'The Sex and the City' Gals Are Still Teaching Audiences About Kegels

Key Points

• Find out more about Kegels—a pelvic floor strengthening exercise, or "push-ups" for your pelvic floor muscles.
• The popular TV series "Sex and the City" has played a role in educating its audience about pelvic floor health through its characters' discussions and experiences.
• The new season of the spinoff series, "And Just Like That," broadens the perspective of Kegel exercises for women and men.

Since its debut in 1999, the hit HBO TV show "Sex and the City" (SATC) has been sharing sexual experiences from its leading women with explicit discussions no other shows dared to illustrate. Remember the episode where Carrie's boyfriend has a urine fetish or the one where Charlotte's date wants to do anal?

Over six seasons, the series explored many prejudices and occasionally succeeded in educating its audience.

Not all of these sex lessons have aged well—particularly the "no sex on the first date" rule—but the one that stuck with audiences and became culturally inseparable from the show is the importance of Kegel exercises.

'Tighten and release'

After Samantha (played by Kim Cattrall) ended up on a mailing list for a menopause catalog (season three, episode eight: "The Big Time"), the women got onto the subject of pelvic floor muscles and Kegel exercises after they saw an ad for vagina weights, known as Kegel exercise vaginal weights.

In this episode, Charlotte (Kristin Davis)—she didn't even know she had pelvic floor muscles—learned the area is a vital part of the anatomy. Miranda (Cynthia Nixon) explained it crudely: "Helps you sit tight down there."

Kegel exercises are named for Arnold Kegel, a gynecologist who first developed them as a way to treat pelvic organ prolapse and urinary incontinence without resorting to surgery. He first described them as a tool for strengthening the pelvic floor in 1948.

In the SATC episode's enlightening cocktail hour, Samantha explained that in order to strengthen your pelvic floor muscles you must "tighten and release" the pelvic floor for 10 minutes a day.

If you're unsure about how to find these muscles, Cleveland Clinic suggests you try stopping the flow of urine next time you go to the toilet. That's your pelvic floor muscles doing the work.

Although Samantha stated in her sultry fashion that "her vagina 'weights' for no man," the benefits of strengthening the pelvic floor muscles extend beyond enhancing sexual pleasure.

"They help strengthen the pelvic floor, which plays a big role in sexual health and vitality," said Jenn Kennedy, Ph.D., L.M.F.T., a sexologist and the founder of The Pleasure Project and Riviera Therapy, in Santa Barbara, California. "In addition to sexual performance, a strong pelvic floor can also help with issues around urinary or fecal incontinence."

The SATC ladies have discussed many issues over the years, from abortions to Viagra, but this moment had a particular cultural significance because it succeeded in educating numerous people about their pelvic floor health.

Now, with the new season of "And Just Like That"—the most recent series following the lives of Carrie (Sarah Jessica Parker), Charlotte and Miranda—the subject of the Kegel exercises has returned.

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What are 'dust balls?'

The issue was first raised on the show as useful knowledge for women only, but the omission of men has been rectified.

"Kegel exercises are good for both men and women," Kennedy said.

In the new season, Charlotte notices that Harry (Evan Handler) orgasms without producing semen—a phenomenon known as "dust balls" or "dry orgasm." The couple grows concerned about his genital health.

When they visit the doctor, they discover Harry is experiencing "retrograde ejaculation." In order to redirect the sperm, Harry's doctor suggests he should try strengthening his pelvic floor.

This, in Harry's case, is the correct course of action, Kennedy noted.

"Post-isometric relaxation (Kegel exercises) help provide blood flow to the artery that runs into the shaft of the penis," she said. "This helps men gain control of their pelvic floor."

Is a retrograde ejaculation harmful?

Retrograde ejaculation is not generally serious or harmful, but it could be a symptom of a larger problem.

Kennedy explained she would have advised against the course of action taken on the show.

"Dry orgasms or retrograde ejaculations are a more complicated, multifaceted issue," she said. "The cause may be a weak pelvic floor, in which case Kegel exercises can certainly help by increasing blood flow to the muscles surrounding the pelvic floor."

The cause, Kennedy added, can also be related to other factors, including:

• Too much masturbation (causing low semen or inflammation)
• Other medical issues (enlarged prostate, diabetes or multiple sclerosis)
• Medications that treat conditions such as high blood pressure or depression

"These issues have nothing to do with the pelvic floor," she said. "It's best to see a doctor to determine the cause before starting a self-led treatment."

Charlotte, having learned about Kegel exercises alongside fans of the show, is ready to jump into action and show Harry everything she knows. So ensues a comical scene in which she teaches her husband how to do Kegel exercises with a chirpy rhyme: "1, 2, 3, 4, slurp that sperm from the pelvic floor."

It's a cringeworthy moment, for sure, but it continues a long-held commitment of the show, in which sexual issues are discussed without euphemism or shame.

"Sex and the City," and its continuation series "And Just Like That," have successfully portrayed blunt conversations about sex. While hearing this line of verse may feel embarrassing, it's actually refreshing to see a married couple so open and communicative while sharing each other's sexual health concerns on screen.

Don't Look to Comics for Relationship Advice: Considering their charisma, mystique, taut physiques and affinity for latex, it's not surprising superheroes of page and screen tend to have no trouble finding dates. Turns out, though, that superheroes are better at saving cities than coping with their emotional trauma.

The predicament Harry and Charlotte face in "And Just Like That" (season two, episode four: "ALIVE!") is in direct response to the SATC episode of pelvic floor discovery. Even down to the remark "I have one of those," which Harry utters when told he has pelvic floor muscles, echoing Charlotte's comment from the original series.

The show's growth in this area illustrates how far sexual health information has come. Strengthening the pelvic floor with Kegel exercises is no longer advised solely for women trying to keep their vaginal muscles taut. Men can play, too.

Samantha originally demonstrated the Kegel exercise as a minor shift while upright, but you can put more oomph into it. Charlotte is an overachiever. So it is unsurprising that the way she teaches Harry Kegel exercises—he lies on his back with his hips off the ground in order to tense the muscles—is more like a pelvic Pilates session.

Just know that Sam's tighten-and-release method gets the job done.

Righting its wrongs

"Sex and the City" made a few wrong turns in its heyday—from Carrie's judgment of bisexuality to the show's misgendering of trans women—but it's clear creator Michael Patrick King is intent on righting those misjudgments.

Given Miranda's evolving sexual identity and the involvement of two nonbinary characters—Che (Sara Ramirez) and Rock (Alexa Swinton)—many conversations go far beyond the heterosexual experience.

Who knew a popular TV show would do so much to open up pelvic floor health education to so many people, and not just those with a vulva?