What is NatraTone™?
NatraTone™ is a clinically proven exercise product that has been designed by women for women as a first treatment choice for Stress Urinary Incontinence (SUI). Sometimes referred to as Light Bladder Leakage or LBL, SUI is the involuntary loss of urine with activity such as laughing, coughing, sneezing, running and even sex. NatraTone™ teaches women how to correctly train and strengthen their pelvic floor and inner core muscles in a 6 week programme incorporating NatraTone™ ABC exercise (5mins. 2 x day, 3 x week) with NatraTone’s™ NatraToner.
What is the ABC Exercise Program?
The ABC Program is a sequence of specific exercise movements along with breathing that are simple and quick to do. As you follow the program outlined in the instruction booklet and follow along with the DVD you will see gentle progressions to challenge your muscles and increase their performance. With the NatraTone™ program you will do 10 ABC cycles, 2 times a day, 3 days a week (i.e. every other day) for 6 weeks.
Are the ABC Exercises different from Kegel pelvic floor exercises?
Recent studies have shown that pelvic floor muscles alone are not sufficient to thoroughly support the long term relief of SUI / LBL in women.* A combined exercise program of pelvic floor and inner core (lower abdominal) muscles is required. We call the combined exercise program, the NatraTone ABCs. The NatraToner training aid supports the ABC exercises making it a very effective and natural solution for SUI /LBL. *Sapsford, R., Hodges, P., Richardson, C., Cooper, D., Markwell, S. and Jull, G. (2001), Co-activation of the abdominal and pelvic floor muscles during voluntary exercises. Neurourology and Urodynamics, 20: 31–42. doi: 10.1002/1520-6777(2001)20:1<31::AID-NAU5>3.0.CO;2-P
How long before I will begin to see results from the ABC Exercise Program?
Some women will feel results within days, others a few weeks and for other women it will take longer. It depends upon the current strength and tone of your pelvic floor and inner core muscles. If you are an active person, results can also vary depending on the type of exercise you do e.g. running versus walking. It may take longer to gain control with high intensity exercise. The most important thing is full compliance to the complete program – don’t give up if it seems hard, it will become easier and remember, it took a long time to bring on the problem, so 6 weeks or more of just 5 minutes twice a day, 3 times a week is not that difficult. Persevere and you will have success (unless your leakage problem is due to something other than weak PF/Inner Core muscles, and in that case, you need to see your health provider).
When should I NOT choose NatraTone?
NatraTone supports regular examinations and check ups for well health. If you have any of the following conditions, you need to see your health provider and it may not be suitable for you to use the NatraTone Program. Pelvic pain needs to be diagnosed correctly and it is managed most effectively when a combined approach is adopted to address the physical, pharmacological, emotional and sexual aspects related to it. Faecal incontinence must also be correctly diagnosed. If pelvic floor strengthening and toning is recommended, then NatraTone would be beneficial. Where there is NO voluntary control over the muscles in the pelvic floor due to nerve damage then NatraTone is not recommended. Electrical stimulators are generally used to stimulate muscles or nerves that are not able to respond optimally without help. They are often recommended for use by women who are unable to contract their pelvic floor muscles at all. Seek medical advice and read more in our Warnings and Precautions in the footer of our website.
Can I use a lubricant to help with insertion?
We recommend you first try wetting the NatraToner just with water if you are too dry. If that does not make insertion easier, then you can use a minimal amount of water-based lubricant just on the insertion tip. Note: too much lubricant may cause the NatraToner, when inserted, to twist & turn or to move up too high, therefore not being in the correct position to achieve desired results.
Can I use the NatraToner if I am pregnant?
Please check with your health provider and lead maternity carer about using the NatraTone™ program while pregnant as it uses an intravaginal training aid called the NatraToner. This program is more comprehensive than traditional pelvic floor exercises alone, and there is a lot of evidence that pelvic floor exercise during the first half of pregnancy can substantially reduce incontinence symptoms in later pregnancy and after birth (Sampselle) for women who are pregnant for the first time. The strength of the pelvic muscle at 20 weeks of pregnancy is an excellent indicator of whether a woman is likely to suffer from leakage later. NatraTone™ is a clinically proven exercise program, designed by women for women as a first treatment choice for Stress Urinary Incontinence (SUI), sometimes referred to as Light Bladder Leakage or LBL. If your maternity carer does not recommend you use the NatraToner while pregnant you may want to consider doing the the NatraTone ABC exericses on their own.
How soon after giving birth can I begin to use the NatraToner?
We recommend that you wait until you have had your 6 week post-natal check, have been cleared by your health professional and that you are feeling healthy and well before using the NatraToner. However, you may be able to do the NatraTone ABC exercises without the NatraToner a lot sooner, if you are healthy and well, but it is important that you check with your health professional first. A pelvic floor muscle strength training program can add significantly to physical recovery after childbirth (Morkved & others).
What is a prolapse and how can you prevent it?
A pelvic organ prolapse (POP) occurs when a pelvic organ, such as your bladder, drops (“prolapses”) from its normal position and pushes against the walls of your vagina. This can happen if the muscles that hold your pelvic organs in place become weak or stretched from childbirth or surgery. More than one pelvic organ can drop at the same time. Organs that can be involved in a pelvic organ prolapse include the bladder, the uterus, the bowel and the rectum. Pelvic organ prolapse can cause pain or problems with bowel and bladder functions or interfere with sexual activity.
An exercise scientist and physiotherapist and leading expert in pelvic floor muscle training Kari Bo says: “The most important factor influencing the success of pelvic floor exercises is your ability to contract your muscles, increase muscle force and adhere to the prescribed program”.
Read more about the types of POP / prolapse.
