Kegel exercises – self-care: MedlinePlus Medical Encyclopedia

Kegel exercises can help make the muscles under the uterus, bladder, and bowel (large intestine) stronger. They can help both men and women who have problems with urine leakage or bowel control. You may have these problems:

• As you get older
• If you gain weight
• After pregnancy and childbirth
• After gynecologic surgery (women)
• After prostate surgery (men)

People who have brain and nerve disorders may also have problems with urine leakage or bowel control.

Kegel exercises can be done any time you are sitting or lying down. You can do them when you are eating, sitting at your desk, driving, and when you are resting or watching television.

A Kegel exercise is like pretending you have to urinate and then holding it. You relax and tighten the muscles that control urine flow. It is important to find the right muscles to tighten.

Next time you have to urinate, start to go and then stop. Feel the muscles in your vagina (for women), bladder, or anus get tight and move up. These are the pelvic floor muscles. If you feel them tighten, you have done the exercise right. Your thighs, buttock muscles, and abdomen should remain relaxed.

If you still are not sure you are tightening the right muscles:

• Imagine that you are trying to keep yourself from passing gas.
• Women: Insert a finger into your vagina. Tighten the muscles as if you are holding in your urine, then let go. You should feel the muscles tighten and move up and down.
• Men: Insert a finger into your rectum. Tighten the muscles as if you are holding in your urine, then let go. You should feel the muscles tighten and move up and down.

Once you know what the movement feels like, do Kegel exercises 3 times a day:

• Make sure your bladder is empty, then sit or lie down.
• Tighten your pelvic floor muscles. Hold tight and count 3 to 5 seconds.
• Relax the muscles and count 3 to 5 seconds.
• Repeat 10 times, 3 times a day (morning, afternoon, and night).

Breathe deeply and relax your body when you are doing these exercises. Make sure you are not tightening your stomach, thigh, buttock, or chest muscles.

After 4 to 6 weeks, you should feel better and have fewer symptoms. Keep doing the exercises, but do not increase how many you do. Overdoing it can lead to straining when you urinate or move your bowels.

Some notes of caution:

• Once you learn how to do them, do not practice Kegel exercises at the same time you are urinating more than twice a month. Doing the exercises while you are urinating can weaken your pelvic floor muscles over time or cause damage to bladder and kidneys.
• In women, doing Kegel exercises incorrectly or with too much force may cause vaginal muscles to tighten too much. This can cause pain during sexual intercourse.
• Incontinence will return if you stop doing these exercises. Once you start doing them, you may need to do them for the rest of your life.
• It may take several months for your incontinence to lessen once you start doing these exercises.

Contact your health care provider if you are not sure you are doing Kegel exercises the right way. Your provider can check to see if you are doing them correctly. You may be referred to a physical therapist who specializes in pelvic floor exercises.

Pelvic muscle strengthening exercises; Pelvic floor exercises

Guerrero K. Pelvic organ prolapse. In: Magowan B, ed. Clinical Obstetrics and Gynaecology. 5th ed. Philadelphia, PA: Elsevier; 2023:chap 10.

Newman DK, Burgio KL. Conservative management of urinary incontinence: behavioral and pelvic floor therapy and urethral and pelvic devices. In: Partin AW, Dmochowski RR, Kavoussi LR, Peters CA, eds. Campbell-Walsh-Wein Urology. 12th ed. Philadelphia, PA: Elsevier; 2021:chap 121.

Patton S, Bassaly R. Urinary incontinence. In: Kellerman RD, Rakel DP, Heidelbaugh JJ, Lee EM, eds. Conn’s Current Therapy 2023. Philadelphia, PA: Elsevier; 2023:1174-1176.

• Anterior vaginal wall repair
• Artificial urinary sphincter
• Radical prostatectomy
• Stress urinary incontinence
• Transurethral resection of the prostate
• Urge incontinence
• Urinary incontinence
• Urinary incontinence – injectable implant
• Urinary incontinence – retropubic suspension
• Urinary incontinence – tension-free vaginal tape
• Urinary incontinence – urethral sling procedures

• Multiple sclerosis – discharge
• Prostate resection – minimally invasive – discharge
• Radical prostatectomy – discharge
• Self catheterization – female
• Self catheterization – male
• Stroke – discharge
• Transurethral resection of the prostate – discharge
• Urinary incontinence products – self-care
• Urinary incontinence surgery – female – discharge
• Urinary incontinence – what to ask your doctor
• When you have urinary incontinence

Updated by: Kelly L. Stratton, MD, FACS, Associate Professor, Department of Urology, University of Oklahoma Health Sciences Center, Oklahoma City, OK. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

Browse the Encyclopedia

15 Tips To Keep Your Bladder Healthy

People rarely talk about bladder health, but everyone is affected by it. Located in the lower abdomen, the bladder is a hollow organ, much like a balloon, that stores urine. Urine contains waste and extra fluid left over after the body takes what it needs from what we eat and drink. Each day, adults pass about a quart and a half of urine through the bladder and out of the body.

