Pelvic muscles strengthening exercises

Pelvic Floor Muscle (Kegel) Exercises for Males

Time to Read: About 2 minutes

This information explains how to do pelvic floor muscle (Kegel) exercises.

About Kegel Exercises

The goal of Kegel exercises is to help you strengthen your pelvic floor muscles. These muscles support your bladder and bowel.

Kegel exercises can help you:

Manage or prevent incontinence. Incontinence is leakage of urine (pee) and stool (poop) that you cannot control.
Improve your sexual health.

About Your Pelvic Floor Muscles

Your pelvic floor muscles make up the bottom of your pelvis and support your pelvic organs (see Figure 1). They’re the muscles that relax when you’re urinating (peeing), passing gas, or having a bowel movement (pooping). You also use these muscles to hold in your urine and prevent urine leakage.

Figure 1. Your pelvic floor muscles

Identifying your pelvic floor muscles

The first step in doing Kegel exercises is to identify your pelvic floor muscles. Think of these muscles as the same ones you would use to stop your stream of urine when you’re urinating. Do not do this often because starting and stopping your urine stream every time you urinate can be harmful.

How to Do Kegel Exercises

Before you start your Kegel exercises, make sure to urinate so your bladder is empty.

When you’re ready, follow these steps:

Start by holding your pelvic floor muscles in for 5 seconds. To do this, think of pulling in and lifting up your genitals.
- Do not hold your breath while you do this. Counting out loud can stop you from holding your breath.
After holding for 5 seconds, slowly and completely relax your muscles for 5 seconds.
Repeat this process 10 times, at least 3 times every day.

Your pelvic floor muscles may get tired during this exercise. If this happens, stop and do the exercise later.

Do not use your stomach, leg, or buttock muscles when doing this exercise. Exercising these muscles will not help you get back urinary control or improve your sexual health.

As you continue to practice these exercises, increase the time you hold and rest your pelvic floor muscles. Start with 5 seconds, and slowly build up the time each week. Do this until you’re holding in and resting for 10 seconds.

When to Do Kegel Exercises

Most people prefer doing Kegel exercises while lying down on a bed or sitting in a chair. You can do them in any position you feel comfortable in. Doing Kegel exercises while standing can be very helpful because that’s usually when urinary leakage happens.

To keep your urine from leaking, try to do a Kegel exercise before these activities:

When standing up.
Walking.
Walking to the bathroom.
Sneezing or coughing.
Laughing.

Doing these exercises every day will help strengthen your pelvic floor muscles and reduce urinary leakage.

‌ Don’t do Kegel exercises while you have a Foley catheter (thin, flexible tube) in place.

Pain and Kegel Exercises

Kegel exercises should not hurt. Most people find them relaxing and easy. But if you use the wrong muscles during Kegel exercises, you may feel uncomfortable.

If you get back or stomach pain after doing Kegel exercises, you may be using your stomach or back muscles instead of your pelvic floor muscles.
If you get a headache after doing Kegel exercises, you may be making your chest muscles tight and holding your breath.

When to Call Your Healthcare Provider

Call your healthcare provider if you:

Have concerns about your bowel, bladder, or sexual function.
Are having trouble feeling your pelvic floor muscles.
Have pain when you do Kegel exercises.
Have trouble doing Kegel exercises.
Have pelvic pain.
Want a referral to a physical therapist who is a specialist in pelvic health.

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Last Updated

Wednesday, June 15, 2022

Pelvic Floor Exercises for Everyone (Yes, Everyone)

If you can’t sneeze, laugh, or cough without leaking a little urine, you’re not alone. Problems with the pelvic floor are common and can happen to anyone (1).

The good news? Incorporating specific exercises (aka pelvic floor muscle training) into your overall fitness routine can help strengthen your pelvic floor muscles, as well as reduce the severity of symptoms of pelvic organ prolapse (2).

Here’s an easy-to-understand guide to what the pelvic floor is, what it does, how to find these muscles, and tips regarding when to see a professional. Plus, it provides five exercises to help strengthen your pelvic floor that you can start doing right away!

The pelvic floor comprises muscles and connective tissues. These soft tissues attach to your pelvis, and more specifically, to the bones at the bottom of the pelvis.

