I don’t do my Kegel exercises. Wait…let me correct myself. I do my Kegel exercises faithfully. Once a year. In my OB-GYN’s waiting room. In preparation for my yearly exam. I treat Kegels the way I treat flossing. I floss twice a year. In the restroom of my dentist’s office. In preparation for my twice yearly exam. (I am blessed with good dentition and have never had a cavity. I promise my teeth would not horrify you if you met me someday.)
Since flossing twice a year has produced acceptable results for the past thirty-plus years, I safely assumed that doing Kegels only immediately before seeing my OB would do the same. (Interestingly, despite my hurried attempts at Kegel-ing in the waiting room, no OB has ever said to me, “wow, someone did her Kegels this morning! Great tone!”)
Well, I assumed wrong. Very, very wrong. I have given birth to two children over the past six years. Combine that with my appalling lack of Kegel-ing and my pelvic floor is now about as useful (when it comes to urinary continence) as a crotchless diaper on a toddler.
A quick refresher: The pelvic floor muscles act as a sling that wrap around the urethra, vagina, and anus. When the pelvic floor muscles are contracted, they compress the urethral opening, preventing urine leakage. When the pelvic floor muscles are relaxed, the urethral sphincter is left wide open for easy, complete urination. Kegel exercises, those wonderfully effective exercises you do when you squeeze your pelvic floor muscles, help maintain pelvic floor tone and thus help retain urine in the bladder during non-voiding times. (If you are not sure how to do Kegels, read this.)
My pelvic floor muscles were stretched during pregnancy and they have a terrible personal trainer (me); without Kegels, my pelvic floor muscles are not toned and tight and therefore, I have stress urinary incontinence. (That’s college-talk for, “I leak pee when I sneeze. Or cough. Or laugh.”)
How did Kegels become the gold standard for toning the pelvic floor? Enter Arnold Kegel, a 20th century gynecologist who first noted the connection between urinary incontinence and weak pelvic floor muscles. In 1948, he published his career-defining paper, in which he discussed the ineffectiveness of vaginal repair surgeries. He wrote of a new, non-invasive way to strengthen a woman’s over-stretched pelvic floor – the contraction of the pelvic floor muscle, done entirely by the woman herself.
Kegel’s major concern, however, was that many women would have a difficult time identifying the correct muscle to contract (and therefore would not do the exercise properly, yielding no improvement in urinary incontinence). He was right. At some point, I think all of us have received this basic instruction for Kegels:
Go the bathroom and, while peeing, stop your urine stream. The muscle you just squeezed to stop the pee? That’s the “Kegel muscle”. That’s what you squeeze whenever you do your Kegels.
Perfectly good directions. However, many women, even though they think they are dutifully Kegel-ing, end up contracting their abodminals and glutes far more than their pelvic floor muscles, rendering their attempts ineffective in improving pelvic floor tone. (Note: Don’t do Kegels when you’re urinating. That whole “stop your urine stream” instruction is just a one-time thing, to help you locate your pelvic floor muscles. If you only do Kegels when you pee, you frequently stop your urine flow. By stopping the flow of urine, you’re setting yourself up for one of those wonderful urinary tract infections and you’re messing with the natural order of “relaxing” your muscles to allow urine out, meaning you may not void completely. So don’t do Kegels when you pee. Please.)
How do you ensure a woman is doing her Kegels properly? Arnold Kegel actually invented the first Kegel device (before there was such a thing) – the perineometer, essentially a rubber ball insterted in the vagina and connected by tubes to a pressure-measuring device (manometer) externally. If a woman performed the Kegel correctly, the manometer would register a change.
Today, women have far more convenient ways to guarantee they are doing their Kegels correctly. No tubes, no manometers…these babies can be used at home. It’s a brave new world of Kegel devices, friends. The first widely-marketed device available was the Kegelmaster, a speculum-like device inserted into the vagina which a woman can open and close only with her pelvic floor muscles. Kegel weights also help women properly identify and isolate the pelvic floor muscles for more effective Kegel-ing.
But are any of these devices really worth it? Do they improve pelvic tone more than traditional, unassisted Kegels (done correctly)? Scientific literature says no, at least when discussing the Kegelmaster or Kegel weights.
Of course, if a woman cannot master the proper Kegel technique on her own, then a device certainly seems to be the best way to improve her pelvic floor tone.
And I’ve definitely saved the best for last. What’s it like to actually use a Kegel exerciser? Enter Molly, the WHF Communications Director. A woman who actually does her Kegels. (Excuse me while I retreat, my head hung in shame.)
Enter me – the person who actually has tried these bad boys (girls?) out! Now, I actually haven’t tried the Kegelmaster, skea or kGoal because I don’t have any product to try. (*cough* send me some free stuff *cough*) But here are my thoughts on the exercisers I HAVE tried!
Magic Banana: Developed by a woman, the magic banana is a “self-exploration” tool that can stimulate the g-spot as well as serve as an exercise tool for pelvic floor contractions. No fancy bells or whistles, just an odd looking curved apparatus that allows the user to comfortably use it for exercise or more. Get it.
The Myself Trainer: This thing HAS all the bells and whistles and I highly recommend for any woman who is struggling with some light bladder leakage issues and/or has had a few vaginal childbirths. It’s basically a personal trainer for your vagina: it provides resistance and measures the strength of your muscles all while taking you through a series of repetitions. It’s definitely marketed towards women who are post menopausal, but it can be used at any age. I feel it’s good for anyone who has been advised to “do your kegels” by her healthcare provider and has no idea how/or what to do.
The Yoni Egg: This is like a hippie version of a vaginal weight. No, seriously, it’s really simple and pretty and all you do is insert it and contract your pelvic floor, super easy. For some reason, people think it will get lost (um…don’t worry, your vagina is not a cave), so I’d recommend it for the kind of woman who doesn’t need an applicator when using a tampon and who used a mirror in childbirth. You know the type. Our tantra expert and blogger, Elsbeth, is a big advocate of the yoni egg and has previously written a blog about it here.
My opinion? I think that these Kegel exercisers CAN be effective; however, this is because I’m highly aware of my pelvic floor. I’m a trained instructor in our Total Control program, so clearly I already knew how to kegel before I tried the above devices. The short story here is that Kegel exercisers can work but you have to be diligent about using them.
For women who have been diagnosed with nerve damage or really any kind of pelvic floor issue, I recommend seeing a pelvic floor physical therapist who can determine what is actually going on below the belt. Then, if they recommend it, use one of the above devices and set aside a time of day to work on your “inner” core. If you don’t have any issues and simply want to prevent a pelvic floor disorder, give one of the devices a shot! Just remember it’s AS important to RELAX your pelvic floor for the same amount of time as you contract it.
And now everyone, let’s do a Kegel together! Squeeze lightly around the openings, like you’re gently holding in a tampon, and hoooooold 2, 3, 4, and relaaaaaaax 2, 3, 4. Great job!
Following the recent scientific meeting in July, the International Urogynecological Society (IUGA) released a statement supporting the use of surgically-placed mid-urethral slings (MUS) in the treatment of stress urinary incontinence (SUI). This follows the joint position statement released by the American Urogynecological Society (AUGS) and the Society for Female Urodynamics (SUFU), in January earlier this year.