The Need For Squeeze

Can Video Games Help Your Pelvic Floor? And your sex life?

When I think about people playing video games, my unfortunately biased mind does not primarily think about people who are having great sex. The cliche of young people, primarily men, spending hours and hours in front of a video game conjures images of solitary lives, getting stimulation and satisfaction from what’s going on on the screen.

I have to admit, I was wrong. There is a link between video games and improving your sex life. A few months ago I was speaking to a friend and pelvic floor physical therapist about how to help my patients with pelvic floor weakness, symptoms of prolapse and urine leak. The patients would see her for weekly pelvic floor therapy visits, and most had improvements in their symptoms and function. She told me that the only way to see continued improvement in pelvic floor health is to find a way to get patients to continue doing the exercises at home, that they learned when they were in her care. I had definitely heard from patients that they forgot to do the exercises and consequently had a return of their symptoms.

She relayed to me that one of the best ways to practice pelvic floor therapy exercises at home is through the use of video games! I was intrigued.

I take care of women in all stages of life, and an extremely common complaint of women in perimenopause and menopause is that they have weakness of their pelvic floor. The pelvic floor is a group of muscles, ligaments and connective tissues that stretch like a hammock across the bottom of the pelvis. These tissues support the bladder, uterus, rectum and help control urination, bowel movements and sexual function. Problems with or weakness of the pelvic floor can result in many and varied symptoms from urine and fecal leakage, to pain, loss of sensation and sexual dysfunction. After I talk to and examine my patients, if I find they may have a problem with their pelvic muscles I would often refer them to a pelvic floor physical therapist.

They would see the pelvic floor PT over a period of weeks or months, almost always having improvement in their symptoms. But over time, their symptoms may return, usually if they are not regularly practicing the exercises that the therapist had taught them; just like any exercises, if the muscles are not regularly used, and the exercises not consistently practiced, the progress will be lost.

That’s where the video game idea comes in. What if you could practice pelvic floor therapy exercises while playing a video game? What if those exercises were integrated into the game, and as you got better at the exercises you gained points and prizes and unlocked new levels? What if you could track your progress and feel the muscles getting stronger and more efficient? I didn’t see how that was possible, but I thought it was worth a listen, and a try. I have not been leaking urine or feeling pain, but after three vaginal deliveries and menopause, I thought I might like to test out my pelvic floor and see what all this video game excitement was all about, and if it led to strengthening my muscles in the process, great!

I ordered the device, called a Peri-Fit. It is an FDA cleared device for treating certain types of incontinence by strengthening pelvic floor muscles. The device provides biofeedback via smart-phone technology. It comes with a muscle contraction sensor and a set of instructions so it can be synced to your smart phone. (Isn’t everything attached to your phone these days?) It takes some training and some getting used to, but after a few initial attempts, I was able to do what is called ‘calibration.’ The sensor has to be placed where it can sense pelvic floor contractions, so obviously it is a vaginal device. The device actually tells you how strong or how weak your pelvic muscles are, in several categories: strength, endurance and speed of contractions.

Users of this device are offered a gamified experience, in which pelvic floor training is proposed in the form of short video games. Users control the game by contracting and relaxing pelvic floor muscles to match the directions in each video game. (Want the fish to jump over that pipe? Contract! Want the whale to open its mouth wide enough to eat some fish? Contract! Want to move an airplane down to the landing strip? Relax!) The sensor detects the strength and efficiency of the contractions and the effectiveness of the relaxations, and encourages progress along the way. As someone who was under the (apparently false) impression that because I wasn’t leaking urine, my pelvic floor muscles must be okay, I was quite surprised to see how many of my characters initially got wiped out because I could not make them jump over a mountain no matter how hard I tried.

Some of the initial difficulty is just getting used to the patterns of contracting and relaxing to move the game along (and not have bombs blow up your character when you couldn’t get him to jump high enough) and some of it is just learning how to make the proper pelvic response at the proper time in the game to make it to the next level. It likely won’t solve all of our pelvic floor problems, but the device has been shown to be able to differentiate between a proper pelvic floor muscle contraction versus a straining or a pushing movement, so progress can be tracked over the course of each weekly and daily session.

According to published data (https://pubmed.ncbi.nlm.nih.gov/38516650/) where responses from six thousand women were analyzed after using this device, over 70% of the users felt improvements in their urinary leakage and pressure symptoms after completing approximately fifty games, increasing to 85% of women reporting improvement after completing one hundred games. This is important because urinary symptoms have major consequences for women: many reduce or stop participation in preferred physical activities, and experience negative impacts on their sexuality and sexual function.

For me? After several months of learning how to make video game dragons fly high enough and make rockets maintain a steady flight course, I can say I’ve had some benefits: I can finally understand that feeling of accomplishment that video game players have when they have leveled up and been awarded some new trophy; and there is something to be said for having pelvic floor muscles that have improved strength, endurance and speed, even when not using them to direct a cartoon fish to fly.

I have not been paid by the company that makes this device; these opinions are my own.