In all people, the pelvic organs include the urethra, bladder, intestines, and rectum. If you have a vagina, the pelvic floor also consists of the uterus, cervix, and vagina (3).

A good way to visualize the pelvic floor and its function, says Marcy Crouch, PT, DPT, WCS, a board certified clinical specialist in women’s health, is to picture these muscles at the bottom of the pelvis like a hammock or basket.

“When the pelvic floor is engaged or contracted, it performs a lifting motion toward your head, which feels like you are trying to stop gas or urine, or pucker your anal opening,” she says.

Summary
The pelvic floor comprises muscles and connective tissues that attach to the pelvis.

The pelvic floor muscles are critical to daily functions. They support the pelvic organs, including the bladder, urethra, rectum, anus, prostate, uterus, cervix, vagina, and intestines (4).

Pelvic floor muscles also contribute to sexual health and function, including arousal and orgasm (5, 6).

Plus, they help stabilize your hips and trunk, especially when walking and standing.

Pregnancy and vaginal birth can weaken these muscles, causing a host of issues, which range in severity from mild pain and discomfort to pelvic organ prolapse (7, 8).

But it’s not just pregnancy or childbirth that can cause pelvic floor dysfunction. It can also occur with age, menopause, surgery, repeated heavy lifting, prolonged sitting, sexual abuse, or conditions that create pressure on the abdomen, such as excessive weight.

Additionally, certain habits, symptoms, or conditions can contribute to pelvic floor disorders (PFD), such as endometriosis, irritable bowel syndrome, interstitial cystitis, and habitual patterns of avoiding or restricting bowel movements (4).

Summary
Pelvic floor muscles support the urethra, bladder, intestines, rectum, and other pelvic organs. If you have a uterus, cervix, and vagina, the pelvic floor also supports these organs.

For a lot of people, the concepts of Kegels and the pelvic floor are synonymous with a vagina, and more specifically, pregnancy.

But what you might not know is that people of all genders have these muscles. In people with a penis, the pelvic floor muscles support the bladder and bowel, preventing leakage of stool and urine (9).

They also help with sexual health, including function and sensation.

Common diagnoses of pelvic floor disorders in men include chronic prostatitis, pudendal neuralgia, genitofemoral neuralgia, and hypertonicity (10).

Summary
People of all genders have pelvic floor muscles.

One of the simplest ways to find the pelvic floor is to stop or slow urine flow while going to the bathroom. If you can do this successfully at least a few times, you’ve found your pelvic floor.

Another good way to activate the pelvic floor muscles, says Crouch, is this:

Lie down with your knees bent and feet flat on the floor. Inhale.
Exhale gently, draw in your lower abdominal muscles, and squeeze in the muscles around the urethra like you’re trying to stop gas or urine. People with a vagina can also focus on lifting or squeezing the muscles around the vagina.
Hold for 1–2 seconds, then let everything go. You should feel the pelvic floor muscles release and drop.

One way to find the pelvic floor muscles while standing is to imagine you need to pass gas but don’t want to let it out.

If you’re trying to hold it in, there’s a good chance you’ll squeeze your rectum and anus. The muscles you activate are those comprising the pelvic floor, especially if you feel a pulling sensation at your anus.

When engaging the pelvic floor, it’s important to remember that these muscles span the distance across the bottom of your pelvis. So, if you’re contracting only the muscles that control the flow of urine but not the rectal muscles, you aren’t getting a full contraction.

For the most effective contraction, engage both areas — the muscles that would stop gas and urine simultaneously. Research has also shown that engaging the transversus abdominis and obliques at the same time may help deepen pelvic floor muscle engagement (11).

Likewise, engaging the pelvic floor muscles may contribute to a stronger abdominal contraction (12).

This is especially important to remember when you’re an active individual or looking to increase your core strength for functional purposes.

Still, learning to release or relax the contraction of these muscles is just as important for optimal pelvic floor function. Once you’re able to feel the sensation of contraction in these muscles, check in with yourself occasionally: Are these muscles always turned on, even just a little?

One way to think about it is to imagine your pelvic floor muscles as an elevator. When you’re sitting at your desk or standing and doing dishes, take note of where the elevator has come to a stop. Is it at the bottom floor? At the third floor? Or all the way at the tenth?

Learning to let the elevator rest at the bottom is important, too, as excess tension in these muscles can cause pain.

