In this recurring guest column, Kate White, M.D., of Boston Medical Center, answers your questions on all things gynecology. As the author of the Mayo Clinic Press book Your Sexual Health, she’s ready to dole out wisdom on sex, periods, menopause and more. Submit a question here.
Q: I know Kegels are supposed to be good for me, but I can’t stand them. Are they really necessary?
A: Let’s just admit it: Exercise is hard for most of us. It’s tough to find the time, it can be difficult to do the exercises without cheating (which doesn’t help us in the end), and it’s one more thing that tires us out.
So why do doctors universally recommend exercise such as Kegels? In the same way that most of us need more vegetables in our diets, most of us could benefit from strengthening our pelvic floor muscles. These muscles, which support the uterus, bladder, small intestine and rectum, can get weak over time. And weakness in these muscles can lead to leakage of urine.
You can’t change most of your risk factors for a weak pelvic floor, which include aging, pregnancy and childbirth, and surgery. But you may be able to prevent muscle weakness by:
- Avoiding constipation.
- Seeking treatment for chronic cough.
- Losing weight if you’re overweight.
If you have urine leakage when you cough or laugh (stress incontinence) or have to race to get to the bathroom before you leak (urge incontinence), Kegels may be especially helpful. But if you’re experiencing a great deal of urine leakage, your gyno may recommend other measures like a pessary — a silicone device you insert into your vagina to prevent leakage — or surgery instead.
To do Kegel exercises, imagine you’re sitting on a marble and you want to lift the marble up into your body. Another way to think about it: Tense the muscles you use to stop yourself from passing gas. If you’re not sure you’re doing it right, ask your primary care provider or gyno for tips. In some cases, you may be referred to a pelvic floor physical therapist.
If you’ve decided to gut it out and try to introduce Kegels into your lifestyle, here’s what I recommend to my patients:
- Make it part of your routine. Try doing your Kegels when you brush your teeth twice a day. Or do them when you’ve hit the snooze button in the morning and as you’re getting into bed at night.
- Don’t do too many at once. Kegels are just as effective when you spread them out during the day — and may be even more effective if you give each set your all and don’t tire yourself out halfway through. Aim for three sets of 10 to 15 repetitions.
- Slow and steady is the right pace. Hold each contraction for three seconds, then fully relax before starting the next one.
- Something is better than nothing. Even if you can’t get through three sets of 15 reps a day, any exercise can help strengthen those muscles.
The content on this site is to educate consumers on health care and medical issues. Nothing about the content on this site should be considered, or used as a substitute for, medical advice, diagnosis or treatment. This site and its services do not constitute the practice of any medical or other professional health care advice, diagnosis or treatment.
Relevant reading
Your Sexual Health
This book is intended for people with a vagina, of any identity or orientation. Gain a better sense of what your body’s telling you — and how to know when not to worry about what you feel or see. A crash course in sexual, reproductive and pregnancy health.
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