The training regime for the pelvic floor muscles (PFM) with POP is exactly the same as for SUI (Stress Urinary Incontinence). When you perform a pelvic floor contraction, the pelvic floor muscles should be able to pull the tail-bone forward and lift about 1cm internally, “squeeze and lift”.
NatraTone is ideally suited for prevention of POP by helping to identify the correct “squeeze and lift” action of the pelvic floor muscles (gripping the NatraToner training aid strongly while performing the ‘C’ part of ABC exercise). When you perform the pelvic floor contraction or (C), the pelvic floor muscles should be able to pull the tail-bone forward and lift about 1cm internally. NOTE: 2-3 sessions per week of strong contractions maintain strong pelvic floor muscle tone and require less effort than to try to develop strong muscles.
It is highly recommended to incorporate correct PFM and inner core exercise into a regular exercise regime and not wait until these muscles are weak before you try and strengthen them.
It is important to begin lying on your back or side to learn and achieve the correct squeeze and lift action. Do not alter your position to sitting or standing until you have mastered the ‘C’ contraction both in its quick and long form and you can feel it strongly.
We do not recommend high impact physical activity while doing the NatraTone Programme as it may undo all your good work.
Once you have completed the NatraTone Programme:
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If you have recently had a baby and feel you are still tender in your birth canal – use the NatraTone Programme to gently restore your tone and aid return to intercourse.
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Try testing your NatraTone strength with intercourse.
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Repeat the complete NatraTone ABC exercise sequence (as shown in weeks 5 and 6) two to three times per week using the NatraToner training aid. Do this up to 12 weeks to intensify your training regime
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Use the NatraToner in the shower – alternating with grip and squeeze and grip and hold.
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Aim to NatraTone in the morning when less tired, and if you have POP, when it is least evident (check this over a one month cycle).
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Inner core training should be on-going throughout your life and will help you stay on top of aging and estrogen depletion (which can weaken your pelvic floor muscle tone).
Can I prevent a prolapse or reverse an existing prolapse with the NatraTone™ program?
Medical opinion is divided on the role of pelvic floor exercises in treating an existing prolapse or preventing a prolapse. For some time, pelvic floor exercises were generally considered only appropriate for mild prolapse cases. However, a research review in 2006 suggested that pelvic floor muscle training may be also be useful in cases where the prolapse is severe. After reviewing current evidence, Expert Committee 12 "Adult Conservative Management" of the Fourth International Consultation on Incontinence (ICI), Paris, July 2008, stated that:
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Pelvic floor exercises may reduce pelvic organ prolapse severity
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Pelvic floor exercises may help prevent pelvic organ prolapse
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Pelvic floor exercises before surgery may improve lower urinary tract symptoms and quality of life for women with a prolapse .
* NatraTone™ has not clinically trialed prolapse control. However independent research states a biofeedback exerciser can be very useful for women who have a prolapse.
I've got a prolapse - should I use NatraTone?
There are 3 grades of Prolapse of the urethra (cyctocele): mild/moderate/severe.
It is extremely common and some statistics are as high as 80% of women will have mild to moderate prolapse especially of the urethra. In mild to moderate cases Pelvic Floor exercises are always recommended +/- ovestin cream to support the vaginal walls.
The NatraTone program can be recommended in the following cases:
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The prolapse must be mild to moderate. This would mean no bulging below the vagina entrance, only occassional feelings of heaviness or bulging into the vagina but NO pain. NOTE: If intercourse is not painful then NatraTone would be ideal.
I would NOT recommend NatraTone and instead recommend a gynaecological specialist assessment if:
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The prolapse is severe. This means the bulging is below the vaginal entrance. Coughing or bearing down drags the urethra down and becomes evident, there is pain, dryness, discomfort and intercourse is difficult. NOTE: A specialist can assess the severity - often if no surgery is required they will recommend ovestin + PFM exercises (and so refer to mild/moderate prolapse above). Once a surgical solution has been determined - NatraTone is recommended once healing is completed to provide on-going support the pelvic organs.
Factors to also consider with a prolapse:
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Heavy lifting at the gym or work is to be avoided (if you hold your breathe to lift then it is too heavy)
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Constipation (and straining) is very bad for prolapse and must be avoided
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A chronic cough or sneeze including those linked to asthma, smoking or hayfever needs to be addressed if possible
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A healthy weight as being overweight, obese or having a body mass index (BMI) of over 25 is a risk factor
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Seeking pelvic floor friendly exercises are also important while doing The NT programme and will need to be on going.
Pelvic floor safe cardio exercises
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walking
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swimming
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seated cycling
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cross trainer (low resistance)
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low intensity water aerobics
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walking in the water, and
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low impact exercise classes.
Cardio exercises to avoid
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running
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jumping
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star jumps
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skipping
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boxing
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high impact exercise classes
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sports involving stop start running and rapid direction change (e.g. tennis, netball, basketball, hockey, and touch football).
Can the NatraTone™ program help me if I decide to have surgery?
NatraTone™ has endorsements from medical specialists who state that rehabilitation such as the NatraTone™ program can offer support to your surgical repair by as much as 20 – 30%.
What do I do if I have my period?
Continue with the NatraTone™ ABC exercises without the NatraToner while menstruating, then add an extra week on at the end of the six weeks to complete the full program.
I have an anterverted uterus, what does this mean?
This term refers to the direction the top of the uterus is pointing (or sitting). An anteverted uterus is a uterus that tilts slightly forward. This is a normal and the most common position for the uterus.
Approximately 20 percent of women have a retroverted or backward-tilting uterus and approximately 20 percent have a mid-position uterus - not tilting forward or backward. The remainder of women have an anteverted uterus, the top of the uterus is pointing forward towards the front of your stomach. This has no negative impact on reproductive or sexual function for women, or using NatraTone or SmartBalls.
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