Help for soreness “down there”

Q:

I’m 52 and recently started leaking urine more frequently—so last week I got serious about doing Kegels. But now my vagina feels achy and sore. Is this normal?

A:

Kegel exercises are a great way to strengthen pelvic floor muscles and control urinary leaks. But like other muscles in the body, these muscles can get sore after a too-intense workout.

I advise taking a two-day break and using an anti-inflammatory (like ibuprofen) to ease the ache. Once you feel better, limit Kegels to 15 reps 3 times a day. Over-clenching muscles can cause soreness, so use only the force needed to stop your urine mid-stream. And since doing Kegels too fast may bring on soreness, I advise slowly squeezing pelvic floor muscles for a count of 5 (increasing the force you use with each count), then gradually releasing pressure for another count of 5.

These steps should strengthen your pelvic floor without soreness, but if they don’t, see your doctor. She can rule out other causes of discomfort and suggest more strategies to stop leaks. A You’re referring to vaginal steaming, a spa treatment that involves sitting on a special stool (similar to a toilet seat) over a pot of hot herbinfused water. And while the practice may boost circulation and ease problems like hemorrhoids, there’s no evidence that it has any effect on urinary tract infections (UTIs).

Luckily, there are other natural ways to nip UTIs in the bud. I advise drinking 8 oz. of unsweetened cranberry juice three times daily at the first signs of urinary burning and urgency, which signal an infection. Studies show compounds in cranberries called proanthocyanidins help thwart UTIs by preventing bacteria from sticking to cells in the bladder and urethra.

Or you can try dissolving 1 tsp. of D-mannose powder (like NOW Foods D-Mannose Powder, $14 for 3 oz., Puritan.com) in

8 oz. of water and drinking twice a day—a strategy that can stem 90 percent of infections in as little as 3 days. D-mannose is a simple sugar that binds to UTI-causing bacteria so they can be flushed out of the urinary tract.

Still, if these strategies don’t improve your symptoms, see your doctor, who can perform tests to identify the specific bacteria causing your infection and determine the best antibiotic to treat it.