Editing Kegel exercise

{{Short description|Pelvic floor exercise}}
{{Infobox medical intervention
| synonyms     = pelvic muscles exercise
| image        = 
| caption      = 
| pronounce    = Kegel: {{IPAc-en|ˈ|k|eɪ|ɡ|əl|,_|k|i:|-}}
| alt          =
| ICD10        =
| ICD9         =
| ICD9unlinked =
| MeshID       =
| LOINC        =
| other_codes  =
| MedlinePlus  =
| eMedicine 2   =
}}

'''Kegel exercise''', also known as '''pelvic floor exercise''', involves repeatedly contracting and relaxing the [[muscle]]s 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>{{cite web | title = Pelvic floor muscle training exercises | publisher = MedlinePlus | date = 10 October 2018 | url = https://medlineplus.gov/ency/article/003975.htm | access-date = 14 May 2020 | archive-date = 28 July 2016 | archive-url = https://web.archive.org/web/20160728014759/https://medlineplus.gov/ency/article/003975.htm | url-status = live }}</ref>

Kegel exercises aim to strengthen the pelvic floor muscles.<ref>{{Cite web|url= https://medlineplus.gov/ency/article/003975.htm|title= Pelvic floor muscle training exercises: MedlinePlus Medical Encyclopedia|website= medlineplus.gov|language= en|access-date= 2019-02-26|quote= Pelvic floor muscle training exercises are a series of exercises designed to strengthen the muscles of the pelvic floor.|archive-date= 2016-07-28|archive-url= https://web.archive.org/web/20160728014759/https://medlineplus.gov/ency/article/003975.htm|url-status= live}}</ref> These muscles have many functions within the human body. In women, they are responsible for holding up the [[urinary bladder|bladder]], preventing [[Stress incontinence|urinary stress incontinence]] (especially after childbirth), vaginal and uterine prolapse.<ref>{{Cite news|url= https://www.niddk.nih.gov/health-information/urologic-diseases/bladder-control-problems-women/kegel-exercises|title= Kegel Exercises {{!}} NIDDK|work= National Institute of Diabetes and Digestive and Kidney Diseases|access-date= 2017-12-02|archive-date= 2018-04-22|archive-url= https://web.archive.org/web/20180422224842/https://www.niddk.nih.gov/health-information/urologic-diseases/bladder-control-problems-women/kegel-exercises|url-status= live}}{{PD-notice}}</ref><ref name=":1">{{Cite web|url= https://medlineplus.gov/ency/article/003975.htm|title= Pelvic floor muscle training exercises: MedlinePlus Medical Encyclopedia|website= medlineplus.gov|access-date= 2017-12-02|archive-date= 2016-07-28|archive-url= https://web.archive.org/web/20160728014759/https://medlineplus.gov/ency/article/003975.htm|url-status= live}}</ref> In men, these muscles are responsible for urinary continence, fecal continence, and [[ejaculation]].<ref name="autogenerated22">{{cite journal|last1=La Pera|first1=G|last2=Nicastro|first2=A|year=1996|title=A new treatment for premature ejaculation: the rehabilitation of the pelvic floor|journal=Journal of Sex & Marital Therapy|volume=22|issue=1|pages=22–6|doi=10.1080/00926239608405302|pmid=8699493}}</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">{{cite web |url= http://www.bjui.org/ContentFullItem.aspx?id=427&LinkTypeID=1&SectionType=4 |title= A randomised controlled trial of the PelvicToner Device in female stress urinary incontinence |publisher= BJUI.org |access-date= 2011-09-02 |archive-date= 2011-09-27 |archive-url= https://web.archive.org/web/20110927120712/http://www.bjui.org/ContentFullItem.aspx?id=427&LinkTypeID=1&SectionType=4 |url-status= live }}</ref>

The American [[gynecologist]] [[Arnold Kegel]] first published a description of such exercises in 1948.<ref>{{Citation |last=Huang |first=Yi-Chen |title=Kegel Exercises |date=2024 |work=StatPearls |url=https://www.ncbi.nlm.nih.gov/books/NBK555898/ |access-date=2024-10-21 |place=Treasure Island (FL) |publisher=StatPearls Publishing |pmid=32310358 |last2=Chang |first2=Ke-Vin}}</ref>

