Learn How to Kegel
by John Sunyecz, M.D., F.A.C.O.G.
Kegel exercises help tone and strengthen the pelvic
floor muscles. These muscles are important for proper tone of the
bladder, urethra, vagina, uterus and rectum. Kegel exercises should
be done by all women, but especially after the delivery of an infant,
as a treatment for urinary incontinence and pelvic relaxation that
often comes with the aging process, and for improving sexual relations
by improving pelvic floor control.
Multiple studies have been done with Kegel exercises showing success
for urinary incontinence. A study in the Journal of Gerontology (J
Gerontol 1993 Jul;48(4):M167-74) by Burns PA, et al showed that "biofeedback
and pelvic muscle exercises are efficacious for sphincteric incompetence
in older women. Benefits are maintained and improvement continues
for at least 6 months post-intervention. These therapies may be useful
before considering invasive treatment." A recent study by Cammu
H, et al in the British Journal of Urology (BJU Int 2000 Apr;85(6):655-8)
showed that pelvic floor exercises for urine incontinence, when successfully
performed, had a 66% chance of favorable results for at least 10 years.
Unfortunately, women are poorly informed about the benefits of these
exercises. Through proper teaching and continued practice, women can
learn the correct technique. For optimal benefit, you need to perform
Kegel exercises daily. The best part of these exercises is that they
are free, painless, and can be done at any time of the day.
The proper technique relies upon finding the proper muscle group.
Ask your physician about identifying this muscle group during your
next gynecologic exam. Alternatively, you can find this muscle by
inserting your finger into the vagina and squeezing around it. If
you feel pressure around your finger, you have found the correct muscle.
This is also the muscle used to voluntarily stop your stream of urine.
Try to isolate this muscle (the levator group of muscles) while
relaxing your legs, back, and abdominal muscles. Practice will make
perfect. Initially, do these exercises while lying down or sitting
comfortably. When comfortable with the technique, you can do these
while driving, watching television, during meals, etc. To avoid confusing
the bladder muscle, do not perform repetitively while urinating.
The correct number of exercises per day is variable. Evidence suggests
that at least 50 repetitions are helpful. A repetition consists of
squeezing the levator muscle for 5 seconds and relaxing for 5 seconds.
Performing 10 repetitions five times a day will achieve the minimum
50 repetitions. You should be able to build up to holding the levator
muscle for 10 seconds with practice. Do not expect miracles over night.
Most women find improvement in urine incontinence and sexual relations
after 4-6 weeks of therapy.
One of the most important aspects of these exercises (like any form
of exercise) is persistence and a daily routine. Try to pick activities
during the day to remind you of the exercises. Upon awakening, with
morning tea, driving to work, at lunch, driving home from work, watching
television, and before bed are common times for women to perform these
exercises. Keep a calendar and monitor your improvement.
With a little persistence and patience, these exercises can be very
effective.
John Sunyecz, M.D., F.A.C.O.G., a board certified gynecologist
with special interest in menopause and its treatments. He received
his undergraduate degree cum laude with honors and distinction in
Pharmacy at the Ohio State University. He studied natural products
and developed an interest in their use for medicinal purposes. He
continued at Ohio State for medical school, where he graduated cum
laude. He completed his formal residency training at Magee-Womens
Hospital in Pittsburgh, PA., where he served as chief resident during
his final year of residency. He currently has a large clinical practice
in Southwestern, PA. and is president of MenopauseRx.com,
a website devoted to the education of menopause and the perimenopause..
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