Kegel Exercises for Women

Most women have heard of Kegel exercises. Whether it’s in the context of pregnancy, urinary incontinence or sexual health, Kegel exercises are often touted as being beneficial. Kegels can alternatively be called pelvic floor exercises or pelvic muscle strengthening exercises.

But what exactly are Kegel exercises, who should do them and - most important - *how* do you do them often remains a mystery to many. 

The good news: Like any form of exercise, you don’t have to wait for a reason to start doing Kegels. In fact, doing them regularly can help ensure your pelvic floor muscles stay strong and can even help prevent experiences like urinary incontinence. 

So don’t wait to learn more! Read on...

What Are the Pelvic Floor Muscles?

Most of us focus our exercise regimes on muscles that are a little more “visible” to the eye; many hope to achieve tight abs, toned arms and strong legs. 

The pelvic floor muscles are not going to change your physical appearance when they’re more toned. And so it can be easy for those who are focused on exercise-for-appearance-sake to overlook this important workout.

While they may not impact how your jeans fit, the pelvic floor muscles do an important job; they support the bladder, bowels and reproductive organs. Especially as we age, these organs can exert increasing downward pressure on our bodies. This can be caused by things like:

• Childbirth: For women who have had children, childbirth can weaken the pelvic floor muscles or cause injury. Later in life, this can make incontinence and even prolapse more likely.
• Surgery: Any abdominal surgery (e.g. hysterectomy) can disrupt how the organs sit together and support each other, putting more strain on your pelvic floor muscles.
• Constipation / straining: Regular straining on the toilet caused by constipation can put stress on the pelvic floor muscles too.
• Aging / gravity: As we age our skin thins and muscles become weaker. The effects of gravity can start to show. Pure and simple, gravity pulls things downwards over time and if muscles are not strong enough to provide support.

So in order to prevent incontinence or organ prolapse, your pelvic floor muscles must be strong.

Who Should Do Kegel Exercises?

Doctors will often start talking to women about Kegel exercises during pregnancy or later in life. This is because these events are most associated with increased risk of incontinence and prolapse.

However, women of all ages can benefit from doing Kegel exercises. They don’t just help prevent (or manage) urinary incontinence, they also are good for your general wellbeing.

Kegel exercises can also enhance your sexual health by helping you control your vaginal muscles, which allows your vagina to be more open (this is also helpful during pelvic exams). Moreover, the exercises increase blood circulation in the pelvic area, which can increase arousal.

So, don’t think of Kegel exercises just as something to do if/when incontinence occurs. Doing them when healthy can have myriad benefits, both present and preventative:

• Helps prevent urinary incontinence
• Preventing involuntary gas or fecal incontinence
• Improve symptoms of prolapse
• Orgasm improvement
• Maintaining overall pelvic floor strength

How to Do Pelvic Floor Muscle Exercises (Kegel Exercises)?

The good news about Kegel exercises is that you don’t need to set aside workout time, or buy any special gear to do them. You can do them when you’re sitting at your desk, on the couch, even in your car. 

Step 1: Identify the Right Muscles

The first step is to know which muscles you’re exercising. Your abdomen, buttocks and legs should remain relaxed when you’re doing pelvic floor exercises.

One trick to help you locate the right muscles is to stop urinating mid-stream. The muscles you use to do this are your pelvic floor muscles. Become familiar with how these muscles feel when they contract and relax. (Important: You should not make a habit of stopping urinating in this manner, just do it once to help you understand the muscles that come into play).

Other tips for finding the right muscles:

• Imagine you’re tightening your vagina around a tampon.
• Insert a finger into your vagina, then contract your pelvic floor muscles around it. You should feel your vagina tighten and your pelvic floor move upward.
• Pretend you are trying to avoid passing gas.

If you’re still not sure you’ve located the correct muscles, don’t be embarrassed to ask your doctor for help. They may use vaginal weighted cones or biofeedback to help.

Step 2: Breathe and Repeat

Now that you have identified the right muscles, you can focus on your routine. 

• Inhale through your nose. When you inhale, your pelvic floor will naturally relax.
• Now, contract your pelvic floor muscles as you start to exhale slowly.
• Hold the contraction for 3-6 seconds. You might feel the muscles start to tire.
• Relax for the same (or more) time you held your contraction. It’s important to relax between contractions.
• Repeat 10 times.

Step 3: Build Up Your Frequency

Like any workout, you’ll get stronger over time. You may find it difficult to reach 10 times initially, but you can build up to that.

Eventually you’ll want to do one set of 10 Kegels, two or three times a day. Space out the timing so you give yourself a chance to recover and don’t rush the exercises, especially at the beginning.

For continued benefits, make your Kegel exercises a permanent part of your daily routine.

Step 4: Shake it Up

Once you get the hang of it, it’s easy to do Kegels. But it’s also easy to forget! Set yourself a little reminder to do your 2-3 sets a day.

Also, consider shaking it up: Do your Kegels when sitting, standing and laying down. Occasionally, do short quick bursts (called ‘quick flicks’) and sometimes keep a more steady rhythm. 

You can do them just about anytime and anywhere, but particularly good opportunities to do Kegels include:

• In your car or on transit
• While brushing your teeth
• While watching TV
• Before you doze off

Troubleshooting Kegels: Don’ts

Like many conversations around women’s health, there can be some misconceptions about Kegels. Perhaps this is because we don’t have conversations about our health as often as we should (thankfully this is changing!)

Here are some of the things that people regularly get wrong about Kegels:

• If you experience pain: Stop right away. This is not the kind of exercise where you should “feel the burn” or “push through the pain”. Kegels should be completely painless, they can even be pleasurable. Make an appointment with your doctor to discuss it if you experience pain.
• Flexing butt or abdomen muscles: In fact, your butt and abdomen should stay relaxed when you do Kegels.
• Straining while doing the exercises: You should not strain in any way when doing Kegels. This can have a counterproductive result, adding pressure to the muscles instead of strengthening them.
• Relying too much on stopping urine mid-stream: This might be a good way to initially locate the muscles involved in Kegels, but doing this regularly can disrupt your ability to urinate and have the opposite effect; weakening your pelvic floor muscles. This is because when you urinate your brain sends a message to your bladder to loosen the muscles to allow urine to pass out of the body. By holding it in, you’re interrupting that natural process.
• Not asking for help: If you’re having trouble locating the right muscles or are unsure you’re doing Kegels right, you should absolutely ask for help from a physical therapist. Especially if you’re recovering from surgery, childbirth or another trauma, it can be difficult to engage the right muscles. Most of us have to learn to correctly lift weights at the gym. This is no different. So don’t leave it to guesswork; seek help!
• Stopping! If you’re doing Kegels to manage urinary incontinence or just to maintain your pelvic floor muscles, don’t stop. Incontinence may return if you stop. Stick to a daily routine.

How Soon Will I See Results from Kegel Exercises?

Like any exercise, don’t expect an overnight transformation. If you’re doing pelvic floor exercises to help manage stress incontinence or urge incontinence, you might want to get some leakproof underwear to help you manage in the interim.

If you stick to the routine and do your Kegels daily, 15 weeks is a good average time for you to expect to see results. Of course, for some people it can take less or more time.