Kegels

Download PDF Brochure Version Dear Dr. Myrtle, What can you tell me about Kegels? My doctor recommended I start doing them because I leak urine when I sneeze or jump, but I'm not sure what they are or where to begin. What is the pelvic floor? The pelvic floor muscle group is made up of six muscles that form a sling in the lower pelvis. They support the bladder, rectum, and uterus, keeping them in place, and are responsible for: the pleasurable muscle contractions felt in the pelvis during orgasm; assisting in vaginal delivery, keeping urine inside the bladder at moments of increased belly pressure (laughing, coughing, sneezing, jumping) How do I know if I have weakness of my pelvic floor? Do you unexpectedly lose urine when you laugh, cough, sneeze or jump? Do you avoid the above activities because you're afraid you'll leak urine? Do you lose any urine when you do heavy lifting? Have you ever delivered a pregnancy vaginally? Have you noticed that your orgasms feel less intense than they used to feel? If you answered yes to any of these questions, you've experienced events which may relate to weakness of your pelvic floor. What can I do to increase my pelvic floor strength? Kegel exercises are biofeedback exercises developed by Dr. Kegel (a surgeon), designed to increase the resting tone and strength of your pelvic floor muscles. Biofeedback devices allow you to feel and move the muscles of your pelvic floor correctly, and act as resistance weights for your muscles to work against. These tools help you understand how to flex & relax your pelvic floor muscles. You can transition to not using them once your exercise routine is underway. Step 1: Choose a Kegel Device The Stone Exercise Egg is our most frequently recommended Kegel exerciser. Recommended for women who want something moderately weighted, the Stone Exercise Egg has a polished, smooth surface which is comfortable for women with thin, fragile or dry vaginal skin. It is suitable for women who can comfortably insert two fingers or more into their vaginas when they are not aroused. It is not recommended for women who have urethral sensitivity, because when applying resistance, the Egg will push on the urethra. The Smart Balls are the lightest in weight, with an interior rolling ball for subtle additional stimulation. They are recommended for women who have weak pelvic floor muscles, but also want something to wear and condition their vaginal walls while doing chores. Because of their rougher surface texture, they are not recommended for women who have fragile vaginal skin, urethral sensitivity, or who cannot comfortably insert two fingers into their vagina. The Energie Exerciser is recommended for women who have urethral sensitivity because this device will not put pressure forward on the urethra and pubic bone during use. The surface is polished smooth, and it is suitable for women with thin or fragile vaginal skin, and/or women who can comfortalby insert only one finger into their vaginas. The Energie Exerciser is quite heavy, adds extra sensory information for those with less vulvar sensitivity, and is particularly good for women strengthening their perineal muscle group. The larger tip can be used by women with weaker muscles, giving them a more substantial surface to grip onto. Step 2: Other Supplies Most women will not be exercising their pelvic floor in a sexually aroused state and will feel more comfortable using vaginal biofeedback devices with a sexual lubricant like Liquid Silk. Step 3: Learn how to do one Kegel Find a private place where you won't be disturbed and lie down somewhere comfortable. You may want a towel beneath you. Lightly lubricate your device. Take a breath, and insert your Kegel exercise tool or finger(s) about three inches into your vagina. You physically cannot insert your device too far into your body, but you only need to insert it two to three inches. The Smart Balls and Stone Exercise Egg should slip into place just behind the pubic bone, and the cord will remain on the outside of your body. The Energie Exerciser should be inserted a few inches into the vagina until it rests there comfortably; the other end will be outside of your body. If you're not using a tool, insert one or two lubricated fingers 2 - 3inches into the vagina. Lift or pull the tool (or fingers) up into your body using your pelvic floor muscles. Imagine you are pulling the tool up, toward your belly button. If you're lifting correctly, you'll be able to feel the tool rise a bit, or feel the "lift" around your finger(s). Your leg and buttocks muscles are relaxed when lifting. Your pelvic floor will grip your exercise tool internally. Try putting your palm against your vulva, then doing a lift. You may feel the skin and muscles under your palm move into your belly. Provide some light resistance. Tug gently on the string of the Smart Balls or Stone Exercise Egg; tug gently on the end of the Energie Exerciser; pull back out of the vagina a bit with your finger(s). Keep lifting with your muscles, trying not to let the tool/finger slip out. Relax your muscles--let go of all the lift and tension in your pelvis. Take a deep breath to fully relax your muscles. A deep breath broadly releases your muscles, and learning deep relaxation is just as important as the other steps, since the breath relaxes the muscles you are not conscious of. Congratulations - you've done one Kegel! Step 4: Learn how to do several Kegels When doing more than one Kegel at a time, pause a moment before you begin each lift. You are trying to exercise, not fatigue, your muscles. Ultimately, the hold is what you're looking to lengthen (step 3 & 4 above). Studies show that you'll gain strength better if you can hold the lift longer, rather than do 5,000 "quickies". In fact, don't do any "quickies" at all. These muscles are slow-tension muscles, and engaging them step-by-step is more effective. Step 5: Keep it up Many women put their "Kegel supplies" (exercise tool, lubricant, instructions) next to their toothbrush, so they remember to do their exercises once in the morning and once at night, when they brush their teeth. If you forget to do your exercises for a few days, don't fret--just get back to them when you get the chance. Try this progression: Do 5 complete Kegels; quit for the day. Next day: Do 5 complete Kegels in the morning & 5 at night. Continue 5 morning/5 night for 3 days. Give yourself a day off. Go have an orgasm to celebrate. Day 6: Do 10 complete Kegels in the morning & 5 at night. Repeat for a whole week, then give yourself a day off. If you have any pain in your pelvis that feels worse when doing a Kegel, stop, and discuss progress with your health care provider. If you are comfortable doing 10 morning/5 night, move on to 10 morning/10 night. When comfortable doing 10 morning/10 night, work your way up to 20 morning/20 night. Once you're at 20 morning/20 night, work on longer holds (10sec-->15sec-->20sec).