Kegels 101

by Helaina Hovitz Regal

What are Kegels?

A “kegel” is a contraction of the pelvic floor muscles, which in turn lifts the pelvic organs for support. While doing so can serve several functions, we’re here to tell you that it tightens the vaginal opening, rectum, and urethra to help maintain continence and increase sexual pleasure.

“If a strong enough contraction is present, a kegel can also retract the clitoral hood allowing greater exposure of the clitoris,” says Lacey Welch, doctor of physical therapy. “It's important in all phases of life to have a healthy pelvic floor, but when estrogen starts to decline it's especially important to give some love to the pelvic floor. Kegels can also be vital in helping those with pelvic organ prolapse, and back or hip pain.”

In the 1940s Dr. Arnold Kegel began prescribing these exercises to his patients experiencing incontinence after childbirth, and after such great success and further research, "Kegels" were born. That’s why these days, we’re still doing them to help strengthen the support system for the uterus, rectum, and bladder.

Should You Start Doing Them?

Top reasons include:

• You’ve given birth or are pregnant

• You suffer from constipation

• You sometimes let out a drop or two of pee when you laugh

    Note that Welch has also seen people with a hyperactive or tense pelvic floor, and need to learn to relax the muscles before they begin strengthening and performing kegels.

    “I typically encourage women and men to start by becoming aware of the pelvic floor then decide if kegels are appropriate or not,” she says. “We can assess what our pelvic floor does or doesn't do in a number of way.”

    When we have a strong urge to go to the bathroom, are we able to hold it until we get to the toilet, only halfway there, or not at all? When we have the urge to pass gas, can we hold it in or does it enter the public without our consent? Is sex pleasurable, pleasureless, or painful? Can we feel a contraction and relaxation occur when we attempt to perform a kegel?

    “All of these things tell us a lot about our pelvic floor muscles and if there is a need to strengthen and/or relax.”

    How To Do Them

    Mayo Clinic suggests stopping yourself peeing mid-stream in order to identify the muscles you’re targeting.

    However, practicing kegels while peeing or on the toilet can actually cause bacteria to harbor in the urethra and potentially result in a UTI — so make sure you don’t overdo it.

    To do Kegel exercises, just tighten those same muscles like you would any other (like your abs, your fist, your feet) and hold that for 5-10 seconds, then release. Repeat it 5 or 10 times, wait about 10 seconds in between each “rep”, and try to squeeeeeze this in 3 times a day.

    Welch suggests you make your first attempt in a seated position, and if you feel the need to use your butt muscles or find yourself holding your breath, try them laying down.

    “Sometimes gravity is too much resistance for a weakened pelvic floor. Then you can decide on hold time and reps the same way. When you start to feel your body compensate, take a good rest and start again or let that be the end of your kegel session,” Welch says.

    Results?

    Our results will depend on how often we perform them, the quality of the kegel, and what our goal is in performing them.

    Often times, says Welch, if you’re experiencing incontinence, kegels will not be the only factor affecting your ability to resolve that. With that said, with consistent exercise 5-7 days a week, neuromuscular re-education occurs in about 6-8 weeks, and from eight weeks to six months, our muscles begin to bulk up — meaning you'll likely start to feel a increase in strength around that time or sooner.  That strength will continue to build over the next several months or longer if you continue to push your limits.

    As far as sex goes, the fact that kegels = better orgasms — or any orgasms — is kind of a myth, but a myth that comes from a grain of truth.

    You see, one of the muscles you tighten during the process is called your pubococcygeus (PC) muscle, and when you have a vaginal or clitoral orgasm, that’s one of the muscles that contracts to create the sensation.

    Also, more blood flow to the muscles can also make for better orgasms. The same way that blood rushes to the penis to create an erection, blood flow to the vagina can make it feel more sensitive and increase the arousal sensation.

    And of course, the strength you feel from knowing you're caring for yourself down there can create additional confidence, the kind you get from any sort of self-care or work out — and that, too, can make all the difference when it comes to sex.