As people get older, the bladder changes. The elastic bladder tissue may toughen and become less stretchy. A less flexible bladder cannot hold as much urine as before and might make you go to the bathroom more often. The bladder wall and pelvic floor muscles may weaken, making it harder to empty the bladder fully and causing urine to leak.

While you can’t control everything that affects your bladder, here are 15 steps you can take to keep it as healthy as possible:

1. Use the bathroom often and when needed. Try to urinate at least once every 3 to 4 hours. Holding urine in your bladder for too long can weaken your bladder muscles and make a bladder infection more likely.
2. Be in a relaxed position while urinating. Relaxing the muscles around the bladder will make it easier to empty the bladder. For women, hovering over the toilet seat may make it hard to relax, so it is best to sit on the toilet seat.
3. Take enough time to fully empty the bladder when urinating. Rushing when you urinate may not allow you to fully empty the bladder. If urine stays in the bladder too long, it can make a bladder infection more likely.
4. Wipe from front to back after using the toilet. Women should wipe from front to back to keep gut bacteria from getting into the urethra. This step is most important after a bowel movement.
5. Urinate after sex. Sexual activity can move bacteria from the bowel or vaginal cavity to the urethral opening. Both women and men should urinate shortly after sex to lower the risk of infection.
6. Do pelvic floor muscle exercises. Pelvic floor exercises, also known as Kegel exercises, help hold urine in the bladder. Daily exercises can strengthen these muscles, which can help keep urine from leaking when you sneeze, cough, lift, laugh, or have a sudden urge to urinate. These exercises also may help avoid infections by strengthening the muscles that help empty the bladder.
7. Wear cotton underwear and loose-fitting clothes. Wearing loose, cotton clothing will help keep the area around the urethra dry. Tight-fitting pants and nylon underwear can trap moisture and help bacteria grow.
8. Exercise regularly. Physical activity can help prevent bladder problems as well as constipation. It can also help maintain a healthy weight.
9. Keep a healthy weight. People who are overweight may be at higher risk for leaking urine. Making healthy food choices and being physically active can help keep a healthy weight.
10. Watch what you eat. Some people with bladder problems find that some foods and drinks, such as sodas, artificial sweeteners, spicy foods, citrus fruits and juices, and tomato-based foods, make bladder problems worse. Changing your diet may help you feel better.
11. Drink enough fluids, especially water. More than half of the human body is made up of water, so it is important that you are drinking enough. How much water you need can vary based on your size, activity level, and where you live. In general, drink enough fluids so that you need to urinate every few hours. Some people need to drink less water because of certain conditions, such as kidney failure or heart disease. Ask your health care provider how much fluid is healthy for you.
12. Limit alcohol and caffeine. For many people, drinking alcohol can make bladder problems worse. Caffeinated drinks (like coffee, tea, and most sodas) can bother the bladder and increase symptoms such as frequent or urgent need to urinate. Cutting down may help.
13. Avoid constipation. Too much stool built up in the colon, called constipation, can put pressure on the bladder and keep it from expanding the way it should. Eating plenty of high-fiber foods like whole grains, vegetables, and fruits), drinking enough water, and being physically active can help prevent this from happening.
14. Quit smoking. Bladder problems are more common among people who smoke. Smoking can also increase the risk for bladder cancer. If you smoke, take steps to quit.
15. Know your medications. Some medications may make it more likely for your bladder to leak urine. Medications that calm your nerves so you can sleep or relax may dull the nerves in the bladder, and you may not feel the urge to go to the bathroom.

Common bladder problems and when to seek help

Bladder problems can disrupt day-to-day life. When people have bladder problems, they may avoid social settings and have a harder time getting tasks done at home or at work. Common bladder problems include urinary tract infections, urinary incontinence, and urinary retention.

Some signs of a bladder problem may include:

• Inability to hold urine or leaking urine
• Needing to urinate more frequently or urgently
• Cloudy urine
• Blood in the urine
• Pain or burning before, during, or after urinating
• Trouble starting or having a weak stream while urinating
• Trouble emptying the bladder

If you experience any of these symptoms, talk to your health care provider.

