A Woman’s Guide to Urinary Incontinence

by Chloe Jeffreys · 61 comments

in Favorites, Your Vagina and You

 

Female Urinary IncontinenceThe first time I wet my pants was right after my son was born. Those ten pounds of bouncing baby boy passing through my tiny lady parts left me joyful, exhausted, and occasionally incontinent of urine. (You can find my son’s birth story here.)

Fortunately, I was young and healthy, and I healed.

Mostly.

As I traveled through my 30s and early 40s my urinary incontinence wasn’t too bad. As long as I didn’t let my bladder get overfull, laugh too hard, or sneeze too suddenly, over ever, ever ever jump up and down or run, I was mostly okay. But as I neared 50 I noticed I was losing it, literally, more and more often. I began wondering if adult diapers were going to become a necessary accessory.

Urinary Incontinence is NOT Sexy

I don’t care what their ads say, no pair of jeans looks good over a big, bulky pair of Depends®.

Fashion considerations aside, urinary incontinence is emotionally distressing. Who wants to be felt-up by their lover while wearing adult diapers? Not this girl. Not to mention that it is very inconvenient when your life revolves around peeing. Every outing spent constantly worrying about when you’ll have to pee next, where you’ll be able to pee, and how to keep from peeing on yourself in between finding the next place to pee.

If you are a woman who suffers from any or all of the above, take heart.

YOU ARE NOT ALONE

Tons of us ladies have urinary incontinence problems. So much so, that the care and treatment of female  urinary incontinence is a billion dollar industry in the US. Here’s a good article that your tax dollars have paid for: Urinary Incontinence Fact Sheet

What You Need to Know About Female Urinary Incontinence

There are several types of incontinence, but the two primary types of incontinence that I’m talking about today are:

1. Stress incontinence — leakage happens with coughing, sneezing, exercising, laughing, lifting heavy things, and other movements that put pressure on the bladder. It is the most common type of incontinence.

2. Urge incontinence — this is sometimes called “overactive bladder.” Leakage usually happens after a strong, sudden urge to urinate. The sudden urge may occur when you don’t expect it, such as during sleep, after drinking water, or when you hear or touch running water.

If you are really unlucky, you get some combination of both called,

3. Mixed incontinence — two or more types of incontinence together, most often stress and urge incontinence.

My Story

When I first addressed urinary incontinence on my blog in 2009, I was suffering from stress incontinence, but I could feel the cold clammy hand of urge incontinence pressing down on my bladder. This really was bothering me and I’d already seen two doctors to discuss the possibility of surgery. Fortunately, our trip to Rome intervened. Rome is a magnificent city.  The Italians really know how to live. Everything is better there; the food, the view, the architecture, everything. Everything that is,

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EXCEPT THE BATHROOMS

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Rome doesn’t have free public restrooms like the US (it costs a Euro or two to use a public bathroom), and modern bathrooms are an afterthought–so what restrooms they do have are not easily located.

Also, there is apparently a serious shortage of toilet seats in Rome, but that’s a separate problem. First you have to find the bathroom before you can decide if you can afford the luxury of turning your nose up at it.

Our daily walking tours in Rome became centered around me finding a bathroom. Once I would locate a relatively clean one, I would try to keep myself oriented towards the location of that bathroom like a female urinary incontinence compass needle always pointing towards a toilet.

This didn’t always work very well considering we were walking 5-10 miles a day and kept getting lost.

I did two things to cope, one good and one bad.

The bad thing: I didn’t drink much water. I felt dehydrated much of the time, and I was very fortunate that I didn’t pay the ultimate price by getting a urinary tract infection abroad.

But the good thing? I kegeled.

And I kegeled.

Due to necessity and vanity (who wants to walk around Europe peeing their pants or wearing incontinence pads?), I was forced into day-long kegeling marathons while we were traipsing around Rome. And guess what? I started to see an improvement. After a week of walking 5+ miles every day, all while kegeling my little vagina out, I wasn’t having any leaking at all, and I was able to hold it a lot longer.

Kegels work.

But before you kegel you need to know:

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Not all kegels are equal.

Nearly a third of women kegel with the wrong muscles.

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Done incorrectly, you can actually make your incontinence worse. We don’t want that! Isolating the correct muscle, called the perineal muscle, and then doing the exercise correctly is the key to getting the best results.

