The Key to Kegels

What are Kegels? Put simply, Kegels are to the pelvic floor what yoga is to the body, mind and spirit. They are an accessible form of low-impact exercise that has the potential to dramatically improve your life.

To get even more granular, “Kegel pelvic floor exercises are used to strengthen the muscles that support your uterus, bladder, bowel, and rectum,” according to WebMD. Kegels have enjoyed some publicity as of late, being touted as a way to treat erectile dysfunction and achieve pelvic floors of steel.

So how do you do them?

Many of us are not aware of where our pelvic floor muscles even are, so engaging them can be a challenge.

There are several ways, per Healthline. One is to simply replicate the experience of holding in gas. If you attempt that and then feel it in your vagina or back end, you’re doing it right! You can also locate these muscles by stopping urine while on the seat or putting a finger inside yourself while doing the exercise to feel the pull. Although please do not get in the habit of doing this routinely, as it sends mixed messages to your pelvic floor! You get one shot at it, for educational purposes only!

If you are of a certain age, think back to those claw arcade machines you played with as a child. The Cleveland Clinic compares the motion of a Kegel to the claw opening and closing around a prize.

You then will tighten your muscles for a count of five, and relax for the same count. For optimal help, perform these endurance contractions 20x, three times per week. You can also perform Quick Flicks, or “fast exhale squeeze, fast inhale release” 50x, three times per week.

Your physical therapy appointment is another great time to check your Kegel form. You shouldn’t be embarrassed or feel like you are bothering your therapist. That’s what they are there for!

Now, let’s take a closer look at what they’re for.

Pelvic Organ Prolapse

As I explain in my book The Inside Story, “POP is associated with the excessive descent of one or more of the pelvic organs or the vaginal wall.” It can happen after childbirth, and there are several different types of prolapse. These include uterine or cervix prolapse, cystocele/anterior prolapse, rectocele/posterior prolapse, and rectal prolapse. I also talk about prolapse in this blog post – well worth the read! Pelvic organ prolapse has a number of treatments, ranging from a pessary to surgery, but Kegels can make pelvic floor muscles stronger and those are the muscles that keep those organs stable.

Incontinence

Pelvic floor muscles affect how much control we have over our urination and defecation, which is why it may be recommended to strengthen them to treat urinary, urge and fecal incontinence.

Better Sex

Now I’ve got your attention! Yes, Kegels can even help in this department. According to WebMD, there is scientific evidence that Kegels can “enhance female sexual arousal by relaxing the vagina, improving lubrication and allowing more blood flow to the genitals.” In men, they may heighten the pleasure of orgasm and provide “greater control over ejaculation.” (Pelvic floor muscles really are the center to so much that goes on in our bodies!)

Who Shouldn’t Do Kegels

Kegels can be a problem for people with a hypertonic pelvic floor. This means the pelvic floor muscles are unable to fully relax. Nebraska Medicine states, “While these exercises may benefit both men and women, performing too many ─ or performing them incorrectly ─ may increase muscle tension and pain, or worsen your symptoms.” One journalist received a hypertonic pelvic floor diagnosis simply from doing Kegels alone, so you have to be careful. They also provide very limited benefit for overflow incontinence.

As usual, it is best to speak with a healthcare provider.

Also, have patience: Don’t expect overnight success as they can take up to a few months to work. Try adding Kegels to your Google calendar or doing them first thing in the morning. You can even pair them with your favorite podcast to help make the habit automatic. And the result is not only a stronger pelvic floor but stronger relationships, less embarrassment, less pain, more pleasure – overall, a pretty big impact for such a really tiny movement!

Can Urinary Urgency, Pelvic Floor Dysfunction and Vaginal Pain Be Prevented?

You’ve probably been hearing a lot about pelvic floor dysfunction and pelvic pain—because people like me don’t stop talking about it (you’re welcome). You may be wondering, “Okay, Riva, we get that YOU see the world through the lens of PFD, but how common is it really?” … “Can we talk about preventing pelvic pain?” Let me share some stats.

Research shows that at least a minimum, 30% of women have a pelvic floor disorder. So do 16% of men. Meanwhile, up to 25% of women have vestibulodynia (pain in the vestibule—the area around the urethra and vagina). And nearly 10% of women in their forties suffer from urge urinary incontinence.

Surprised? These aren’t always conditions doctors warn patients about. That’s why I’m here!

The good news? Many of these issues may be preventable. And the tips below aren’t just good for your pelvic floor—they’re good for your overall health and well-being.

Curb Constipation

Straining puts unwanted pressure on the pelvic organs. I’ve treated patients who developed prolapse (organ descent) after years of pushing and using faulty toileting mechanics.

Constipation can feel embarrassing, but there’s no room for shame here. It affects about four million people! You might have accepted it as just the consequence of a busy life, but that shouldn’t be the case! Chronic constipation burdens the pelvic floor, especially when you need to strain or push to pass a bowel movement.

Remember: peeing and pooping should be passive. No straining required.

Constipation can be occasional or chronic. Chronic constipation may last more than over 12 weeks. Talk to your doctor for a treatment plan, and also consider more water, more fiber, and regular exercise.

If you have irritable bowel syndrome (IBS), you may hesitate to add fiber since it can upset your stomach. If that’s the case, speak with a nutritionist who knows IBS well. They can help you find safe ways to include fiber.

Stop Smoking

We all know smoking is bad news. The biggest fear is cancer, but smoking also increases your risk for pelvic floor disorders.

A 2020 study in the International Journal of Urology found that urgency and urge incontinence were more common in smokers and ex-smokers than in non-smokers. A study in Neurology and Urodynamics also found a possible link between urinary urgency and smoking.

The Michigan Institute of Urology explains why: frequent coughing (common in smokers) puts downward pressure on pelvic organs. Smoking also irritates the bladder—both big problems for pelvic health.

Run Right

Running is fantastic exercise. It can prevent cancer, protect your heart, and improve sleep. But it’s not without risks. One of them is pelvic floor injury.

As I told Runner’s World, good form and proper shoes are essential to protect your pelvic floor. If you’re unsure, work with a personal trainer who knows running mechanics.

One quick tip? Run with a slight forward lean. This prevents excess strain on the pelvic floor.

Choose the Best Birth Control

Thankfully, we live in a time with many birth control options. But what works for one person may not work for another.

Research in the journal Sexual Medicine shows that combined hormonal contraceptives can increase the risk of hormonally mediated vestibulodynia (pain in the vestibule). Why? Because these contraceptives affect estrogen and testosterone levels.

Many of my patients have seen pain improve with estrogen/testosterone creams prescribed by their doctors. Oral contraceptives can also cause other side effects, such as vaginal bleeding and weight gain—factors that may contribute to pelvic floor dysfunction.

The Takeaway

Pelvic floor dysfunction, urinary urgency, and vestibulodynia can be incredibly tough to live with. And yes, some of these lifestyle changes—like quitting smoking—are difficult. But they are possible.

We work hard to prevent heart attacks or skin cancer because we want to live longer. We should protect our pelvic floor for the same reason: quality of life. Both matter.

You deserve a life full of happiness and health—especially pelvic health.

Wanna learn more? Check out my previous blog – How to Press Fast Forward on Your Pelvic Floor Recovery

Tag: postpartum recovery

What are Kegels?