Summary
There are several ways to find the pelvic floor muscles, including stopping urine midstream and trying to prevent gas from leaving your body. It’s important to learn how to both contract and relax these muscles.

When the pelvic floor muscles are weak or malfunctioning, they lose the ability to fully support the pelvic organs, causing pelvic floor disorders.

These disorders can include urinary or fecal incontinence, urgency urinary incontinence, overactive bladder, and pelvic organ prolapse, and they might cause symptoms like painful sex (13, 14).

It’s hard to estimate how many people have a pelvic floor disorder, as awareness of the symptoms and conditions remains low. Many people who identify as women assume pelvic floor dysfunction is a normal part of childbirth or aging and therefore don’t seek treatment.

However, it’s estimated that about 1 in 4 women experience pelvic floor disorders, and that number doubles by the time women are over 80 years old. Some research shows that about 50% of women are affected by PFD in their childbearing years (4, 13).

What’s more, researchers expect to see a 70% increase in the number of women impacted by PFD by the year 2050, due to health trends like increasing body mass index and chronic constipation (14).

Furthermore, people with a penis don’t often think they can be impacted by PFD, but the prevalence of such conditions in men is estimated to be about 16% (4).

Symptoms of pelvic floor dysfunction include:

pelvic pressure or fullness
the frequent urge to urinate or painful urination
urinary leakage
urinary incontinence
lower back pain
constipation, difficulties with bowel movements, or bowel leakage
difficulty emptying the bladder
pain with sexual intercourse
pain in the pelvic region or genitals
pelvic muscle spasms

Fortunately, there are nonsurgical ways to treat PFD and find relief from pain or embarrassment. Often a consultation with a pelvic floor physical therapist is a good place to start.

Summary
Pelvic floor disorders (PFD) are more common than people realize, but they’re also more treatable than people realize.

Chronic issues with the pelvic floor can be caused by both hypotonic muscles (pelvic muscles that are too lax or weak) or hypertonic muscles (pelvic floor muscles that are too tight or overactive) (15, 16, 17).

Sometimes, these conditions are referred to as relaxing pelvic floor dysfunction and nonrelaxing pelvic floor dysfunction.

Pelvic floor dysfunction can also happen on a continuum, with both hypotonic and hypertonic issues. This often comes as a surprise to people who assume their pelvic floor issues are caused by inactive muscles.

But here’s the deal: Not everyone should be doing Kegels.

The pelvic floor comprises skeletal muscle. “That means it can have the same kind of injuries, weakness, or trauma like any other muscle in your body,” says Crouch. “It can also become “tight” or chronically contracted — think a muscle spasm in your calf.”

If the muscles are in spasm, contracted, or too tight, Crouch says doing Kegels can worsen the problem — pain, leaking, constipation, or sexual dysfunction. In other words, if your pelvic floor is hypertonic, it’s best to avoid Kegels until you consult a pelvic floor physical therapist.

Summary
Pelvic floor muscles can be hypotonic (too weak or lax) or hypertonic (too tight).

Like other muscles in your body, the pelvic floor operates best when the muscles are strong and able to release fully after a full contraction. Strengthening the pelvic floor allows you to better support the bladder, bowels, and uterus (18).

Plus, it can help with bladder and bowel control.

Researchers have also found that improved pelvic floor function improves quality of life (19).

If you have pelvic floor prolapse, strengthening the pelvic floor muscles likewise helps reduce the severity of symptoms, including urinary leakage, incontinence, pelvic pressure, and lower back pain, among others (7).

A pelvic floor strengthening program could likewise lead to better sex (5).

Some research supports the connection between male sexual function and pelvic floor function. Specifically, researchers cite how pelvic floor physical therapy can potentially improve erectile dysfunction and ejaculation problems (20).

Moreover, regularly squeezing or contracting the pelvic floor muscles may boost sexual sensation and sexual function for some people with a vagina (21).

Finally, the American Urological Association recommends pelvic floor muscle training as part of a treatment plan for overactive bladder (22).

The goal of this therapy is to inhibit involuntary bladder contractions and decrease incontinence.

Summary
Strengthening the pelvic floor muscles can reduce incontinence, improve sexual health, decrease symptoms of pelvic floor prolapse, and help treat overactive bladder.