 

Learning to Kegel

The best way to find the muscle is to put your finger in your vagina and squeeze your finger. Try to keep all your other muscles relaxed. Do not bear down, and do not squeeze your thighs. Focus on squeezing your finger with just your vagina like a Chinese finger puzzle.

Now that you’ve found your perineal muscle, how should you strengthen it?

Once you’ve isolated the correct muscle, the best self-exercise for strengthening it is called The Elevator.

In this exercise, you imagine your vaginal vault like an elevator. When the vagina is totally relaxed it is at ” The Ground Floor”, and squeezed as tight as you can is “The Penthouse”. When I started doing this exercise, the movement for me was more like a spasmodic fluttering than a controlled, sustained, upward movement, but with practice, this muscle, like any other, will get stronger and stronger and eventually I was able to contract it with intention and control, and hold it at the top for sustained periods of time.

The Elevator Kegel

  1. Start the exercise either in either a sitting or lying down position.

  2. With the muscle completely relaxed, start squeezing slowly for a count of 5-10 as you raise the elevator to The Penthouse. (There are rapid-fire muscle cells in the vagina, but we’re trying to improve the over-all tone which means we’re going to focus on slow, sustained movements here.)

  3.  Once you’ve reached the Penthouse: Do not just let go at this point!  Hold it there for the count of 5-10. This will take time and practice.

  4. Then try to slowly bring the elevator back down to ground floor over another 5-10 counts.

The Elevator takes time and practice to do well, but the slower you do the exercise and the more control you exert, the stronger the muscle will get. I try do 3 sets of 10 two or three times a day. As I said, I had to work up to this over several weeks before I could do it well with control.

Kegel Time

To make kegeling a habit, I put kegeling triggers in my day. You can use traffic lights, commercials, brushing and flossing your teeth, washing dishes, opening the refrigerator, anything. Just find something you do regularly every day and kegel during that time.

What about Surgery?

Vaginal repair surgery is one of the most common medical procedures done today. But how effective is it?

Choosing surgery is a serious decision with potential serious lifelong consequences. Several studies show mixed results with many women reporting excellent results and other women finding that not only is their incontinence not cured, but they have additional sexual function problems. And many women find they need to have the surgery repeated 10 years or so all over again as the organs continue to prolapse due to gravity.

And realize this: Surgery can repair damaged tissues, but surgery will NOT restore weak and lax muscle tone. Therefore, if you are considering any vaginal repair surgeries I strongly suggest that you seek out a Physical Therapist who specializes in Pelvic Floor Rehabilitation.

Physical Therapy? Really?

Yes, there really is such a thing as pelvic floor physical therapy. I did it for a year before I ultimately decided to have surgery. I am so glad I did. Your doctor should be able to give you a referral to a physical therapist trained in the treatment of pelvic floor dysfunction (PFD).

Choosing a Surgeon for your Vaginal Vault Repair

I cannot say this often enough:

DO NOT HAVE JUST ANYONE PERFORM VAGINAL REPAIR SURGERY ON YOU!!!

The lovely guy or gal who delivered your baby is NOT the person you want performing your vaginal/bladder repair surgery. The specialist you need to perform your vaginal vault repair or bladder surgery is called a Urogynecologist. A Urogynecologist is an OB/GYN with an additional three year Fellowship in Female Pelvic Medicine and Reconstructive Surgery. These surgeons are the experts. Your vagina and you deserve less than the best.

If you have any private questions you’d like to ask me about this important issue for yourself or a loved one, feel free to email me at chloe@chloejeffreys dot com.

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{ 48 comments… read them below or add one }

Apogium May 16, 2017 at 4:46 am

A very frank and open post about an embarrassing yet quite common problem that many women (and a lot of men) suffer from.

Pelvic Floor (Kegel) Exercises will certainly help but may not completely eradicate and so quite often a visit to your Dr is the only solution.

Don’t be embarrassed further by this he \ she will have encountered these issues many times and there is so much help now available.

Don’t suffer in silence, get you life back on track!

Thanks again, useful resource!

Apogium

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McKenzie May 11, 2017 at 2:37 pm

This is a great post. Thanks for sharing this information so openly! It is great that you had some success!

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McKenzie January 10, 2017 at 2:33 pm

Urinary incontinence is so common. Thank you for sharing this information, and thank you for sharing your story! Hope everything is going good for you!

