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Kegel exercise, also known as pelvic floor exercise, involves repeatedly contracting and relaxing the
muscle Muscle is a soft tissue, one of the four basic types of animal tissue. There are three types of muscle tissue in vertebrates: skeletal muscle, cardiac muscle, and smooth muscle. Muscle tissue gives skeletal muscles the ability to muscle contra ...
s that form part of the
pelvic floor The pelvic floor or pelvic diaphragm is an anatomical location in the human body which has an important role in urinary and anal continence, sexual function, and support of the pelvic organs. The pelvic floor includes muscles, both skeletal and ...
, 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. Kegel exercises aim to strengthen the pelvic floor muscles. These muscles have many functions within the human body. In women, they are responsible for holding up the
bladder The bladder () is a hollow organ in humans and other vertebrates that stores urine from the kidneys. In placental mammals, urine enters the bladder via the ureters and exits via the urethra during urination. In humans, the bladder is a distens ...
, preventing urinary stress incontinence (especially after childbirth), vaginal and uterine prolapse. In men, these muscles are responsible for urinary continence, fecal continence, and
ejaculation Ejaculation is the discharge of semen (the ''ejaculate''; normally containing sperm) from the penis through the urethra. It is the final stage and natural objective of male sexual stimulation, and an essential component of natural conception. ...
. Several tools exist to help with these exercises, although various studies debate the relative effectiveness of different tools versus traditional exercises. The American gynecologist Arnold Kegel first published a description of such exercises in 1948.


Mechanism of action

Kegel exercises aim to improve
muscle tone In physiology, medicine, and anatomy, muscle tone (residual muscle tension or tonus) is the continuous and passive partial contraction of the muscles, or the muscle's resistance to passive stretch during resting state.O’Sullivan, S. B. (2007) ...
by strengthening the pubococcygeus muscles of the
pelvic floor The pelvic floor or pelvic diaphragm is an anatomical location in the human body which has an important role in urinary and anal continence, sexual function, and support of the pelvic organs. The pelvic floor includes muscles, both skeletal and ...
. Kegel is a popular prescribed exercise for pregnant women to prepare the
pelvic floor The pelvic floor or pelvic diaphragm is an anatomical location in the human body which has an important role in urinary and anal continence, sexual function, and support of the pelvic organs. The pelvic floor includes muscles, both skeletal and ...
for physiological stresses of the later stages of
pregnancy Pregnancy is the time during which one or more offspring gestation, gestates inside a woman's uterus. A multiple birth, multiple pregnancy involves more than one offspring, such as with twins. Conception (biology), Conception usually occurs ...
and
childbirth Childbirth, also known as labour, parturition and delivery, is the completion of pregnancy, where one or more Fetus, fetuses exits the Womb, internal environment of the mother via vaginal delivery or caesarean section and becomes a newborn to ...
. Various advisors recommend Kegel exercises for treating vaginal prolapse and preventing uterine prolapse in women and for treating
prostate The prostate is an male accessory gland, accessory gland of the male reproductive system and a muscle-driven mechanical switch between urination and ejaculation. It is found in all male mammals. It differs between species anatomically, chemica ...
pain and swelling resulting from
benign prostatic hyperplasia Benign prostatic hyperplasia (BPH), also called prostate enlargement, is a noncancerous increase in size of the prostate gland. Symptoms may include frequent urination, trouble starting to urinate, weak stream, urinary retention, inability t ...
(BPH) and prostatitis in men. Kegel exercises may have benefits in treating
urinary incontinence Urinary incontinence (UI), also known as involuntary urination, is any uncontrolled leakage of urine. It is a common and distressing problem, which may have a significant effect on quality of life. Urinary incontinence is common in older women ...
in both men and women. Kegel exercises may also increase sexual gratification, allowing women to complete pompoir and aiding men in reducing
premature ejaculation Premature ejaculation (PE) is a male sexual dysfunction that occurs when a male Ejaculation, expels semen (and most likely experiences orgasm) soon after beginning sexual activity, and with minimal penile stimulation. It has also been called ''e ...
. 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. The components of
levator ani The levator ani is a broad, thin muscle group, situated on either side of the pelvis. It is formed from three muscle components: the pubococcygeus, the iliococcygeus, and the puborectalis. It is attached to the inner surface of each side of the ...
(the pelvic diaphragm), namely pubococcygeus,
puborectalis The levator ani is a broad, thin muscle group, situated on either side of the pelvis. It is formed from three muscle components: the pubococcygeus, the iliococcygeus, and the puborectalis. It is attached to the inner surface of each side of the ...
, and iliococcygeus, contract and relax as one muscle. Hence pelvic-floor exercises involve the entire levator ani rather than pubococcygeus alone. Pelvic floor exercises may help in cases of
fecal incontinence Fecal incontinence (FI), or in some forms, encopresis, is a lack of control over defecation, leading to involuntary loss of bowel contents—including flatus (gas), liquid stool elements and mucus, or solid feces. FI is a sign or a symptom ...
and in pelvic organ prolapse conditions, e.g.,
rectal prolapse A rectal prolapse occurs when walls of the rectum have prolapsed to such a degree that they protrude out of the anus and are visible outside the body. However, most researchers agree that there are 3 to 5 different types of rectal prolapse, depen ...
.