Treatment for bladder problems may include behavioral and lifestyle changes, exercises, medications, surgery, or a combination of these treatments and others. For more information on treatment and management of urinary incontinence, visit Urinary Incontinence in Older Adults.

For more information on bladder health

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
800-860-8747
866-569-1162 (TTY)
[email protected]
www.niddk.nih.gov

National Kidney and Urologic Diseases Information Clearinghouse
800-860-8747
866-569-1162 (TTY)
[email protected]
www.niddk.nih.gov/health-information/kidney-disease
www.niddk.nih.gov/health-information/urologic-diseases

National Association for Continence
800-252-3337
[email protected]
www.nafc.org

This content is provided by the NIH National Institute on Aging (NIA). NIA scientists and other experts review this content to ensure it is accurate and up to date.

Content reviewed:
January 24, 2022

Related Articles

Women’s Pelvic Floor Strengthening Exercises

This fact sheet has been compiled to educate patients about pelvic floor strengthening exercises.

More than 50% of women who have given birth have problems with urination, and at an older age, prolapse of the uterus (prolapse), which can be caused by weakness of the pelvic floor muscles.

Strong pelvic floor muscles help improve bladder and sexual function, as well as maintaining internal organs in a normal anatomical position. Pelvic floor muscle problems can be caused by pregnancy, childbirth, chronic constipation, being overweight, smoking, menopause, and neurological problems.

Symptoms of pelvic floor weakness may include incontinence when coughing and sneezing, frequent urination and the need to urinate at night, vaginal pain, pain during sex.

To prevent and alleviate urinary incontinence and organ prolapse, it is very important to learn how to contract the pelvic floor muscles correctly.

The pelvic floor muscles are located in the pelvic floor area between the pubic bone and the coccyx. Their function is to maintain the correct position of the organs (uterus, bladder, intestines) inside the pelvis, as well as to keep the urethra and anus closed to prevent involuntary leakage of contents, and to relax them during emptying.

Like all other muscles in the body, the pelvic floor muscles also need special training.

Manual

Get into a comfortable sitting or lying position. Try to tighten your pelvic floor muscles as if you are trying to interrupt the flow of urine or intestinal gases by pulling the muscles up.

You may feel tension when the muscles contract. Do not hold your breath, take a deep breath through your nose and slowly exhale through your mouth. At the same time, the abdominal muscles may tense up, this is normal.

Try to keep the muscles of the buttocks and legs relaxed. After each contraction of the pelvic floor muscles, try to completely relax these muscles.

Three basic ways to control the correct contraction of the pelvic floor muscles:

1. Observe the perineum through a mirror and tighten the pelvic floor muscles. Watch to see if the vagina moves inward in the opposite direction from the mirror. If you see the movement of the vagina towards the mirror, stop immediately and seek help from a physical therapist who specializes in training the muscles of the pelvic floor.
2. Place your thumb or index finger into your vagina. As your pelvic floor muscles contract, you should feel your vagina tighten around your finger.
3. Contract your pelvic floor muscles during sex, asking your partner if they feel pressure.

How to Do Pelvic Floor Exercises

1. Contract your pelvic floor muscles and try to hold that contraction for a count of seconds, and then relax those muscles for the same number of seconds. For how many seconds can you maintain muscle tension? How many reps can you do?
2. Alternately contract the pelvic floor muscles for 1 second and then relax them also for 1 second. How many of these short repetitions can you do before you feel tired in the muscles? Always relax your pelvic floor muscles before each new contraction.

Your goal is to do 10 long contractions while holding the muscle tension for 10 seconds; each contraction should be alternated with a 10 second relaxation. Then do 10 short contractions; each contraction should alternate with a short relaxation.

You can start with a shorter duration and fewer repetitions. Do exercises at least 3 times a day. At first, the exercises are easier to perform in a sitting or lying position. You should feel the results in 3-5 months. Subsequently, to maintain the result of the exercise, you can do it once a day. As your muscles strengthen, try to do the exercises in other positions as well (for example, lying on your side, while resting on your knees, standing, while moving).

Try to tense your pelvic floor muscles before coughing, sneezing, lifting weights, laughing.

Avoid carbonated or caffeinated drinks to prevent constipation. Drink at least 1.5 liters of water per day. When you have a bowel movement, place your feet on a small footrest to squat as if (this makes it easier to have a bowel movement). When you have a bowel movement during constipation, pressure on the pelvic floor muscles increases.

Eat healthy and be physically active (move at least 150 minutes a week).

Try to make pelvic floor muscle training your daily routine, so as not to forget about it, you can set a reminder on your phone. Do these exercises while waiting for public transport or in line at the grocery store.