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Julie December 13, 2016 at 2:41 pm

Thank you for this post. I wanted to get surgery but its too expensive for me and frankly I’m afraid. I tried kegal exercises in the past but didn’t help me enough. A few months ago I ran into my ex-husband while purchasing period pads at Walgreens and I was very embarrassed, to say the least, because I had already gone through menopause years ago. So I found a site that helped me find products that were much better than what I was purchasing at the store.

They asked me a few questions and within about a day they had an incontinence package for me. It was very easy to do and now I get them sent to my house every month. I get incontinence pads, which are made to absorb pee (not blood like period pads) and wipes. I didn’t know there was such a thing as incontinence bladder pads. Also , it saves me an embarrassing trip to Walgreens.

The company is http://www.care.club if you need help finding a good product for you they can help.

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Cindy Santa Cruz May 21, 2016 at 8:45 am

Bladder leaks and urges are way to common. The Lady Patch has really helped me and it’s drug free. You should check out their website, www,theladypatch.com.

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Ian November 29, 2015 at 6:12 pm

Very informative. Thanks.

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LB August 17, 2015 at 12:41 pm

Hi,

Interesting post. I have always hated kegels. My, ahem, leaking always seems to get worse when I begin a regular kegel routine. You mention that many people do them wrong. Could you elaborate as to what we’re doing when we’re doing them incorrectly? I thought I was doing them per your instructions, but I seem to be backtracking.

Thanks!

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punit gupta October 30, 2014 at 2:46 am

How to strengthen Pelvic Floor muscles of women? – Do you know that weighted balls is been resulted as a good alternative for training pelvic floor muscles in women through stress urinary incontinence

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good income October 9, 2014 at 6:17 pm

Thanks for sharing your thoughts about kegel.

Regards
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Marylyn September 12, 2014 at 2:28 pm

Its like you read my mind! You appear to know soo much about this, like you
wrote the book in it oor something. I think that you can do with some picfs to drive tthe message home a little
bit, but other thann that, thiss is magnificent blog. A fantastic read.
I’ll certainly be back.
Marylyn recently posted..MarylynMy Profile

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Frederick Springer July 18, 2014 at 12:12 pm

Hello Chloe,
I am with the DR. PHIL Show, and looking for Women (40-60) with Bladder control issues to come on the Show. Your blog re: Urinary Incontinence is extremely informative, and I am hoping will help find our Guest! We’ll be talking about the effects of aging, and how bladder sensitivity increases as one ages and a couple tips on how to help it.

Please send me an email if interested.

Thank you!

Frederick

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Stacy June 15, 2014 at 1:25 am

Doing Kegels is certainly one of the best ways to manage urinary incontinence, naturally. Stay positive and you will see results around 2 to 3 months, and finally say goodbye to adult diapers and pads!

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Chloe Jeffreys June 15, 2014 at 8:31 pm

I’m pretty sure you’re a spammer who didn’t even read my article, but I’m feeling magnanimous today so I’ll let your little link stay. But Kegels WILL NOT work if you have a cystocele or rectocele any more than sit-ups will cure a man’s hernia.

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Sandra Kane February 11, 2014 at 9:40 am

Thank you for writing this blog! Most blogs I read about this bash Any type of surgeries for vaginas even if they are not for aesthetic reasons. After having three children I suffered from urinary incontinence and I was not getting any relief from any exercises that I was doing. I did a lot of research and came across Laser Vaginal Rejuvenation Institute of Los Angles. The doctors there were absolutely amazing and I am very pleased with my results! I no longer have any issues and I would recommend this Institute to everybody!

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Stacey McCurry December 11, 2013 at 2:46 am

Thank you for the information. I have been doing my kegels incorrectly. I am perimenopause and am running to the bathroom and sometimes I don’t make it. But I find that there is leakage and sometimes I can tell and sometimes I can’t. It is frustrating and embarrassing. Finding out how to do kegels right is sure cheaper and healthier than surgeryif you can avoid it. Not everyone is so lucky. I’m crossing my fingers. Thanks again! And God bless!

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Charles Runels August 26, 2013 at 12:19 am

There’s a new and safer way to achieve the same results as Coaptite. Using blood-derived growth factors to treat stress incontinence avoids the risk of granuloma formation.

You can find out more by going to the following website: http://OShot.info/members/stress

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Julie Turner July 4, 2013 at 12:04 am

I am very glad with what you have shared here regarding urinary stress incontinence in women. I find your blog helpful not only to me but also many people out there who suffers from urinary abnormalities!
Julie Turner recently posted..Overactive Bladder: Causes, Symptoms and TreatmentMy Profile

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Craig June 8, 2013 at 1:13 pm

Very informative and helpful, thanks.

