Alternative Names pelvic muscle strengthening exercises, incontinence exercises, pelvic floor muscle exercises, Kegel exercises for women
Definition Kegel exercises are designed to strengthen the pelvic floor muscles that surround the openings of the urethra, vagina and rectum.
What is the information for this topic? Often, seemingly simple body functions can be quite complex. One example of this is urination, which is controlled only if a series of physical and behavioural dominoes fall into place each time a person needs to urinate.
The bladder is a muscle that expands to hold urine arriving from the kidneys. When the bladder is full, nerves signal the need to urinate. If there is no appropriate place to do so, the brain overrides this signal. The brain keeps closed the muscular valve, or sphincter around the urethra, which is the tube that carries urine away from the bladder to the outside of the body. Muscles within the bladder that help squeeze it must stay relaxed, too, to prevent urination.
When conditions are right, these muscles tighten, the valve relaxes and urine starts to flow.
Damage to the pelvic floor muscles that help support the uterus, bladder, urethra and rectum can allow those body parts to sag. Pelvic muscles are most often damaged or weakened by childbirth and ageing. As the problem worsens, incontinence can occur.
Pelvic examinations can determine if there is:
a cystocele, which is a weakened support between vagina and bladder
a rectocele, or a weakened support between vagina and rectum
a prolapsed uterus
urinary stress incontinence, which is the loss of urine when a person sneezes, coughs, or laughs
Kegel exercises can be used for the urinary stress incontinence condition. The exercises can also enhance sexual pleasure. After childbirth, the exercises promote healing of the perinium. The perineum is the area between the vagina and rectum that is sometimes is cut or torn during childbirth.
Because weak pelvic floor muscles contribute to incontinence, exercises to strengthen these muscles may lessen or sometimes prevent incontinence.
To do Kegel exercises, a woman squeezes or tightens the vaginal muscles normally used to stop urination. Some women have poor sensation in the lower pelvis. They may incorrectly contract their abdominal muscles instead of their pelvic floor muscles. To find the right muscles, a woman can try one or more of these approaches:
Sit on the toilet to urinate. As the stream of urine slows, try to stop it by contracting the pelvic floor muscles.
Ask a doctor to help by inserting two fingers into the vagina during a pelvic examination. Squeeze down on the fingers. The doctor can tell when the muscles are tightening properly.
Place two fingers inside the vagina. Squeeze down as if stopping the flow of urine. Pressure should then be felt on the two fingers.
Repeat the chosen approach several times until the feel of squeezing and releasing the right muscles is familiar. Urinary reflux can result from multiple times of holding urine.
To do Kegel exercises:
Empty the bladder.
Tighten the pelvic muscles for 10 seconds.
Relax the muscles for 10 seconds.
Repeat this sequence a total of 20 times, at least 3 to 5 times a day. Do not overdo it, though. Tiring the muscles may make incontinence worse.
Do not contract abdominal, thigh, leg or buttocks muscles while doing the exercises. This makes them less effective.
Keep breathing during the exercises. Learn to relax while doing the exercises and concentrate on isolating the right muscles.
A woman can ask a doctor about using special weighted vaginal cones or balloons inside the vagina. Working to hold the weights inside can also help isolate and strengthen pelvic floor muscles. And if none of these steps work, a woman can seek further help from a doctor. The doctor may suggest electrical stimulation of the correct muscles if the muscles cannot be identified in any other way. Electrical stimulation can be done in the office by the doctor or with a home unit. Electrical stimulation is usually performed daily, for 15 to 20 minutes.
When Kegel exercises are done 150-200 times per day, 15 to 30 percent (15% to 30%) of women with stress incontinence report satisfactory improvement. Another 30 to 40 percent (30% to 40%) find that symptoms get somewhat better.
After doing Kegel exercises regularly for at least six weeks, a woman can expect to see some improvement. Just as occasional sit-ups will not give a woman a flat stomach, occasional Kegel exercises will not cure incontinence. If incontinence does not get better with regular exercise, options such as weight loss, medication or surgery may be necessary.
Author: Eva Martin, MD Reviewer: HealthAnswers Australia Medical Review Panel Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia Last Updated: 1/10/2001 Contributors Potential conflict of interest information for reviewers available on request
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