The Pelvic Floor Manual

The pelvic floor runs from the pubic bone at the front to the tailbone at the back, and between the two sit bones. Three passages run through it: from front to back, the urethra, the vagina and the anus. The muscles wrap around them in a figure of eight and, when they contract, draw inward and up. The rhythmic pulsing you feel during orgasm is these muscles contracting at intervals of roughly 0.8 seconds.

First, locate them. There are three ways.

1. Imagine: holding in wind, or stopping the flow of urine. That squeeze-and-lift is the one. Don't actually practise by stopping your urine mid-flow; it strains the bladder.
2. Feel: slide one clean finger a little way into the vagina and squeeze. If the finger feels gripped and drawn inward, you have it.
3. Look: sit with your legs apart and a mirror. When you squeeze, the perineum (the skin between the vagina and anus) should lift slightly.

If your buttocks, thighs or stomach tighten, those are the wrong muscles. Keep breathing throughout.

1. Slow holds: on an out-breath, squeeze and lift and hold for 5 seconds, then release completely over 5 to 10 seconds. Ten times.
2. Quick flicks: squeeze for one second, release for one second. Ten times.
3. Three times a day, lying down, sitting or standing.

Over six to eight weeks, build the hold up to ten seconds. Most people begin to notice a difference after a few weeks. The release matters as much as the squeeze.

Too much tension is its own problem. Pain on penetration, tightness and difficulty reaching orgasm often come from a floor that cannot let go, not from one that is weak. Learn the opposite movement, the reverse Kegel: breathe in deeply and feel the floor soften, drop and widen. Not pushing; unclenching. The diaphragm and the pelvic floor move together with the breath, descending as you breathe in and returning as you breathe out. If you have pain, start here before any squeezing.

How close the fit feels depends far more on arousal and muscle control than on anatomy. When you are fully aroused, the vagina lengthens and widens at its inner end, which is why not rushing is the surest route to a close fit.

During penetration, try gentle pulses: squeeze and release in time with your partner's movement. A rhythm is felt more by both of you than a constant clench. Positions where you set the pace, such as being on top, make this easier to control.

1. Build slowly: the more gradually arousal accumulates, the deeper orgasm tends to be.
2. Approach and retreat: when you come close to the edge, ease off and drop back a little. Repeat three or four times (edging).
3. Keep breathing: most people hold their breath near climax; long, slow out-breaths tend to spread the sensation instead.
4. Meet it with the floor: rhythmic squeezes just before the peak can make the contractions feel stronger and longer. Some people find the opposite, a soft bearing-down release, more intense. Try both.

After the first orgasm the clitoris is often too sensitive for direct touch. Don't stop: lighten the touch or move it (around it, the inner thighs, the breasts), keep arousal up, wait a little, then return. Many women can come again and again this way. It is a possibility, not a target: if once is full, once is enough.

Reaching orgasm without genital touch, through breath, attention and imagery alone (what Japanese calls 脳イキ, nō-iki, the "brain orgasm"), is not a myth. A small 1992 laboratory study recorded the physiological signs of orgasm in women using imagery alone. It does not happen for everyone; it takes practice, and it suits some people more than others.

To practise: lie down and breathe slowly and deeply. Let the floor soften on the in-breath and lift gently on the out-breath, then lay an arousing scene over that rhythm. When a wave comes, don't chase it: keep the breath and the pulse steady and let it spread.

See a gynaecologist or a pelvic health physiotherapist if you have pain during sex, urine or bowel leakage, heaviness or a sense of something bulging in the vagina, or changes after childbirth or menopause. Stop any exercise that causes pain.