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Dr. Charles Runels December 27, 2012 at 12:56 am

There’s a procedure called o-shot that can treat stress incontinence and has been very effective. This uses blood derived growth factors to give healthier vaginal tissue by stimulating uni-potent stem cells. Watch the procedure at http://oshot.info

Charles Runels, MD

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Chloe Jeffreys January 5, 2013 at 1:24 pm

Dear Dr. Runels, I’m fascinated by your procedure. Thanks for stopping by and commenting.

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The Bearded Iris September 28, 2012 at 2:26 pm

Okay, yep. It’s official. We’re friends.

You are the first other person I’ve ever met who knows THE ELEVATOR Kegel! I love that move.

Seriously, how have we not crossed paths before now?!
The Bearded Iris recently posted..Does a Kegel a day keep the transvaginal mesh away?My Profile

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Cathy December 5, 2011 at 3:09 pm

I so agree with going to a urogyn specialist. It took me six years and two surgeries, before I knew I needed someone whose whole focus is on female problems. My urogyn spent a lot of time explaining everything I had going on and all of the treatment options. I went into my surgery confident in his ability to help me. It has been worth it to drive 2 hrs one way just to see him and then again to have my surgery. A skilled knowledgeable surgeon makes all the difference.

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Chloe December 5, 2011 at 5:34 pm

If nothing else, I hope talking about this will encourage women to seek specialists in female pelvic repair surgeries and not leave this up to just your generic OB/GYN.

I work with OB/GYNs and many of them are great, but to trust them with vaginal reconstruction? No way! There is too much at stake.

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Margaret December 5, 2011 at 5:03 am

“Look for a surgeon with a Fellowship in Female Pelvic Medicine and Reconstructive Surgery or Urogynecology and Pelvic Surgery.” This. It can not be emphasized enough. I’ve had 2 surgeries. One by your average Joe Gyno, one by a (female) Reconstructive Urogyn. The difference from the first appointment to the final “all clear” was astounding. Your urinary, rectal, and sexual health are all worth finding a specialist who knows what they are doing.

And always always always go the physical therapy/exercise route first. Long before ever considering surgery.

Thanks again, Chloe.

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Chloe December 5, 2011 at 11:49 am

This cannot be stressed enough, can it?

I am so happy with the doctor I’ve found. He’s the doctor who did my regular OB/GYN’s pelvic reconstruction. An OB/GYN with a Fellowship in Female Pelvic Medicine and Recontructive Surgery spends 2-3 YEARS–that’s after medical school and becoming an OB/GYN–specifically studying pelvic reconstruction.

Readers, listen to me and Margaret! You do not want just any ole doctor performing these sorts of surgeries on you.

I had to wait a coon’s age to get in to see this doctor, but he spent a lot of time with me once I was there. This is the fourth opinion I’ve gotten, and I do trust that he’ll do his level best.

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Liza Lee December 3, 2011 at 4:42 pm

I can’t believe I missed this one the first time around! The first time I peed myself was when I was pregnant with my fourth child. And losing my lunch due to “morning” sickness. It was not my finest moment. Fortunately, I have excellent muscle control and it has not been an on-going problem. 🙂

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Chloe December 3, 2011 at 7:31 pm

I have not had urinary incontinence in 2.5 years, but along with my other problems I’m having to revisit this issue.

Sometimes I don’t enjoy being a girl.
Chloe recently posted..A Woman’s Guide to Urinary IncontinenceMy Profile

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Chloe December 5, 2011 at 11:58 am

I also apparently have excellent muscle control that has been masking the real deal going on inside. The Urogynecologist I saw was amazed I don’t have leaking because of how significant my bladder prolapse is. Kegeling is important which is why I recommend anyone see a physical therapist who specializes in pelvic rehabilitation before surgery. This is so important.

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Cheri Rogers December 3, 2011 at 3:25 pm

Hey lady,

Thanks for this post. I am slightly mortified at the end result of my sneezing or jumping on the trampoline. I cannot even believe that I am owing up to having this issue.

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Chloe December 3, 2011 at 7:29 pm

You are not alone. Many women suffer from this. It is embarrassing, but most of us got this from having babies. There really isn’t anything we should be ashamed about, is there?
Chloe recently posted..A Woman’s Guide to Urinary IncontinenceMy Profile

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Aimee December 3, 2011 at 2:58 pm

…like a Chinese finger puzzle!!!!