You can activate the pelvic floor anytime, anywhere. But it’s also beneficial to incorporate specific exercises that strengthen and target the pelvic floor muscles.

One way to design a program is to categorize the exercises for those who have hypotonic pelvic floor muscles versus those who have hypertonic pelvic floor muscles.

According to Crouch, hypotonic means you have low tone pelvic floor issues and need to strengthen and improve endurance and power.

Exercises for hypotonic pelvic floor muscles

To target hypotonic pelvic floor issues, Crouch recommends these 3 exercises:

Quick flick Kegels

Crouch says the quick flick Kegel requires quick contractions of your pelvic floor to help activate the muscles faster and stronger to stop leaks upon sneezing or coughing.

Begin by lying on the floor with your knees bent and feet flat on the floor. As this exercise becomes easier, try sitting or standing while performing it.
Find your pelvic floor muscles using the tips described above.
Exhale, pull your navel to your spine, and quickly contract and release your pelvic floor muscles. Aim to contract for 1 second before releasing.
Maintain steady breathing throughout.
Repeat the quick flick 10 times, then rest for 10 seconds. Do 2–3 sets.

Heel slides

Heel slides encourage pelvic floor contractions while targeting the deep abdominal muscles.

Begin by lying on the floor with your knees bent and pelvis in a neutral position.
Inhale into the rib cage, then exhale through the mouth, letting your ribs naturally compress.
Draw your pelvic floor up, lock in your core, and slide your right heel away from you. Only go as far as you can without losing your connection to your deep core.
Find the bottom position, then inhale and bring your leg back to starting position.
Repeat.
Do 10 slides on each side before changing to the other leg.

Marches (also called toe taps)

Like heel slides, the marching exercise increases core stability and encourages pelvic floor contractions.

Begin by lying on the floor with your knees bent and pelvis in a neutral position.
Inhale into your rib cage, then exhale through your mouth, letting your ribs naturally compress.
Draw your pelvic floor up and lock in your core.
Slowly lift one leg up to a tabletop position.
Slowly lower this leg to the starting position.
Repeat the movement alternating legs. You should not feel any pain in your lower back. It’s important that your deep core stays engaged throughout the entire exercise.
Alternate legs for 12–20 times total.

Exercises for hypertonic pelvic floor muscles

Hypertonic exercises may provide some relaxation and lengthening for someone who has a short or tight pelvic floor.

Crouch says the goal is to lengthen and release the hypertonic muscles, so contractions are more effective and the muscles can work effectively. “We have to make sure the muscle can do what we need it to do, so lengthening is just as important as strengthening,” she says.

Here are 2 exercises that she recommends:

Happy Baby Pose

The Happy Baby Pose is a great addition to a pelvic floor routine when stretching and releasing are the goal.

Begin by lying on the floor with your knees bent.
Bring your knees toward your belly at a 90-degree angle, with the soles of your feet facing up.
Grab and hold the outside or inside of your feet.
Open your knees until they’re slightly wider than your torso. Then, bring your feet up toward your armpits. Make sure your ankles are over your knees.
Flex your heels and push your feet into your hands. You can stay in this position for several breaths or gently rock from side to side.

Diaphragmatic breathing

Diaphragmatic breathing encourages the functional relationship between the diaphragm and pelvic floor. It’s also an excellent exercise for reducing stress. (23)

Begin by lying flat on the floor on a yoga or exercise mat. You can also perform the exercise in a seated position.
Do a few seconds of progressive relaxation. Focus on releasing the tension in your body.
Once relaxed, put one hand on your stomach and the other on your chest.
Inhale through your nose to expand your stomach — your chest should stay relatively still. Then, breathe in for 2–3 seconds and exhale slowly.
Repeat several times while keeping one hand on the chest and one on the stomach.

Crouch also recommends adding lunges and squats to a pelvic floor routine. “Everyday exercise like lunging and Swiss ball squats can be great ways to add in pelvic floor strengthening,” she says.

When performing these moves, Crouch says to think about contracting the pelvic floor before you go down into the lunge or squat, re-engaging at the bottom, and then contracting again as you drive up to standing.

Summary
Quick flick Kegels, marches, heel slides, Happy Baby Pose, and diaphragmatic breathing are five exercises that help relax and condition the pelvic floor muscles.

