Last Thursday, a friend of mine asked if I wanted to go grab drinks after work. "I can't," I texted in response. "I have to go meet some people about kegels." I got the sort of reply I expected: "Lol. What."
This seems to be the typical response people have to kegels, or anything having to do with pelvic floor health. It's seen as a joke, and to be honest, I haven't taken it very seriously in the past. As someone who's effectively required to be open about sex and sexuality for the sake of my job, talking about kegels -- and admitting that, yes, I occasionally do the exercises -- has made me squeamish. It never struck me as ripe for discussion, nor did pelvic floor health seem like a particularly notable issue. Having "problems" related to urinary control over the course of a lifetime as a cisgender woman, for example, seemed pretty standard from the messages I'd been given by my mother and older female relatives. It's just another fun thing to look forward to.
But when I met Elizabeth Miracle and Brian Krieger, the pair behind the recently released kegel device kGoal, last week, that notion was quickly dispelled. An unlikely pair, Miracle and Krieger met serendipitously through their shared desire to improve women's understandings of pelvic floor health, and decided to do so by creating their "Fitbit for vaginas." Miracle is a pelvic floor physical therapist who found herself dissatisfied with existing products, but also with the existing knowledge of how important kegels can be; Krieger, whose background is in engineering, works for the sexual health design start-up Minna Life. Both saw the same need for their collaboration.
"Women are coming to me for medical issues, which is kind of a little different than what our device is about," Miracle told me. "Urinary incontinence, pain with sex, pain with urination, pain with bowel movements, constipation... maybe they've had a baby and they don't feel like themselves anymore so they want to get back to how they felt before, or they're leaking urine and they can't run or do the activity that they want to do. It's something that affects a large amount of women, but we just don't talk about it."
She and Krieger explained the philosophy behind kGoal, an insertable silicon device that can be linked to a corresponding app that measures pelvic floor muscle performance. The instrument provides internal biofeedback by vibrating, but the designers are sure to note that it's not a sex toy.
"We don't want people to go, 'Oh, hey, you squeeze this and do your kegels and you'll have an orgasm,'" Miracle explained. "If it feels good, more power to you. But this isn't a kitschy thing. I have women cry in my office daily -- I buy my Kleenex at Costco -- because they don't feel like themselves. It has a serious, serious effect on women's health."
I spoke more with Miracle and Krieger about their inspiration to create kGoal, what needs to change about the way we talk about women's full body health and how to make kegels more than a punch line. Our conversation has been condensed and lightly edited for clarity.
As someone who is invested in sexual health and education, I'm always interested to know how people get to their specific corner of that. Why kegels? What about this exercise and this dearth of knowledge among most women draws you in?
EM: I'm a pelvic floor physical therapist, so for me it wasn't just, what is drawing you in but, what made you decide to make this your life career, which is a huge question. I initially got into physical therapy because I wanted to be a [physical therapist] for basketball stars. My best friend [a gynecologist] kind of convinced me that [pelvic floor physical therapy] was an area where women really needed help. I found it all unbelievably fascinating because it's not like any other area of physical therapy, where you just get a knee exercise, or everybody does the same exercise for ACL repair. There's a breadth of different pelvic floor pathology that's out there and it's very personal. I feel very invested in my patients because it's an area where women don't really feel like sharing or talking about it. ... Right now, the home devices that women are using--some of them are, like, the size of hairdryers that you have to insert vaginally. Some of them have wires that connect to converters that connect to wires that connect to devices that...
So they're not particularly appealing.
EM: No. People bring them to me and they're like, “I don't even know how to put this thing together, much less actually use it.” What use is that to anybody in their home? If you're lucky enough to have a physical therapist who does what I do accessible to you, you still have to go see them and then you have to go home. Women get super bored of doing the exercises. Kegels are boring!
BK: It's like any kind of exercise; there's different layers. We're basically trying to address the problem [of women not doing pelvic floor exercises] from all these different directions, in hopes that we can maximize the number of people that something resonates with them. Maybe for some people the data resonates with them, for some people it's the game or the guided workout or something about this idea of tactile feedback—because they couldn't feel it, so they weren't sure if they were doing it right before—but just trying to have a really universal approach to the problem.
I assume that in creating this you had certain problems that you identified and tried to address. What were they and how did you address them? What were the things you wanted your product to have?
BK: Anatomy is the first driver. There are certain design constraints that are introduced by the human body, but within that the human body is very non-standard. Everybody has a very unique anatomy, a very unique body, so that was one of our core design drivers— I sound like a broken record, but being versatile.
EM: Just being ergonomic and being able to fit different women. I think that's the big thing: not everybody's vagina is the same. When you're asking for the must-haves, it was being able to make contact with the pelvic floor muscles, being the right size, and being able to use all the muscles when you're doing the squeeze. For me, it was very important that the device not look phallic.
Why is that?
EM: I think there's an idea that pelvic floor strengthening is to please your partner, and while that is a nice benefit for some people, I really think it should be more about the woman's health and what's important to her and what her goals are. Maybe she's strengthening her pelvic floor because she wants to get better core strength and not have back pain; maybe she doesn't want to leak when she runs; maybe she's getting ready to have a baby. It has nothing to do with a male sexual partner. This whole idea that female sexual aids look like penises is very frustrating to me.
Do you worry that the current popularity of kegels is sort of this tongue-in-cheek fascination? Because it is the kind of thing that makes people squeamish. Do you worry about the way in which you're receiving attention?
EM: We think about it a lot. That's why we choose our words carefully about how we describe it. I mean, this vibrates. You squeeze it and it vibrates because that is really the only good way to give woman feedback inside of her body. ... Maybe running was the only thing [a woman] could do for exercise, and now she can't run because she pees her pants and it's so embarrassing that she doesn't leave her house. Women sequester themselves and then they go into postpartum depression.
I’m curious as to how much of the need for such a device you think would be alleviated if we would just teach children about their bodies and what they need to do to stay healthy.
EM: I think it would just promote a culture of making [kegeling] normal. I think we would probably use devices like this the same way we all use Fitbits. We know we need to get cardio health, we know we need to walk every day, but some people like to have that information. I don't know what percentage we would use these less if we had that education. It's such an imaginary world to me that I can't conceive of it.
BK: To me, it's a compliance thing. Yes, a million times yes, I think we should have better sex education and tell people that they should do kegel exercises. Yes, you can do kegel exercises without this product and you should and that's awesome. I don't know if it's uniquely American, but something that resonated with me is that the easier you can make it for people, the more likely they're going to do it.