Thanks for the helpful info and the peals of extremely juvenile laughter pouring from my mouth.
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Chloe December 3, 2011 at 7:29 pm

I was trying to think of something descriptive. That’s the best I could come up with. It sure gives a visual and a tactile, doesn’t it?
Chloe recently posted..A Woman’s Guide to Urinary IncontinenceMy Profile

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Anne (@notasupermom) December 3, 2011 at 2:29 pm

I’m Kegeling right now!
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Maddie Kertay December 3, 2011 at 2:26 pm

Tinkle tinkle little star.. how I wonder… oh.. wrong song… Have you tried Betty Dodsons’s kegel barbell?.. also a bit hard to use while tidying up the house.. but very pretty! http://www.goodvibes.com/display_product.jhtml?id=1-3-BF-0102 and otherwise useful!

Maddie
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Anonymous May 1, 2010 at 2:42 am

>Chloe,You are such a crack up. I laughed so hard after the "ten pounds of baby flesh" comment I almost peed my pants! But…I have been doing some Kegels since little man shot out and did them while reading the whole Kegel section of your blog. It's really good info. And so honest.I had a professor in school, a theology professor, who said, "Sex is holy….it brings husband and wife together and 9 months later you've got to give it a name." There was more to his teaching but at 0245 I can't really remember (and that was 17 odd years ago) :).T-

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Desiree November 11, 2009 at 4:05 pm

>Thank you for your informative post! -heartofjoy

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Karen (KayKay) October 7, 2009 at 2:57 pm

>Great post, Chloe. Tons of good information and you made it so clear and understandable.

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Magnolia October 7, 2009 at 2:09 pm

>I'm not a fan of kegels. Could be because I hate excercise in general and it's just the worst form of torture for me trying to locate just the right muscle group "down there" to be effective.Forgive me for not reading your post word for word, but I guess I didn't expect to learn anything new about an excercise I hate. ;)I did want to mention though that hormonal fluctuations during perimenopause can also contribute to the dreaded incontinence and frequent trips to the bathroom at night.When you are on the other side of perimenopause, things seem to improve in that arena. I no longer wake up at all to go to the bathroom at night when I used to wake up at least 2 to 3 times a night for years.Just thought you might be interested in that little ditty.the kegels certainly can't hurt, but I doubt I'll be doing them.

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Missus Wookie October 6, 2009 at 7:43 am

>One of my favourite mentors told me to start kegeling at a young age. Great article, thanks for writing it 🙂

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Quentin&Heather October 6, 2009 at 3:16 am

>Thanks for the info that doing a kegel the wrong way might make matters worse. I will definitely take the time to figure out how to get it right. And thanks for the info that you couldn't do this well, for long, at the beginning either. I've always thought "I can't hold this for 10 seconds?! What am I doing wrong???" Now I know; I was just giving up too soon. Thanks for the encouragement. -TexasHeather

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Anonymous October 5, 2009 at 9:36 pm

>Thanks so much for all this info, Chloe. I had just about become resigned to peeing myself and also blaming it on diabetic nerve stuff. I'm going to start doing this to see if I can at least slow down my descent to dodderton.Sharon in Wa

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Carletta October 5, 2009 at 9:17 pm

>Timely post considering I am in the 3rd trimester of my 4th pg and sneezing is something I avoid at all costs!

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Chloe October 5, 2009 at 9:04 pm

>The Kegel Master 2000 is a good piece of equipment, and I think it probably helps (even though it is quite over-priced even at the bargain I paid for it); I just can't figure out when to use it.

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Natalie October 5, 2009 at 7:51 pm

>I'd never knew such a thing as the Kegel Master existed either! I do think I'll take your advice to steer clear.Thanks for the tips and inspiration.

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Chloe October 5, 2009 at 6:32 pm

>See the lengths to which I'll go to help educate my readers?

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Robin October 5, 2009 at 5:46 pm

>WOW. Who knew there were such things as kegel masters and the like?Thanks for all the great information you put into this post C.

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Susan in the Boonies October 5, 2009 at 4:34 pm

>M.C. Hammer is hammering his groove into my brain. "Kegel Time! Nah nah nah nah. Nah. Nah. Can't touch this!"I feel inspired!!! Elevator up???

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John@ flotrol July 11, 2015 at 10:43 am

My friends always told me about kegel , I think that They right
Thanks for talking about it
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