==Mechanism of action==
Kegel exercises aim to improve [[muscle tone]] by strengthening the [[pubococcygeus muscle]]s of the [[pelvic floor]]. Kegel is a popular{{quantify|date=September 2020}} 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>{{cite web|url= http://www.emedicinehealth.com/vaginal_prolapse/article_em.htm|title= Vaginal Prolapse|author= September 2, 2011|date= 2011-02-09|publisher= eMedicineHealth|access-date= 2011-09-02|archive-date= 2006-07-21|archive-url= https://web.archive.org/web/20060721174112/http://www.emedicinehealth.com/vaginal_prolapse/article_em.htm|url-status= live}}</ref> and preventing [[uterine prolapse]]<ref>{{cite web|url= https://www.nlm.nih.gov/medlineplus/ency/article/001508.htm#Prevention|title= MedlinePlus Medical Encyclopedia: Uterine prolapse|date= 2011-08-29|publisher= Nlm.nih.gov|access-date= 2011-09-02|archive-date= 2001-08-20|archive-url= https://web.archive.org/web/20010820053741/https://www.nlm.nih.gov/medlineplus/ency/article/001508.htm#Prevention|url-status= live}}</ref> in women and for treating [[prostate]] pain{{citation needed|date=August 2019}} 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">{{cite web|url= https://www.nlm.nih.gov/medlineplus/ency/article/003975.htm|title= MedlinePlus Medical Encyclopedia: Kegel exercises|date= 2011-08-29|publisher= Nlm.nih.gov|access-date= 2011-09-02|archive-date= 2001-06-17|archive-url= https://web.archive.org/web/20010617161228/https://www.nlm.nih.gov/medlineplus/ency/article/003975.htm|url-status= live}}</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>{{cite book |last1=Gowda |first1=Supreeth N. |last2=Bordoni |first2=Bruno |title=StatPearls |date=2022 |publisher=StatPearls Publishing |url=https://www.ncbi.nlm.nih.gov/books/NBK556078/ |access-date=11 May 2022 |chapter=Anatomy, Abdomen and Pelvis, Levator Ani Muscle |pmid=32310538 |archive-date=9 November 2022 |archive-url=https://web.archive.org/web/20221109014229/https://www.ncbi.nlm.nih.gov/books/NBK556078/ |url-status=live }}</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">{{cite journal|last= Bø|first= K|year= 2006|title= Can pelvic floor muscle training prevent and treat pelvic organ prolapse?|journal= Acta Obstet Gynecol Scand|volume= 85|issue= 3|pages= 263–8|doi= 10.1080/00016340500486800|pmid= 16553172|s2cid= 221452341|doi-access= free}}</ref>

==Health effects==
=== Women ===
Factors such as [[pregnancy]], [[childbirth]], aging, and being [[overweight]] often weaken the pelvic muscles.<ref>{{Cite news|url=https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/pelvic-floor|title=Pelvic floor|last=Services|first=Department of Health & Human|access-date=2018-02-21|archive-date=2018-02-22|archive-url=https://web.archive.org/web/20180222043950/https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/pelvic-floor|url-status=live}}</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>{{Cite web |last=Mentor |first=Physio |date=2022-10-15 |title=Kegel Exercises – Pelvic Floor Muscles Strengthening |url=https://www.physiomentor.co/kegel-exercises/ |access-date=2022-10-16 |website=Physiomentor |language=en-US |archive-date=2022-10-15 |archive-url=https://web.archive.org/web/20221015114643/https://www.physiomentor.co/kegel-exercises/ |url-status=dead }}</ref>

