FAQ
Do kegels help with prolapse?
They can. Many women experience symptom证明 improvement—less heaviness, better support, and improved comfort—especially when kegels are done correctly and consistently.
How do I know if I’m doing kegels correctly?
If you can easily multitask or chat through them, you may not be using the right technique. Effective therapeutic kegels require focused contraction and full relaxation, with correct breathing and timing.
Can menopause cause prolapse even if I didn’t have kids?
Yes. Menopause can affect connective tissue and support structures, which can increase prolapse risk even without childbirth.
What is “sneeze pee” and why does it happen?
“Sneeze pee” is often stress urinary incontinence—leaking caused by pressure (like sneezing or coughing) that the pelvic floor can’t fully counter yet.
What is a pessary?
A pessary is a silicone device worn in the vagina to help support pelvic organs that have shifted downward. It can reduce symptoms and help you stay active.
Are prolapse surgeries guaranteed to work?
No. Surgeries can help some people, but outcomes vary and some procedures have complication or failure risks. A urogynecologist is often the best specialist to consult.
Should I buy a kegel device?
Not as your first step. Learning correct technique and building consistency tends to be a better starting point than buying a device impulsively.
Conclusion
Kegel exercises for prolapse and incontinence aren’t about quick fixes or awkward “squeezing whenever you remember.” They’re about building an optimized pelvic floor—strong, functional, and flexible—so your body feels supported and your life feels bigger again.
This episode’s biggest message is empowering: you don’t have to accept leaking, discomfort, or losing confidence as “just what happens.” You can learn what works, layer the right supports, and make decisions from clarity instead of fear.
If you found this episode helpful, you might also enjoy this related Thin Thinking episode: