How and Why to Do Kegels

Kegels at a glance

  • Kegels are simple contraction exercises for a woman’s pelvic floor that can prevent & cure conditions caused by weak pelvic floor muscles, including stress incontinence, and improve overall pelvic health.
  • The pelvic floor muscles that support the uterus, bladder, urethra, bowel and vagina can weaken due to aging, childbirth, menopause and other causes.
  • The CU Urogynecology team recommends that all women do Kegels, even if they have no urinary incontinence symptoms, in order to prevent incontinence later in life.
  • Women usually start seeing benefits from Kegels after 1 to 3 months of consistent practice.

About Kegels and why we do them

Dr. Arnold Kegel was a gynecologist who developed the exercise now named after him in 1948 for his patients experiencing stress urinary incontinence – leaking urine when a cough, laugh, sneeze, exercise or strain adds pressure to pelvic floor muscles. Stress incontinence and other problems are caused by weakened pelvic floor muscles that support the urethra and keep it closed at rest.

The loss of pelvic floor muscle strength may be due to a number of factors, including:

  • Aging (urinary incontinence occurs more often as women age)
  • Pregnancy
  • Childbirth
  • Being overweight
  • Stress from lifting or straining with constipation
  • Neurological disorders of the brain and spinal cord

Kegels are a noninvasive, easy way for women to prevent or lessen incidents of urinary incontinence. Kegels are also good exercises for men, particularly those who have had prostate surgery. These muscles squeeze on the urethra to keep it closed at rest and also keep the urethra closed during movement or when coughing, laughing or sneezing. If these muscles do not contract well, then urine will leak from the bladder under pressure.

The American College of Physicians recommends Kegel exercises for women with stress urinary incontinence and with mixed urinary incontinence (stress and urge incontinence combined). We recommend that every woman adopt a Kegel exercise routine, even perfectly healthy women, because Kegels can prevent pelvic floor disorders from occurring.

Another benefit: better sex

Kegels can also improve a woman’s sexual experiences. Research shows they can improve orgasms and sexual arousal. They can help some women relax their pelvic muscles during intercourse, making sex more pleasurable. A woman can also do Kegels during sex, which can be pleasurable for her partner.

How to Kegel: exercise steps

Kegel exercises can be done when lying down, sitting at a desk or riding in a car. They don’t require a trip to the gym, changing into workout clothes or even a change of facial expression.

Contracting the pelvic floor muscles in a Kegel exercise is the same action as starting to urinate then stopping, while making sure the buttocks, thighs and abdomen remain relaxed. If done correctly, a woman will feel the muscles in the vagina, anus and bladder tighten and lift upward.

One can practice this while sitting on the toilet by urinating then suddenly holding in the urine flow. Contracting to achieve that hold is a Kegel. If urine leaks out during the contraction, the woman is probably pushing her muscles down, not up. Once a woman knows the correct muscles are contracting, then it is best for her to do Kegels when she is not urinating. If she cannot contract her pelvic floor muscles, she should talk with her urogynecologist and consider pelvic floor physical therapy.

Basic Kegel exercise sequence

Kegels, like many exercises, are done in sets. We recommend women start by doing three sets of 10 Kegels, three times a day (for a total of 90 Kegels). This routine may sound like it would be too time consuming to complete every day, but fortunately each Kegel takes only a few seconds.

Steps to follow for each Kegel session:

  • Have an empty bladder
  • Relax and focus on muscle control
  • Sit with feet and knees wide apart, elbows resting on the knees
  • Stomach, leg and buttocks muscles must be relaxed
  • Contract the pelvic floor muscles (as if holding back urine) for 3-5 seconds
  • Relax for 3-5 seconds, then repeat the process.

Our guidelines on more advanced Kegel exercises are below.

Seeing results

Women can establish their own Kegel routines and pursue different methods to motivate themselves to stick with it. As with any exercise routine, it takes time and consistency to increase pelvic floor strength.

Some women start to see results, such as reduction of stress urine leakage, in one month. For others it can take up to three months. A pelvic floor physical therapist or urogynecologist can also help if a woman is having problems with her exercises.

Request an appointment with our urogynecologists

Testing Kegel technique & advanced exercises

A woman can check if she is doing the Kegel contraction properly by inserting a finger into her vagina, tightening the pelvic floor muscles as if holding in urine, then releasing them. If she feels the muscles tighten and move up, then down upon release, she is doing the Kegel correctly.

If not, the wrong muscles are being contracted. And doing the Kegel incorrectly lessens the benefit of the exercise.

Traditional products such, as weights, cones and instructional videos, can help women do Kegel exercises correctly. So can newer electronic devices inserted in the vagina.

Several products are on the market, varying by use with smartphone apps, method of measuring muscle movement and additional features. They include Elvie, KGoal and KegelSmart. Several smartphone apps, such as Birdi and Kegel Kat, provide instruction and reminders.

Kegel devices & apps for quality control

Advanced Kegel exercises

The basic exercise routine of 90 Kegels a day is a good start. Dr. Kegel wanted his patients to do 600 a day. Some women may need specialized regimens, depending on their doctor’s advice.

A woman can first establish a routine of doing morning, afternoon and evening sets. While performing Kegels, she should routinely monitor her exercise technique to make sure it is correct. Once she feels she has mastered the basics, she can move into a more advanced exercise routine, such as the following:

  • Increase the amount of time holding each contraction, up to 10 seconds
  • Combine sets of 5-second and 10-second contractions
  • Add quick, repetitive squeezes and graduated squeezes (tight, tighter, tightest) to work this muscle in several ways
  • Do them after another workout routine
  • Try different positions
    • Lying down with legs stretched out and relaxed
    • Lying on the side with legs bent some.

University of Colorado Urogynecology is a specialty women’s health practice focused on female pelvic health and surgery. Our physicians are also professors & researchers for the CU School of Medicine, one of the top-ranked medical schools in the nation.

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