If you read PART 1 (“Your vagina has a sphincter”), you might be thinking “I can’t wait to get to know my bulbocavernosus muscle!” Here’s an introductory activity to get familiar with your bulbocavernosus muscle.

DISCLAIMER: This is not medical advice. This is a self-care activity. If at any time you feel pain or discomfort, you should stop immediately. If you think you may have vaginismus, you should see a medical professional even if this activity works.

Bear Down

The first step of this self-care exercise can be done fully clothed, or even on the toilet. Simply try bearing down on that bulbocavernosus muscle like you are trying to push something out of your vagina (if you are doing this clothed, you might want to empty your bladder first.) If you like the image, imagine yourself a hen laying an egg!

If you can’t bear down or push out, then think about this muscle next time you bear down to have a bowel movement. If you have ever experienced the pushing stage in labor, you may remember someone cheering you on with “Push! Push!” And what this helpful person was really telling you was “Release your bulbocavernosus muscle! Open your vaginal sphincter!”

Get to know your bulbocavernosus muscle

If you’ve tried the bearing down exercise with some feeling of optimism and intrigue, then you might try the next steps. First, wash your hands with regular soap and water (just in case you’ve been changing dirty diapers or finishing up a nuclear physics experiment) and then assemble these things:

• A comfortable and clean place to lie down where the goalie from your 14 year old son’s soccer team isn’t going to unexpectedly walk in.
• A hand mirror or some mirror that allows you to see your vulva when you are lying down.
• A vaginal lubricant – coconut, vegetable, or olive oil all work.
• A pillow or two to put under your bottom.
• A finger-sized vaginal dilator, dildo, or vibrator. A small tampon with a rounded applicator might also work, as long as the tampon is still inside and feels comfortable.
• A finger works too!

Then try these steps:

1. Lie down on the floor or in bed with frog legs (feet touching, knees wide apart—see photo!). Place a pillow or two under your bottom to prop yourself up.
2. Point a mirror at your vulva so you can see it from your lying down position.
3. While looking in the mirror at your vulva, bear down on your bulbocavernosus muscle.
4. When you bear down, it should look like a slight bulge toward the mirror. The vaginal opening should open up a little bit.
   NOTE: Often times, when the brain of a woman with a tight bulbocavernosus muscle tells the muscle to bear down, the muscle actually squeezes up and in. Looking in the mirror will help you notice if this is happening. If you’re in squeezing mode, you’ll probably see your buttocks squeezing up, too.
5. If you can bear down and the vaginal opening looks like it’s opening up even a little bit, then you can try the next step.  If you cannot bear down, then stop the exercise and refer to the information below.
6. Apply some lubricant to your finger or the object you are using for insertion.
7. WHILE BEARING DOWN, insert the small vaginal dilator, dildo, vibrator, finger or tampon with applicator into your vagina. Did I mention that you should try this WHILE BEARING DOWN? Keep bearing down the whole time!NOTE: Aim BACKWARD toward your TAILBONE to avoid hitting the urethra (the tube where urine comes out) or the bladder. These organs are sensitive, especially when there is less estrogen around. Do not aim forward toward your belly button.
8. Once you pass your finger or the insertion device past the bulbocavernosus muscle, you may feel like you are “over the ridge” or “over the bump” or “past the wall” and you will probably feel a decrease in resistance from your vagina. At that point, you can STOP BEARING DOWN but keep your finger or other the device where it is. You may even be able to insert it further. If you don’t get past the muscle, it will not feel good. Once you get past, it will feel better.
9. Breathe. Breathe. Breathe. Think about how this feels. Notice your anatomy.
10. Now, looking in the mirror at your vulva, bear down again to push the insertion device out without using your hand to help it (this is where a finger is less helpful than the other options).

NOTE: Almost always, this step of the exercise is a EUREKA moment. This is where you can prove to yourself that your vagina has a sphincter! The bulbocavernosus muscle is real! And your brain can control it! And you might just say to yourself: “OMG.” “Well I’ll be damned.” “Why did nobody ever tell me that my vagina has a sphincter?”

Repeating this exercise will help train your brain and your vaginal sphincter to communicate better. If you can’t do this exercise because you can’t get the bearing down motion going or, even with the bearing down, you can’t get the insertion going, it’s OK! Even if you do get through these steps, the next thing on the list to do is call your doctor and get checked out. You might be a candidate for pelvic floor physical therapy. You might need some estrogen in your vagina for post-menopausal dryness or you might benefit from information about moisturizers, dilators or even a change in your birth control. If you get the right help, you can recover from painful sex and painful gynecologic exams. Your sexual arousal and orgasm can improve. Overall, you definitely can feel much better.

A few last tips:

• This information is also helpful for teaching someone how to use a tampon. Bearing down can make it easier to insert a tampon! And aiming the tampon BACK TOWARD THE TAILBONE will make it easier, too.
• You can use the bearing down technique during a gynecologic exam when the doctor puts in a speculum or examines you with her fingers. While you are there, ask your doctor to please say words like “bear down” and “release” rather than “relax” when she is inserting things into your vagina. Every female gynecologist knows it’s ridiculous, if not maddening, to tell a woman lying on her back with her feet in metal stirrups to “relax.”
• You can use this bearing down technique during intercourse. Bearing down on your bulbocavernosus muscle during intercourse can feel pleasurable and facilitate deeper penetration. And don’t worry, it won’t push your partner out! If this doesn’t work for you, then STOP. Pain typically causes more tightness in the bulbocavernosus muscle, which causes more pain. That can be a vicious cycle.

And now here IS some medical advice: print this PDF and bring it with you to your doctor.

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Edited by Chenab Navalkha, Gillian Feldmeth, & Kelsey Paradise