By Joseph Gauta, M.D.
As a woman, maintaining the integrity of your pelvic floor is an important part of maintaining your overall heath, regardless if you are approaching childbearing or passing through menopause. Understanding the role your pelvic floor plays in your health and wellness may give you the motivation to keep it toned and healthy.
At its most basic level, a Kegel exercise consists of tightening and releasing the PC muscle. If you are unfamiliar with the action of your PC muscle, you can isolate it by stopping the flow of your urine midstream
About the Pelvic Floor
Your pelvic floor is a band of muscles in the shape of a figure eight that surrounds your vaginal opening and rectum. These muscles act as a kind of hammock that supports the organs of your pelvic region, such as your uterus and bladder. The pubococcygeus muscle (PC muscle) is a part of your overall pelvic floor muscular makeup.
This muscle helps you control the flow of your urine, and its strength is also often associated with the increased ability to orgasm.
Over the course of a woman’s life, the hammock of pelvic muscles becomes stretched and can loose its integrity from hormonal changes and the aging process. The integrity of the pelvic floor can also be jeopardized by other life factors such as:
• The added weight of pregnancy
• Vaginal birth
• Surgery in the pelvic region, including C-sections
• Being overweight
• Chronic constipation or coughing
Dangers of a Weak Pelvic Floor
A weakened pelvic floor presents several health risks for women:
Pelvic organ prolapse: Prolapses occur when your pelvic floor is too weak to hold up one or more of your pelvic organs and they fall from their normal place to walls of your vagina or, in worse case scenarios, protrude from the vagina. Bladder, uterine, vaginal, bowel, and rectum prolapses can occur.
Incontinence: A weakened PC muscle is not able to properly support the weight of a full bladder and control urine output, leading to incontinence.
Lack of sexual sensation: Women with a compromised pelvic floor may have less sexual sensation and trouble reaching orgasm.
Strengthen the Pelvic Floor Using Kegels
To help avoid the problems that arise from a weak pelvic floor, most gynecologists recommend that all women from their childbearing years onward should exercise the muscles of the pelvic floor by doing Kegel exercises.
At its most basic level, a Kegel exercise consists of tightening and releasing the PC muscle. If you are unfamiliar with the action of your PC muscle, you can isolate it by stopping the flow of your urine midstream (though you shouldn’t regularly perform Kegels while going the bathroom).
Once you identify your PC muscle, tighten the muscle as you exhale, which ensures that you aren’t actually using the surrounding muscles of your thighs and buttocks. All you need to do is tighten and release this muscle, and you’re doing Kegels.
There are many different Kegel variations that you can try:
• Rapidly contract and relax your muscles, working up to a count of 100, then 200, a day.
• Contract the muscles and hold them taut for as long as you can. Try working up to holding the Kegel for 10, then 15, then 20 seconds.
• Imagine the muscles of your vagina as a building, with your pelvic floor as the first floor of the building and the top floor as your bellybutton. Slowly tighten your muscles upward, as if it they are an elevator moving up through the building. Hold at the top floor then slowly release downwards.
• Tighten your muscles a little and hold for five seconds, tighten a little more and hold for another five seconds. Tighten as hard as you can and hold for five more seconds. Then reverse the motion, relaxing slightly and holding for five seconds, then relaxing a little more, holding for five seconds, then relaxing the muscles completely.
Even though well woman care providers recommend that you do Kegel exercises everyday, Kegels are at least convenient. You can do them anytime, anywhere, without anyone ever knowing the difference. Picking a specific time of day can help you remember to do them.
Some examples include:
• At each stoplight while driving to work
• Reading the morning news
• For new moms, while feeding your baby
It doesn’t matter where or when you do your Kegels – just try to do them everyday.
If you are doing Kegels because you suffer from urinary incontinence, it might take two to three months of practicing the exercises to help reduce your incontinence. But even though your symptoms aren’t instantly relieved, you will likely be surprised and encouraged at how rapidly your muscles strengthen.
For example, you may find that you are only able to do 50 basic Kegels at first, or only able to do the first half of an elevator Kegel, and that’s okay. Just do what you can and you will find that with a little practice you can challenge yourself as you gain more muscular control.
Kegel exercises, when done regularly, can help reverse some incontinence, prevent pelvic organ prolapse, and increase sexual sensation. They are the important tool that helps keep your pelvic floor strong for life.
If you have questions about Kegels, pelvic organ prolapse, incontinence, or pregnancy and birth, don’t hesitate to call and schedule an appointment.
Florida Bladder Institute