DESCRIPTION

Kegel exercises (named for the individual who invented them) can strengthen the muscles around the vagina and increase your ability to control and relax these muscles completely. The pelvic floor muscles are special in women because they support the organs in the pelvis (uterus, bladder and bowel). Keeping these muscles strong can help prevent a prolapsed uterus or poor bladder control and may add pleasure to sexual intercourse. Kegels are often encouraged along with counseling and sex therapy, as a helpful treatment for persistent problems with reaching orgasm.

Over time, weakness develops in the pelvic floor muscles due to normal wear and tear and childbirth. The bladder, uterus and rectum begin to slip down and get squeezed into the lower regions of the pelvis. Stress incontinence may develop (urine is released during lifting, sneezing or exercising). Performing Kegel exercises can help many women relieve these symptoms.

Pregnant women will benefit from Kegel exercises. They may be performed while on your back only through the fourth month of pregnancy, and then should be done only while standing or sitting during subsequent months. After the fourth month, the growing uterus could put excessive weight on major blood vessels. Well-toned pelvic floor muscles may make you feel more comfortable as your due date approaches. You may be less likely to develop urine leakage and hemorrhoids, both common problems near the end of pregnancy and are prone to persist long after you have given birth. Following childbirth, the exercises are helpful and can be started almost immediately.

INSTRUCTIONS

LEARNING THE TECHNIQUE

To get the feel of the muscles, alternately start and stop urinating while using the toilet. Practice this tightening and releasing action while sitting, standing, walking, driving and watching TV or even while you are in your car and waiting for a red light to turn green. Another technique to try if you are not sure you are exercising the right muscles is to insert a finger into the vagina during a kegel. You should feel your vagina tighten and your pelvic floor move upward. Then relax your muscles and feel your pelvic floor move down to the starting position. As your muscles become stronger, and you become more experienced with the exercises, this movement will be more pronounced.

Note: Caution - Do not make a habit of starting and stopping your urine stream. Doing Kegel exercises with a full bladder or while emptying your bladder can actually weaken the muscles. It can also lead to incomplete emptying of the bladder, which increases your risk of a urinary tract infection.

Kegel exercises can be performed while on the floor, sitting or standing. On the floor, lie on your back with knees bent and about 12 inches apart with feet flat on the floor (do not lie on your back after the fourth month of pregnancy... sit or stand instead). Arms should be resting at your sides.

Firmly tense your pelvic floor muscles. Try to tighten the muscles a small amount at a time, "like an elevator going up to the tenth floor." Then, release very slowly, one "floor" at a time. Try it at frequent intervals for 5 seconds at a time, four or five times in a row. Work up to keeping the muscles contracted for 10 seconds at a time, relaxing for 10 seconds between contractions.

Be careful not to contract or squeeze other muscles (abdomen, thighs, buttocks) when you do Kegel exercises. If you are on your back on the floor keep your knees apart as you squeeze, and focus on tightening only the pelvic floor muscles. Also, try not to hold your breath. Just relax, breathe freely and focus on tightening the muscles around your vagina and rectum.

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EXERCISE ROUTINE

Do these exercises every morning, afternoon, and evening (3 times a day). Try to maintain a daily schedule. They can be done before or after meals, while in the shower or at the sink brushing teeth.

Start with 5 times each and gradually work up to 10 and then 20 to 30 each time.

You can vary your technique. Try doing sets of mini-kegels. Count quickly to 10 or 20, contracting and relaxing the pelvic floor muscles each time you say a number. Or slow it down, gradually contracting your pelvic floor muscles, one time.

In addition to the daily routine, try to think about the pelvic muscle when you are lifting something heavy, sneezing, coughing or laughing. Do the pelvic muscle contraction whenever you anticipate extra pressure on your pelvis. Practice is required, but eventually it will become a habit.

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KEGEL AIDS

Weighted vaginal cones can be used to help strengthen the pelvic muscle. The cones come in a set of 5 that vary in weight. The tapered end of the cone is inserted into the vagina and the pelvic muscle is contracted to try and hold it in, so that it does not slip out of the vagina. As the muscles get stronger, you progress to a heavier cone.

VAGINAL CONE LINKS & PRODUCTS


• www.kegel-exercise.com: Vaginal Cones
  
• Yahoo.com: FemTone Vaginal Weights
  
• Q&A: Vaginal Weights
  
• www.biolifedynamics.com: Step Free Vaginal Weights
  
• A Study on Using Vaginal Weights

A perineometer (or Kegelometer) is a device that is placed in the vagina and has a numbered gauge that will show the strength of the muscle contraction.

PERINEOMETER LINKS & PRODUCTS


• A Personal Perineometer Patient Instructions
  
• Cardio Design, Australia: Peritron Perineometer
  
• Peritron Perineometer, UK
  
• The Foundation For Intimacy: Kegel Perineotometer

BIOFEEDBACK & PELVIC FLOOR MUSCLES

If you have trouble doing Kegel exercises, biofeedback training may help. In a biofeedback session, a nurse, therapist or technician will either insert a monitoring probe into your vagina or place adhesive electrodes on the skin outside your vagina or rectal area. When you contract your pelvic floor muscles, you will see a measurement on a monitor that lets you know whether you have successfully contracted the right muscles. You will also be able to see how long you hold the contraction.

Another technique uses electrical stimulation to help you feel the muscles contract. The procedure is painless, although you'll experience a buzzing feeling as a small electrical current is applied to your pelvic floor muscles, making them contract. Once you feel this sensation a few times, you will probably be able to duplicate the exercise on your own. Because simpler methods work for most women, this technique is rarely used.

WHEN TO EXPECT RESULTS

If you do your Kegel exercises faithfully, you can expect to see some results, such as less frequent urine leakage, within about eight to 12 weeks. Your improvement may be dramatic - or, at the very least, you may keep your problems from worsening. As with other forms of physical activity, you need to make Kegel exercises a lifelong practice to get lifelong benefits.

KEGEL PRODUCTS

Some Kegel Products from Amazon.com



Note: These devices are not inexpensive. Talk to your health care provider or midwife about their possible usefulness in your situation.

A self-help audiotape is available that teaches pelvic floor exercises (there is a cost for the tape). Contact:

Help for Incontinent People (HIP)
(800) BLADDER

or write to:
HIP
P.O. Box 8310
Spartanburg, SC 29305.

Training on Kegel exercises may also be provided by the health care provider, midwife or physical therapist.

Computer assisted biofeedback technique is available in some medical offices. It measures the strength of muscle contractions and determines if the correct muscles are being used.

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OTHER SUGGESTIONS TO KEEP PELVIC FLOOR STRONG

If you are overweight, try to lose the excess pounds. Pelvic floor problems are more likely to occur in overweight women.

Do not smoke. There appears to be a predisposition to pelvic weakness among smokers.

Always lift heavy objects with care, or get help with lifting if needed. Always lift using your legs, not your back to prevent back strain and injury.

Keep aerobic exercises low impact. It is not known for sure if high impact aerobics affect the pelvic floor, but the trauma of repetitive jolting may lead to damage of the pelvic nerves and muscles.

Avoid constipation. Straining may cause damage to pelvic muscles or nerves. Eat a high fiber diet and drink at least 8 to 10 glasses of water daily.

MoonDragon's ObGyn Womens Health Information: Constipation



NOTIFY YOUR MIDWIFE OR HEALTH CARE PROVIDER IF...

You want additional information about Kegel exercise.

If you have concerns or problems with incontinence.

MoonDragon's ObGyn Womens Health Information: Incontinence, Stress

MoonDragon's ObGyn Womens Health Information: Incontinence, Urge

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