“If you don’t you use it, you lose it” principle also applies to the muscles in the pelvis. Age, menopause and childbirth can cause weakness and looseness to the pelvic floor muscles known as the levator ani.
They wrap around the anus, urethra and vagina in the female pelvis and support the organs in the pelvis: the bladder, vagina/uterus and rectum. When pelvic muscles and their connective tissue covering (fascia) weaken or tear, women may experience urine leak when coughing, sneezing, laughing or exercising (stress incontinence), or have the sense that the bladder or other pelvic organs are dropping or pushing into the vagina. Overactive bladder symptoms can also occur with a dropped bladder, such as urgency , frequency and urine leak (the “I gotta go and I can’t hold it any longer” feeling). Importantly, weak pelvic floor muscles can give a woman the feeling of vaginal looseness, and decreased sensation and/or satisfaction during sex.
Strengthening the pelvic floor muscles (PFM) by performing Kegel exercises helps to improve the tone, essentially, of these muscles. Imagine trying to stop the flow of urine during urination, or holding in poop, well, these are the sphincter muscles that can be strengthened by Kegel exercises. The main challenge is figuring out for yourself how to isolate and squeeze these muscles. But once you have, it’s easy.
Repetitive exercises can reduce stress incontinence, help with mild bladder drop, and improve tightness and sensation during sex and orgasm.
One should always begin by emptying the bladder, then relax. Tighten the PFMs and hold it for a count of 10 seconds. You should feel a sensation of lifting around the vagina or pulling around the rectum. Another way to do PFMs is to tighten and hold the PFMs tight for 10 seconds straight and then relax. Do this 10 times and repeat 3 times a day.
Try to do 10 sets of PFMs in the morning, 10 in the afternoon, and 15 at night. Or you can do it for 10 minutes 3 times a day. In the beginning, you may not be able to hold the contraction for the complete 10 count or do 10 full repetitions. However, you will slowly build to this over time. The muscles may start to tire after 6 or 8 contractions or sets. Take a break then and do some later on.
These exercises can be practiced anywhere and anytime. Most women seem to prefer doing them in bed while lying down or while sitting. Women can also try to do them during sex. Tighten the muscles to grip your partner’s penis or finger and then relax. Your partner should be able to feel the increase in pressure.
Never use your stomach muscles, legs or buttock muscles. Rest your hand on your abdomen during PFMs to see if you tense up here. Eventually, they will become effortless and part of your lifestyle. You may do them while walking, before you sneeze, or on the way to the bathroom.
After 4-6 weeks of consistent daily exercise, most women will see results. Women will notice less accidents, and feel more confident. Sex may feel better as well. After 3 months the results will be even more noticeable.
Kegel muscle exercises are not harmful and most women find them easy and relaxing. If your stomach or back muscles feel tense, then you’re probably not doing PFMs the right way. Breathing during any exercise is important, including these. Headache or neck ache can be from holding one’s breath. Breathe easy like in Lamaze or yoga.
Dr. Matthew Karlovsky is a urologist that specializes in female pelvic health in Phoenix, Ariz. For more information, visit www.urodoc.net or www.femaleurologyaz.blogspot.com/