For a lot of people, adding pelvic floor exercises to their daily routine is a simple way to strengthen these muscles and maintain overall pelvic health.

But for many others, seeking help from a doctor or a physical therapist trained in pelvic floor issues is a necessary intervention. This is especially true if you’re having bowel or bladder control problems.

Here are some signs to watch for that may indicate it’s time to see a professional (24).

leaking urine or stool
problems with having a bowel movement
pressure or discomfort in the pelvis
seeing or feeling a bulge protruding out of the vagina or anus
pain while urinating
incontinence
difficulty emptying the bladder or bowels completely

Remember, it’s always OK to call your doctor, even if you feel your symptoms are not that severe. Finding the right treatment for your situation can help you feel better and prevent any further damage to the pelvic floor area.

Summary
Call your doctor if you’re experiencing bladder control issues, pain or discomfort, or symptoms related to pelvic floor prolapse.

Adding pelvic floor strengthening exercises to your day is an excellent way to give these muscles a workout and boost your overall health. Remember to focus on form and function and engage the muscles each time you do an exercise.

If you’re new to these exercises or you would like some extra help, consider consulting a pelvic floor physical therapist. They can recommend exercises specific and ensure you’re doing them correctly.

Finally, if your symptoms interfere with daily activities or seem to be getting worse, make an appointment with your doctor.

Exercises to strengthen the pelvic floor muscles in women (Kegel exercises)

This information describes exercises for the pelvic floor muscles (Kegel exercises).

About Kegel Exercises

The main purpose of Kegel exercises is to help you strengthen your pelvic floor muscles. She will help you:

Manage or prevent urinary incontinence. Incontinence is the leakage of urine or stool (feces) that you cannot control.
Support the pelvic organs (uterus, bladder and intestines). This will help reduce incontinence and soreness.
Relax the vaginal muscles. This will provide better vaginal elasticity, which is important if you experience pain or discomfort during intercourse or during a pelvic exam.
Relieve pelvic pain.

About the pelvic floor muscles

The pelvic floor muscles form the pelvic cavity and support the pelvic organs. These are the muscles you use to stop urinating and keep you from passing gas or having a bowel movement (when you go to the bathroom in a big way). In addition, these muscles can contract (tighten) during orgasm. Figure 1 shows the pelvic floor muscles and pelvic organs.

Figure 1 Pelvic floor muscles and pelvic organs

How to identify the pelvic floor muscles

If you are not sure which muscles are pelvic floor muscles, there are several ways to identify them.

Imagine that you are urinating. Tighten the muscles that you use to interrupt the flow of urine while urinating. Do not exercise your pelvic muscles by stopping the flow of urine while urinating in real life, especially when the bladder is full. This can weaken your pelvic muscles and cause your bladder to not empty completely when you urinate, which increases your risk of a urinary tract infection (UTI).
Tighten the muscles you use to hold back a bowel movement or the passage of intestinal gases, but do not contract the muscles in your buttocks, abdominals (abdomen) or inner thighs. If you do it right, your body should not rise at all. If you feel that your body is slightly lifted, you are most likely using the muscles of the buttocks.
Insert a finger into the vagina and then squeeze the pelvic floor muscles around the finger. You should feel the muscles in your vagina tense up and your pelvic floor move up.

Pelvic floor contraction does not involve the abdominal, leg, or buttock muscles. Contraction of these muscles does not strengthen the pelvic floor muscles. To find out if the muscles in your abdomen, legs, or buttocks are also contracting, you can put one hand on your stomach and the other under your buttocks or thighs. Tighten your pelvic floor muscles. If you feel the movement of the abdominals, hips or buttocks, then you are using the wrong muscles.

Be sure to completely relax your pelvic floor muscles after contracting them. If you have difficulty identifying your pelvic floor muscles, contact your doctor.

Performing Kegel Exercises

Once you have learned how to properly contract your pelvic floor muscles, do 2-3 sessions of Kegel exercises daily for best results. These sessions are best done at regular intervals throughout the day.

Instructions

Before you begin, take a comfortable position so that your body is relaxed. Most people prefer to do Kegel exercises while lying in bed or sitting in a chair. Once you are familiar with the exercises, you can do them in any position and anywhere, such as standing somewhere and waiting in line.

