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Kegel exercises - self-care

Description

Kegel exercises can help make the pelvic floor muscles under the uterus, bladder, and bowel (large intestine) stronger. They can help both men and women who have problems with urine leakage or bowel control. You may have these problems:

• As you get older

• If you gain weight

• After pregnancy and childbirth

• After gynecologic surgery (women)

• After prostate surgery (men)

People who have brain and nerve disorders may also have problems with urine leakage or bowel control.

Kegel exercises can be done any time you are sitting or lying down. You can do them when you are eating, sitting at your desk, driving, and when you are resting or watching television.

How to Find the Right Muscles

A Kegel exercise is like pretending you are urinating and then holding it. You relax and tighten the muscles that control urine flow. It is important to find the right muscles to tighten.

Next time you have to urinate, start to go and then stop. Feel the muscles in your vagina (for women), bladder, or anus get tight and move up. These are the pelvic floor muscles. If you feel them tighten, you have done the exercise right. Your thighs, buttock muscles, and abdomen should remain relaxed.

If you still are not sure you are tightening the right muscles:

• Imagine that you are trying to keep yourself from passing gas.

• Women: Insert a finger into your vagina. Tighten the muscles as if you are holding in your urine, then let go. You should feel the muscles tighten and move up and down.

• Men: Insert a finger into your rectum. Tighten the muscles as if you are holding in your urine, then let go. You should feel the muscles tighten and move up and down.

How to do Kegel Exercises

Once you know what the movement feels like, do Kegel exercises 3 times a day:

• Make sure your bladder is empty, then sit or lie down.

• Tighten your pelvic floor muscles. Hold tight and count 3 to 5 seconds.

• Relax the muscles and count 3 to 5 seconds.

• Repeat 10 times, 3 times a day (morning, afternoon, and night).

Breathe deeply and relax your body when you are doing these exercises. Make sure you are not tightening your stomach, thigh, buttock, or chest muscles.

After 4 to 6 weeks, you should have fewer symptoms. Keep doing the exercises, but do not increase how many you do. Overdoing it can lead to straining when you urinate or move your bowels.

Some notes of caution:

• Once you learn how to do them, do not practice Kegel exercises at the same time you are urinating more than twice a month. Doing the exercises while you are urinating can weaken your pelvic floor muscles over time or cause damage to bladder and kidneys.

• In women, doing Kegel exercises incorrectly or with too much force may cause vaginal muscles to tighten too much. This can cause pain during sexual intercourse.

• Incontinence will return if you stop doing these exercises. Once you start doing them, you may need to do them for the rest of your life.

• It may take several months for your incontinence to lessen once you start doing these exercises.

When to Call the Doctor

Contact your health care provider if you are not sure you are doing Kegel exercises the right way. Your provider can check to see if you are doing them correctly. You may be referred to a physical therapist who specializes in pelvic floor exercises.

References

Lentz GM, Miller JL. Lower urinary tract function and disorders: physiology of micturition, voiding dysfunction, urinary incontinence, urinary tract infections, and painful bladder syndrome. In: Gershenson DM, Lentz GM, Valea FA, Lobo RA, eds. Comprehensive Gynecology. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 21.

Newman DK, Burgio KL. Conservative management of urinary incontinence: behavioral and pelvic floor therapy and urethral and pelvic devices. In: Partin AW, Dmochowski RR, Kavoussi LR, Peters CA, eds. Campbell-Walsh-Wein Urology. 12th ed. Philadelphia, PA: Elsevier; 2021:chap 121.

Resnick NM, DuBeau CE. Urinary incontinence. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 115.

Review Date: 1/1/2025

Reviewed By: Kelly L. Stratton, MD, FACS, Associate Professor, Department of Urology, University of Oklahoma Health Sciences Center, Oklahoma City, OK. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.