Neglected Muscle

One of the most neglected muscles in the human body may also be one of the most important. It is, says the University of Southern California's Dr. Arnold H. Kegel, the pubococcygeus, which lies near the base of the pelvis, just above the perineum* It has the task of holding up the organs in the lower pelvis. But, Kegel believes, in many cases--particularly among women--it may not be highly enough developed by nature to do its job efficiently.

Most doctors pay little attention to the pubococcygeus until a woman has serious trouble;resulting from its inability to support vital organs--usually after childbirth. Then, in severe cases, they call in the surgeon. Dr. Kegel, 62, gynecologist and onetime (1927-31) health commissioner of Chicago, argues that this is wrong on two counts: 1) the importance of the pubococcygeus has been neglected because it has usually been studied only in cadavers, where it is always flaccid, whereas its weakness should be detected promptly in living patients; 2) there is a better way than surgery to correct most cases of pubococcygeal weakness.

Patient Endurance. In the current Journal of the American Academy of Obstetrics and Gynecology, Dr. Kegel spells out a long list of symptoms that may mark this condition: bladder weakness in adolescents and young adults, poor muscle tone during pregnancy, poor recovery of muscle tone after delivery, bladder disturbances in older age groups, and poor sensory perception for women during sexual intercourse. Often, he believes, "women patiently endure [these] discomforts throughout the best years of their lives."

One trouble is that most women have no idea that they possess a muscle called pubococcygeus, let alone know how to strengthen it. At his Perineometer Clinic at Los Angeles County General Hospital, Dr. Kegel has developed an answer to that problem: a device (approved by the A.M.A.) called the Perineometer. Essentially a pressure-registering gauge, it consists of a compressible part inserted in the vagina, and a dial. Dr. Kegel tells the patient being tested to tighten her muscles. If the needle registers above 20 or 25 (the millimeters of mercury that the exerted pressure would support), the pubococcygeus is healthy; if the reading is no higher than five, the muscle is in poor shape. With the Perineometer Dr. Kegel's patients practice pubococcygeal contractions and note improvement by progressively higher readings on the dial. This treatment is quickly successful in 75% of cases, Kegel reports.

Corrected Frigidity. The most remarkable outcome of Kegel's work has been almost incidental: the realization that many cases of sexual maladjustment, notably apparent frigidity, could be cured by pubococcygeal retraining.

Freudian thinking has emphasized emotional factors in frigidity. Kegel does not deny the importance of psychic elements, but insists that the emphasis is misplaced. Says Kegel in sum: "We have had many cases previously diagnosed as 'emotionally frigid,' but we found that after the muscles had been strengthened by exercise and the patient learned to use them, the emotional frigidity--if there ever was any--disappeared." In correcting this disorder, he reports success in 65% of cases.

*Originally, say the evolutionists, it was a tail-flexing muscle, but has lost that function since mankind lost its simian appendage, has taken on new duties.

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