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    Kegel exercises - self-care

    Pelvic muscle strengthening exercises; Pelvic floor exercises

    Kegel exercises can help make the 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 or if you gain weight, after pregnancy and childbirth, or after prostate surgery (men) or gynecologic (female) surgery. 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 have to urinate and then holding it. You relax and tighten the muscles that control urine flow. It's 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've done the exercise right.

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

    • 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 three times a day:

    • Make sure your bladder is empty, then sit or lie down.
    • Tighten the pelvic floor muscles. Hold tight and count to 6 to 8.
    • Relax the muscles and count to 10.
    • Repeat 10 times, three 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 feel better and 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.
    • 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

    Call your doctor or nurse if you are not sure you are doing Kegel exercises the right way. Your doctor or nurse can check to see if you are doing them correctly.

    References

    Holroyd-Leduc JM, Tannenbaum C, Thorpe KE, Straus SE. What type of urinary incontinence does this woman have? JAMA. 2008;299:1446-1456.

    Landefeld CS, Bowers BJ, Feld AD, Hartmann KE, Hoffman E, Ingber MJ, et al. National Institutes of Health state-of-the-science conference statement: prevention of fecal and urinary incontinence in adults. Ann Intern Med. 2008 Mar 18;148(6):449-58. Epub 2008 Feb 11.

    Rogers RG. Clinical practice. Urinary stress incontinence in women. N Engl J Med. 2008;358:1029-1036.

    Lentz GM. Urogynecology. In: Lentz GM, Lobo RA, Gershenson DM, Katz VL, eds. Comprehensive Gynecology. 6th ed. Philadelphia, Pa: Mosby Elsevier; 2012;chap 21.

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              Review Date: 12/12/2012

              Reviewed By: Jennifer K. Mannheim, ARNP, Medical Staff, Department of Psychiatry and Behavioral Health, Seattle Children's Hospital; and Louis S. Liou, MD, PhD, Chief of Urology, Cambridge Health Alliance, Visiting Assistant Professor of Surgery, Harvard Medical School. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, David R. Eltz, Stephanie Slon, and Nissi Wang.

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