The symptoms of [[Prolapse#Pelvic floor prolapse|prolapse]] and its severity can be decreased with pelvic floor exercises.<ref name="pmid22161382">{{cite journal |vauthors=Hagen S, Stark D |title=Conservative prevention and management of pelvic organ prolapse in women |journal=Cochrane Database Syst Rev |volume=12 |issue= 12|pages=CD003882 |year=2011 |pmid=22161382 |doi=10.1002/14651858.CD003882.pub4}}</ref><ref name=":0">{{Cite news|url=https://www.niddk.nih.gov/health-information/urologic-diseases/bladder-control-problems-women/cystocele-prolapsed-bladder|title=Cystocele (Prolapsed Bladder) {{!}} NIDDK|work=National Institute of Diabetes and Digestive and Kidney Diseases|access-date=2017-12-02|archive-date=2017-10-04|archive-url=https://web.archive.org/web/20171004190143/https://www.niddk.nih.gov/health-information/urologic-diseases/bladder-control-problems-women/cystocele-prolapsed-bladder|url-status=live}}</ref> Effectiveness can be improved with feedback on how to do the exercises.<ref>{{cite journal |last1=Herderschee |first1=R |last2=Hay-Smith |first2=EJ |author-link2=Jean Hay-Smith |last3=Herbison |first3=GP |last4=Roovers |first4=JP |last5=Heineman |first5=MJ |date=6 July 2011 |title=Feedback or biofeedback to augment pelvic floor muscle training for urinary incontinence in women. |journal=The Cochrane Database of Systematic Reviews |issue=7 |pages=CD009252 |doi=10.1002/14651858.CD009252 |pmid=21735442}}</ref>

=== Men ===
Kegel exercises can train the perineal muscles by increasing the oxygen supply and the strength of those muscles.<ref name=":2">{{Cite journal|last1=Puppo |first1=Vincenzo|last2=Puppo|first2=Giulia|date=January 2016 |title=Comprehensive review of the anatomy and physiology of male ejaculation: Premature ejaculation is not a disease: Anatomy and Physiology of Ejaculation |journal=Clinical Anatomy |volume=29|issue=1|pages=111–119|doi=10.1002/ca.22655|pmid=26457680|s2cid=9213013}}</ref> The names of the perineal muscles are: [[Ischiocavernosus muscle|ischiocavernosus]] (erection), [[Bulbospongiosus muscle|bulbocavernosus]] (ejaculation), external sphincter of the anus, striated [[Urethral sphincters|urethral sphincter]], [[Transverse perineal muscles|transverse perineal]], levator of the prostate, and puborectalis.<ref name="Woodley2020">{{cite journal |last1=Woodley |first1=SJ |last2=Lawrenson |first2=P |last3=Boyle |first3=R |last4=Cody |first4=JD |last5=Mørkved |first5=S |last6=Kernohan |first6=A |last7=Hay-Smith |first7=EJC |title=Pelvic floor muscle training for preventing and treating urinary and fecal incontinence in antenatal and postnatal women. |journal=The Cochrane Database of Systematic Reviews |date=6 May 2020 |volume=5 |issue=3 |pages=CD007471 |doi=10.1002/14651858.CD007471.pub4 |pmid=32378735|pmc=7203602 }}</ref>

[[Premature ejaculation]] is defined as when male ejaculation occurs after less than one minute of penetration.<ref>{{Cite book |editor1-last=Goldstein |editor1-first=Sam |editor2-last=Naglieri |editor2-first=Jack A. |title=Encyclopedia of child behavior and development |date=2011|publisher=Springer |isbn=9780387790619 |location=[New York]|oclc=704395400}}</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">{{Cite journal |last1=Puppo |first1=V. |last2=Abdulcadir |first2=J. |last3=Mannucci |first3=A. |last4=Catania |first4=L. |last5=Abdulcadir |first5=D. |date=April 2008 |title=T09-P-13 The importance of the Kegel exercises for the erection of the male and female erectile organs (male and female penis) |journal=Sexologies |volume=17 |pages=S136 |doi=10.1016/s1158-1360(08)72894-9 |issn=1158-1360}}</ref>

