First, a little background: Kegels tone and strengthen the pubococcygeal (PC) muscles — three sets of muscles that run like a hammock from your back to your pubic bone, encircling the openings to the vagina and the rectum. “During orgasm, these muscles contract rhythmically. The stronger they are, the more intense the sensation,” says urogynecologist Hilary Cholhan, M.D., director of the Rochester Regional Continence Center in Rochester, NY. Another sex bonus: A woman with strong PCs can grasp her partner’s penis and heighten his sensations by contracting and releasing her muscles.

Locate the right muscles by stopping your urine stream the next time you’re in the bathroom. (Don’t routinely do Kegels while urinating or with a full bladder, though, because this can actually weaken the muscles.) You can also find your PC muscles by inserting a finger into your vagina and trying to squeeze your finger. Make sure you’re not tensing your thighs, buttocks, or anal muscles. Then try these exercises:

The basic Kegel: Slowly contract your muscles, drawing inward and upward. Hold for a count of three; then slowly relax for three seconds. Repeat as many times as you can, working up to 25 or 30 three-second squeezes.

Flutter Kegels: Squeeze and relax the PC muscle rapidly, in a pulsing motion. In the beginning aim for consistency of pulses, rather than speed; that will come with time and practice. Work up to 25 or 30 pulses.

The Kegel push-out: After releasing the contraction, gently push down and out with your PC muscles (no bearing down!). Create Kegel sequences that combine long and short repetitions with push-outs — for example, 10 short squeezes, 10 long squeezes, and five push-outs (any sequence will do).

Elevator Kegels: Picture your vagina as an elevator shaft, with the elevator car at the opening of your vagina. Slowly tighten your muscles as you imagine raising the elevator, pausing at the top, and then lowering it again. Repeat 10 times.

Finally, to really work the PC muscles, do Kegels in various positions — while sitting, standing, lying down, or kneeling — two or three times a day. If you do them regularly, you’ll feel the difference in eight to 12 weeks.

Exercising Your Pelvic Muscles

Why exercise pelvic muscles? How do you exercise your pelvic muscles? Hold the Squeeze ’til After the Sneeze Points to Remember Why exercise pelvic muscles?

Life’s events can weaken pelvic muscles. Pregnancy, childbirth, and being overweight can do it. Luckily, when these muscles get weak, you can help make them strong again.

Pelvic floor muscles are just like other muscles. Exercise can make them stronger. Women with bladder control problems can regain control through pelvic muscle exercises, also called Kegel exercises.The pelvic muscles work to control the release of urine.

Pelvic Fitness in Minutes a Day

Exercising your pelvic floor muscles for just 5 minutes, three times a day can make a big difference to your bladder control. Exercise strengthens muscles that hold the bladder and many other organs in place.

The part of your body including your hip bones is the pelvic area. At the bottom of the pelvis, several layers of muscle stretch between your legs. The muscles attach to the front, back, and sides of the pelvis bone.

Two pelvic muscles do most of the work. The biggest one stretches like a hammock. The other is shaped like a triangle. These muscles prevent leaking of urine and stool.

You can make these pelvic floor muscles stronger with a few minutes of exercise every day.
How do you exercise your pelvic muscles?
Find the right muscles. This is very important. Your doctor, nurse, or physical therapist will help make sure you are doing the exercises the right way.

You should tighten the two major muscles that stretch across your pelvic floor. They are the “hammock” muscle and the “triangle” muscle. Here are three methods to check for the correct muscles.

Try to stop the flow of urine when you are sitting on the toilet. If you can do it, you are using the right muscles.

Imagine that you are trying to stop passing gas. Squeeze the muscles you would use. If you sense a “pulling” feeling, those are the right muscles for pelvic exercises.

Lie down and put your finger inside your vagina. Squeeze as if you were trying to stop urine from coming out. If you feel tightness on your finger, you are squeezing the right pelvic muscle.

Don’t squeeze other muscles at the same time. Be careful not to tighten your stomach, legs, or other muscles. Squeezing the wrong muscles can put more pressure on your bladder control muscles. Just squeeze the pelvic muscle. Don’t hold your breath.

Repeat, but don’t overdo it. At first, find a quiet spot to practice—your bathroom or bedroom—so you can concentrate. Lie on the floor. Pull in the pelvic muscles and hold for a count of 3. Then relax for a count of 3. Work up to 10 to 15 repeats each time you exercise.

Healthy sphincter muscles can keep the urethra closed.
Do your pelvic exercises at least three times a day. Every day, use three positions: lying down, sitting, and standing. You can exercise while lying on the floor, sitting at a desk, or standing in the kitchen. Using all three positions makes the muscles strongest.

Be patient. Don’t give up. It’s just 5 minutes, three times a day. You may not feel your bladder control improve until after 3 to 6 weeks. Still, most women do notice an improvement after a few weeks.

Exercise aids. You can also exercise by using special weights or biofeedback. Ask your health care team about these exercise aids.

Hold the Squeeze ’til After the Sneeze
You can protect your pelvic muscles from more damage by bracing yourself.

Think ahead, just before sneezing, lifting, or jumping. Sudden pressure from such actions can hurt those pelvic muscles. Squeeze your pelvic muscles tightly and hold on until after you sneeze, lift, or jump.

After you train yourself to tighten the pelvic muscles for these moments, you will have fewer accidents.

Points to Remember
- Weak pelvic muscles often cause bladder control problems.|
- Daily exercises can strengthen pelvic muscles.
- These exercises often improve bladder control.
- Ask your doctor of nurse if you are squeezing the right muscles.
- Tighten your pelvic muscles before sneezing, lifting, or jumping. This can prevent pelvic muscle damage.

My Pelvic Muscle Exercise Log
Print out this chart and record your pelvic muscle exercises.

Sunday
I exercised my pelvic muscles ____ times.
I spent ____ minutes exercising.
At each exercise session, I squeezed my pelvic muscles ____ times.

Monday
I exercised my pelvic muscles ____ times.
I spent ____ minutes exercising.
At each exercise session, I squeezed my pelvic muscles ____ times.

Tuesday
I exercised my pelvic muscles ____ times.
I spent ____ minutes exercising.
At each exercise session, I squeezed my pelvic muscles ____ times.

Wednesday
I exercised my pelvic muscles ____ times.
I spent ____ minutes exercising.
At each exercise session, I squeezed my pelvic muscles ____ times.

Thursday
I exercised my pelvic muscles ____ times.
I spent ____ minutes exercising.
At each exercise session, I squeezed my pelvic muscles ____ times.

Friday
I exercised my pelvic muscles ____ times.
I spent ____ minutes exercising.
At each exercise session, I squeezed my pelvic muscles ____ times.

Saturday
I exercised my pelvic muscles ____ times.
I spent ____ minutes exercising.
At each exercise session, I squeezed my pelvic muscles ____ times.

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Let’s Talk about Bladder Control for Women is a public health awareness campaign conducted by the National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC), an information dissemination service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institutes of Health.

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The National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC) is a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). The NIDDK is part of the National Institutes of Health of the U.S. Department of Health and Human Services. Established in 1987, the Clearinghouse provides information about diseases of the kidneys and urologic system to people with kidney and urologic disorders and to their families, health care professionals, and the public. The NKUDIC answers inquiries, develops and distributes publications, and works closely with professional and patient organizations and Government agencies to coordinate resources about kidney and urologic diseases.

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