Health effects


Women

Factors such as
pregnancy Pregnancy is the time during which one or more offspring gestation, gestates inside a woman's uterus. A multiple birth, multiple pregnancy involves more than one offspring, such as with twins. Conception (biology), Conception usually occurs ...
,
childbirth Childbirth, also known as labour, parturition and delivery, is the completion of pregnancy, where one or more Fetus, fetuses exits the Womb, internal environment of the mother via vaginal delivery or caesarean section and becomes a newborn to ...
, aging, and being
overweight Being overweight is having more body fat than is optimally healthy. Being overweight is especially common where food supplies are plentiful and lifestyles are sedentary. , excess weight reached epidemic proportions globally, with more than ...
often weaken the pelvic muscles. 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. The symptoms of
prolapse In medicine, prolapse is a condition in which organ (anatomy), organs fall down or slip out of place. It is used for organs protruding through the vagina, rectum, or for the misalignment of the valves of the heart. A spinal disc herniation is al ...
and its severity can be decreased with pelvic floor exercises. Effectiveness can be improved with feedback on how to do the exercises.


Men

Kegel exercises can train the perineal muscles by increasing the oxygen supply and the strength of those muscles. The names of the perineal muscles are:
ischiocavernosus The ischiocavernosus muscle (erectores penis ''or'' erector clitoridis in older texts) is a muscle just below the surface of the perineum, present in both men and women. Structure It arises by tendinous and fleshy fibers from the inner surface of ...
(erection), bulbocavernosus (ejaculation), external sphincter of the anus, striated
urethral sphincter The urethral sphincters are two muscles used to control the exit of urine in the urinary bladder through the urethra. The two muscles are either the external sphincter muscle of male urethra, male or external sphincter muscle of female urethra, fe ...
, transverse perineal, levator of the prostate, and puborectalis.
Premature ejaculation Premature ejaculation (PE) is a male sexual dysfunction that occurs when a male Ejaculation, expels semen (and most likely experiences orgasm) soon after beginning sexual activity, and with minimal penile stimulation. It has also been called ''e ...
is defined as when male ejaculation occurs after less than one minute of penetration. The perineal muscles are involved in ejaculation when they are involuntarily contracted. 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.


Urinary incontinence

Pelvic floor exercises (muscle training) can be included in conservative treatment approaches for women with
urinary incontinence Urinary incontinence (UI), also known as involuntary urination, is any uncontrolled leakage of urine. It is a common and distressing problem, which may have a significant effect on quality of life. Urinary incontinence is common in older women ...
. There is tentative evidence that
biofeedback Biofeedback is the technique of gaining greater awareness of many physiology, physiological functions of one's own body by using Electronics, electronic or other instruments, and with a goal of being able to Manipulation (psychology), manipulate ...
may give added benefit when used with pelvic floor muscle training (PFMT). There is no clear evidence that teaching pelvic floor exercises alters the risk of stress urinary incontinence in men who develop this condition post
prostatectomy Prostatectomy (from the Ancient Greek language, Greek , "prostate" and , "excision") is the surgical removal of all or part of the prostate gland. This operation is done for benignity, benign conditions that cause urinary retention, as well as ...
. 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.


Fecal incontinence

In pregnancy, it is not yet clear if antenatal PFMT helps to prevent or treat
fecal incontinence Fecal incontinence (FI), or in some forms, encopresis, is a lack of control over defecation, leading to involuntary loss of bowel contents—including flatus (gas), liquid stool elements and mucus, or solid feces. FI is a sign or a symptom ...
.


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. 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


Marketing

During the latter part of the 20th century, several medical and pseudo-medical devices were marketed to consumers as improving sexual performance or
orgasm Orgasm (from Greek , ; "excitement, swelling"), sexual climax, or simply climax, is the sudden release of accumulated sexual excitement during the sexual response cycle, characterized by intense sexual pleasure resulting in rhythmic, involu ...
s, increasing "
energy Energy () is the physical quantity, quantitative physical property, property that is transferred to a physical body, body or to a physical system, recognizable in the performance of Work (thermodynamics), work and in the form of heat and l ...
", "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 Pseudoscience consists of statements, beliefs, or practices that claim to be both scientific and factual but are incompatible with the scientific method. Pseudoscience is often characterized by contradictory, exaggerated or unfalsifiable cl ...
.


See also

*
Pelvic floor physical therapy Pelvic floor physical therapy (PFPT) is a specialty area within physical therapy focusing on the rehabilitation of muscles in the pelvic floor after injury or dysfunction. It can be used to address issues such as muscle weakness or tightness post c ...
* Taoist sexual practices * Vacuum exercise * Vaginal steaming


References


External links


Mayo Clinic – Kegel Exercises for Men


{{DEFAULTSORT:Kegel Exercise Health issues in pregnancy Obstetrical and gynaecological procedures Physical exercise Sexual health Women's health
weightlifting Weightlifting or weight lifting generally refers to physical exercises and sports in which people lift weights, often in the form of dumbbells, barbells or machines. People engage in weightlifting for a variety of different reasons. These can ...