=== Urinary incontinence ===
Pelvic floor exercises (muscle training) can be included in conservative treatment approaches for women with [[urinary incontinence]].<ref>{{Cite journal|last1=Dumoulin|first1=Chantale|last2=Cacciari|first2=Licia P.|last3=Hay-Smith|first3=E. Jean C.|date=2018-10-04|title=Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women |journal=The Cochrane Database of Systematic Reviews|volume=2018|issue=10|pages=CD005654|doi=10.1002/14651858.CD005654.pub4|issn=1469-493X|pmid=30288727 |pmc=6516955}}</ref> There is tentative evidence that [[biofeedback]] may give added benefit when used with pelvic floor muscle training (PFMT).<ref>{{cite journal|vauthors=Herderschee R, Hay-Smith EJ, Herbison GP, Roovers JP, Heineman MJ|date=6 July 2011|title=Feedback or biofeedback to augment pelvic floor muscle training for urinary incontinence in women.|journal=The Cochrane Database of Systematic Reviews |issue=7|pages=CD009252|doi=10.1002/14651858.CD009252|pmid=21735442}}</ref> There is no clear evidence that teaching pelvic floor exercises alters the risk of [[Stress incontinence|stress urinary incontinence]] in men that develop this condition post [[prostatectomy]].<ref>{{Cite journal|last1=Anderson|first1=Coral A.|last2=Omar|first2=Muhammad Imran|last3=Campbell|first3=Susan E.|last4=Hunter|first4=Kathleen F.|last5=Cody|first5=June D.|last6=Glazener|first6=Cathryn M. A.|date=2015-01-20 |title=Conservative management for postprostatectomy urinary incontinence|journal=The Cochrane Database of Systematic Reviews|volume=1|issue=1 |pages=CD001843|doi=10.1002/14651858.CD001843.pub5|issn=1469-493X|pmid=25602133 |pmc=7025637|hdl=2164/6141}}</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>{{cite journal|last1=Herbison|first1=GP|last2=Dean|first2=N|title=Weighted vaginal cones for urinary incontinence|journal=The Cochrane Database of Systematic Reviews|date=8 July 2013|volume=2013 |issue=7|pages=CD002114|pmid=23836411|doi=10.1002/14651858.CD002114.pub2|pmc=7086390}}</ref><ref name="bjui.org" />

<gallery widths="200px" heights="200px">
Image:Kegel exerciser.JPG|A Kegel exerciser
File:Jade Eggs usually come in 3 different sizes.jpg|'''Jade eggs''' (or '''Yoni eggs''') have been marketed for use in vaginal weightlifting.
File:Ben Wa Balls.jpg|[[Ben wa balls]]
</gallery>

===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 [[orgasm]]s, increasing "[[Energy (esotericism)|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">{{cite news |last1=Tuteur |first1=Amy |title=Vaginal weight lifting |url=http://www.skepticalob.com/2008/12/vaginal-weight-lifting.html |work=The Skeptical OB |date=18 December 2008 |access-date=1 June 2018 |archive-date=8 November 2022 |archive-url=https://web.archive.org/web/20221108120622/http://www.skepticalob.com/2008/12/vaginal-weight-lifting.html |url-status=live }}</ref><ref>{{cite news|title=No, Gwyneth Paltrow, women should not put jade eggs in their vaginas, gynecologist says|url=https://www.washingtonpost.com/news/to-your-health/wp/2017/01/22/no-gwyneth-paltrow-women-should-not-put-jade-eggs-in-their-vaginas-gynecologist-says/|access-date=6 February 2017|newspaper=Washington Post|archive-date=12 February 2021|archive-url=https://web.archive.org/web/20210212191255/https://www.washingtonpost.com/news/to-your-health/wp/2017/01/22/no-gwyneth-paltrow-women-should-not-put-jade-eggs-in-their-vaginas-gynecologist-says/|url-status=live}}</ref>

==See also==
* [[Pelvic floor physical therapy]]
* [[Taoist sexual practices]]
* [[Vacuum exercise]]
* [[Vaginal steaming]]

==References==
{{Reflist|30em}}

==External links==
{{Commons category}}
* [https://www.mayoclinic.org/healthy-lifestyle/mens-health/in-depth/kegel-exercises-for-men/art-20045074 Mayo Clinic – Kegel Exercises for Men]
* [http://www.medicinenet.com/kegel_exercises_for_men/article.htm Kegel Exercises: Treating Male Urinary Incontinence]

{{Authority control}}

{{DEFAULTSORT:Kegel Exercise}}
[[Category:Health issues in pregnancy]]
[[Category:Obstetrical and gynaecological procedures]]
[[Category:Physical exercise]]
[[Category:Sexual health]]
[[Category:Women's health]]
[[Category:Vagina|weightlifting]]