Kegel exercise

Kegel exercise, also known as pelvic floor exercise, involves repeatedly contracting and relaxing the muscles that form part of the pelvic floor, now sometimes colloquially referred to as the "Kegel muscles". The exercise can be performed many times a day, for several minutes at a time but takes one to three months to begin to have an effect.<ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref>

Kegel exercises aim to strengthen the pelvic floor muscles.<ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref> These muscles have many functions within the human body. In women, they are responsible for holding up the bladder, preventing urinary stress incontinence (especially after childbirth), vaginal and uterine prolapse.<ref>Template:Cite newsTemplate:PD-notice</ref><ref name=":1">{{#invoke:citation/CS1|citation |CitationClass=web }}</ref> In men, these muscles are responsible for urinary continence, fecal continence, and ejaculation.<ref name="autogenerated22">Template:Cite journal</ref><ref name=":1" /> Several tools exist to help with these exercises, although various studies debate the relative effectiveness of different tools versus traditional exercises.<ref name="bjui.org">{{#invoke:citation/CS1|citation |CitationClass=web }}</ref>

The American gynecologist Arnold Kegel first published a description of such exercises in 1948.<ref>Template:Citation</ref>

Mechanism of action

Kegel exercises aim to improve muscle tone by strengthening the pubococcygeus muscles of the pelvic floor. Kegel is a popularTemplate:Quantify prescribed exercise for pregnant women to prepare the pelvic floor for physiological stresses of the later stages of pregnancy and childbirth. Various advisors recommend Kegel exercises for treating vaginal prolapse<ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref> and preventing uterine prolapse<ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref> in women and for treating prostate painTemplate:Citation needed and swelling resulting from benign prostatic hyperplasia (BPH) and prostatitis in men. Kegel exercises may have benefits in treating urinary incontinence in both men and women.<ref name="autogenerated2">{{#invoke:citation/CS1|citation |CitationClass=web }}</ref> Kegel exercises may also increase sexual gratification, allowing women to complete pompoir and aiding men in reducing premature ejaculation.<ref name="autogenerated22"/> The many actions performed by Kegel muscles include holding in urine and avoiding defecation. Reproducing this type of muscle action can strengthen the Kegel muscles. The action of slowing or stopping the flow of urine may be used as a test of the correct pelvic-floor exercise technique.<ref>Kenway, M., and Goh, J. (2009). Inside Out: The Essential Women's Guide to Pelvic Support.</ref><ref name=":0" />

The components of levator ani (the pelvic diaphragm), namely pubococcygeus, puborectalis and iliococcygeus, contract and relax as one muscle.<ref>Template:Cite book</ref> Hence pelvic-floor exercises involve the entire levator ani rather than pubococcygeus alone. Pelvic floor exercises may help in cases of fecal incontinence and in pelvic organ prolapse conditions e.g. rectal prolapse.<ref name="Bø 2006">Template:Cite journal</ref>

Health effects

Women

Factors such as pregnancy, childbirth, aging, and being overweight often weaken the pelvic muscles.<ref>Template:Cite news</ref> This can be assessed by either digital examination of vaginal pressure or using a Kegel perineometer. Kegel exercises are useful in regaining pelvic floor muscle strength in such cases.<ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref>

The symptoms of prolapse and its severity can be decreased with pelvic floor exercises.<ref name="pmid22161382">Template:Cite journal</ref><ref name=":0">Template:Cite news</ref> Effectiveness can be improved with feedback on how to do the exercises.<ref>Template:Cite journal</ref>

Men

Kegel exercises can train the perineal muscles by increasing the oxygen supply and the strength of those muscles.<ref name=":2">Template:Cite journal</ref> The names of the perineal muscles are: ischiocavernosus (erection), bulbocavernosus (ejaculation), external sphincter of the anus, striated urethral sphincter, transverse perineal, levator of the prostate, and puborectalis.<ref name="Woodley2020">Template:Cite journal</ref>

Premature ejaculation is defined as when male ejaculation occurs after less than one minute of penetration.<ref>Template:Cite book</ref> The perineal muscles are involved in ejaculation when they are involuntarily contracted.<ref name=":2" /> The ischiocavernosus muscle is responsible for male erection, and the bulbocavernosus muscle is responsible for ejaculation. By actively contracting the perineal muscles with Kegel exercises regularly, strength and control of these muscles increase, possibly aiding in the avoidance of premature ejaculation.<ref name=":2" /><ref name=":4">Template:Cite journal</ref>

Urinary incontinence

Pelvic floor exercises (muscle training) can be included in conservative treatment approaches for women with urinary incontinence.<ref>Template:Cite journal</ref> There is tentative evidence that biofeedback may give added benefit when used with pelvic floor muscle training (PFMT).<ref>Template:Cite journal</ref> There is no clear evidence that teaching pelvic floor exercises alters the risk of stress urinary incontinence in men that develop this condition post prostatectomy.<ref>Template:Cite journal</ref>

In pregnant women, antenatal PFMT probably helps prevent urinary continence during pregnancy and up to six months after giving birth but for pregnant women who already have incontinence, it is not clear if antenatal PFMT helps to reduce symptoms.<ref name="Woodley2020"/>

Fecal incontinence

In pregnancy, it is not yet clear if antenatal PFMT helps to prevent or treat fecal incontinence.<ref name="Woodley2020"/>

Pelvic toning devices

Some devices, marketed to women, are for exercising the pelvic floor muscles and to improve the muscle tone of the pubococcygeal or vaginal muscle.

As of 2013, there was no evidence that doing pelvic floor exercise with weights worked better than doing Kegel exercises without weights; there is greater risk with weights, because a foreign object is introduced into the vagina.<ref>Template:Cite journal</ref><ref name="bjui.org" />

• Kegel exerciser.JPG

  A Kegel exerciser

• Jade Eggs usually come in 3 different sizes.jpg

  Jade eggs (or Yoni eggs) have been marketed for use in vaginal weightlifting.

• Ben Wa Balls.jpg

  Ben wa balls

Marketing

During the latter part of the 20th century, a number of medical and pseudo-medical devices were marketed to consumers as improving sexual performance or orgasms, increasing "energy", "balancing hormones", and as having other health or lifestyle benefits. There is no evidence for any of these claims, and many of them are pseudoscience.<ref name="skeptical">Template:Cite news</ref><ref>Template:Cite news</ref>

See also

• Pelvic floor physical therapy
• Taoist sexual practices
• Vacuum exercise
• Vaginal steaming

External links

• Mayo Clinic – Kegel Exercises for Men
• Kegel Exercises: Treating Male Urinary Incontinence