ATTENTION! Interruption of the urine stream during urination is allowed only as a control exercise 3 months after you start doing the exercises. This should not be done every time you urinate, as this can interfere with normal bladder emptying.

If you experience pain or problems while exercising your pelvic floor muscles, ask for help from a physiotherapist who specializes in pelvic floor exercises.

ITK963

The information material was approved by the Health Care Quality Committee of East-Tallinn Central Hospital on 10/14/2020 (minutes no. 10-20).

Men’s Pelvic Floor Strengthening Exercises

The purpose of this fact sheet is to provide information on strengthening the pelvic floor muscles for men who have frequent or nocturnal urination or urinary incontinence when coughing and/or sneezing.

Trained pelvic floor muscles significantly improve bladder, bowel and sexual function.

Risk factors for pelvic floor muscle disease include:

• chronic constipation;

• overweight;

• low physical activity;

• smoking;

• heavy physical work, heavy lifting;

• neurological diseases;

• prostate surgeries.

Pelvic floor muscles (see picture) are located in the pelvic floor between the pubic bone and the coccyx. Their task:

• keep the organs inside the pelvis (bladder, intestines) in the correct position;

• keep the bladder and bowel sphincters closed and help them relax at the right time to void;

• prevent accidental excretion of urine and/or faeces;

• help achieve an erection and prevent premature ejaculation.

Both urinary incontinence and erectile dysfunction can occur in men of any age. Pelvic floor exercises help prevent and treat these problems.

Like all other muscles in the body, the pelvic floor muscles need special training.

Drawing. Male Pelvic Anatomy

Exercise Procedure

Sit in a comfortable position. Try tensing your pelvic floor muscles as if you are trying to stop the flow of urine or intestinal gases, or pulling the penis up and in.

You may feel tension when the muscles contract. Do not hold your breath, take a deep breath through your nose and slowly exhale through your mouth. At the same time, the abdominal muscles may tense up, this is normal.

Try to keep your buttocks and legs relaxed. After each contraction of the pelvic floor muscles, try to completely relax these muscles.

To prevent pelvic floor problems, exercise regularly every day and at least once a day. If you have weak pelvic floor muscles that are causing problems, do the exercises three times a day for three months, and then continue with the exercises once a day.

How to check if you are contracting your pelvic floor muscles correctly?

1. Find a comfortable position, place your fingers in the perineal area between the penis and anus. As you tighten your pelvic floor muscles, you should feel your perineum move up.

2. Stand in front of a mirror. As you tighten your pelvic floor muscles, you should see the penis pull inward and the testicles move up.

Pelvic Floor Exercises

1. Tighten the pelvic floor muscles, try to stay tense and count the seconds, and then relax the muscles for the same amount of time. For how many seconds can you maintain muscle tension before fatigue sets in? How many reps can you do?

For example, if you can hold muscle tension for five seconds and do it five times, then you should start exercising from that number. After each effort, relax the muscles for five seconds so that they can recover.

2. Alternately contract your pelvic floor muscles for one second and then relax them for four seconds. How many of these short repetitions can you do before you feel tired in the muscles? Before each new contraction, always relax the muscles.

Your goal is to do 12 long contractions while holding the muscle tension for 12 seconds; each contraction should be alternated with a 4-second relaxation. Then do 12 short contractions; each contraction should alternate with a short relaxation.

If you are just starting to exercise, the duration and number of repetitions may be less than 12. At first, it will be easier to perform the exercises in a sitting or lying position. You should feel the results in 3-5 months. As your muscles strengthen, try other positions as well, such as lying on your side, kneeling, standing, and/or while moving.

Try tensing your pelvic floor muscles before activities that cause you to leak urine (eg, coughing, sneezing, lifting weights, rising from a seated position) until it becomes a habit. If you are sexually active, tighten your pelvic floor muscles during intercourse to maintain an erection. After urinating, tighten your pelvic floor muscles to release the last drop of urine; this helps prevent leakage after urination.

Attention! Do not stop the stream of urine during urination, as this may interfere with the emptying of the bladder.

What else do you need to know?

• Do not drink carbonated or caffeinated drinks or alcohol.

• Drink at least 1-1.5 liters of water per day.

• Place your feet on a small bench while having a bowel movement; thus, you will be in a squatting position, which makes it easier to defecate.

• Eat healthy and be physically active (move at least 150 minutes per week).

Try to make pelvic floor muscle training your daily routine, so as not to forget about it, create, for example, a reminder on your phone. Do the exercises while waiting for public transport or in line at the store.

If you experience pain or have questions while exercising, see a physiotherapist who specializes in pelvic floor exercises.