From a comfortable position, follow the instructions below:

Inhale deeply through your nose to contract your abdominal muscles and fill your lungs with air. During inhalation, the pelvic floor muscles should be relaxed.
Inhale slowly and deeply through your mouth while gently contracting your pelvic floor muscles.
Hold the pelvic floor muscles in a contracted state for 3-6 seconds (until they begin to tire) while you exhale. This is called a cut.
Inhale again and stop contracting the muscles. This will allow the muscles to relax.
Relax your pelvic floor muscles completely for 6-10 seconds. It is very important to completely relax the muscles between each contraction and not hold your breath. Always keep the muscles relaxed for the same amount of time as they were contracted, or a little longer.

Do this exercise for 10 repetitions per session.

If you experience pain while doing Kegel exercises, stop doing them immediately. Kegel exercises are not harmful, but not suitable for everyone. When performed correctly, many find them relaxing. They should not cause pain. If you experience pain during or after Kegel exercises, you may not be doing them correctly, or Kegel exercises may not be right for you. Call your health care provider to discuss this.

When to increase the duration of contractions

If the pelvic floor muscles do not begin to tire after contracting for 3-6 seconds or after doing 10 consecutive Kegel exercises, you can increase the duration of the contraction to 6-10 seconds, then completely relax the muscles for 10 seconds. Be sure to keep breathing as the muscles contract.

Try to achieve the goal of holding a strong contraction for 10 seconds 10 times in a row.

If you have difficulty doing Kegel exercises, a physical therapist who specializes in pelvic floor muscles can help. Ask your healthcare provider to refer you to such a specialist.

What to do if you have pain or continue to incontinence

If you continue to have problems with pelvic pain or incontinence, contact your health care provider to be referred to one of MSK's specialist physical therapists. pelvic health. This specialist will be able to understand the causes of pain or problems in the pelvic floor. You can also ask for a referral to a physical therapist if you have difficulty doing Kegel exercises.

MSK physical therapists provide services at the following address:

Sillerman Center for Rehabilitation
515 Madison Avenue, 4th ^{floor
(entrance from 53 ^rd Street between Park Avenue and Madison Avenue)
New York , NY 10022}

The Sillerman Rehabilitation Center can be called at 646-888-1900.

Sexual health and intimacy support and information

If you need more support or information about sexual health and intimate life, talk to your health care provider about the Female Sexual Medicine & Women’s Health Program at Memorial Sloan Kettering (MSK). For more information or to make an appointment, call 646-888-5076.

Services available through the Female Sexual Medicine & Women’s Health Program at the following locations:

Rockefeller Outpatient Pavilion
160 East 53 ^rd Street
New York, NY 10022

Breast Center. Evelyn H. Lauder Breast Center
300 East 66 ^th Street,
New York, NY 10065

Tell your healthcare provider if you have:

difficulty identifying your pelvic floor muscles;
pain during Kegel exercises;
difficulty doing Kegel exercises;
concerns about bowel, bladder, or sexual function;
pelvic pain;
questions requiring a referral to a physical therapist who specializes in pelvic health.

Women's pelvic floor exercises (Kegel exercises) for sexual health benefits

This information describes pelvic floor exercises (Kegel exercises) that are beneficial for sexual health and sexual satisfaction.

About Kegel Exercises

The main purpose of Kegel exercises is to help you strengthen your pelvic floor muscles. They can help you manage or prevent physical problems like incontinence. Incontinence is the leakage of urine or stool (feces) that you cannot control.

Kegel exercises can also benefit sexual health and sexual satisfaction because they:

relax the vaginal muscles, allowing the vagina to expand, which is important if you experience pain or discomfort during intercourse or pelvic exams;
improve blood circulation in the vagina and pelvic floor muscles, which can increase sexual arousal;
make it easier to achieve orgasm;
increase the production of vaginal lubrication (vaginal moisture).

About the pelvic floor muscles

The pelvic floor muscles form the pelvic cavity and support the pelvic organs (uterus, bladder, and intestines). These are the muscles you use to stop urination or hold back gas or stools (bowels). In addition, these muscles can contract (tighten) during orgasm. Figure 1 shows the pelvic floor muscles and pelvic organs.

Figure 1 Pelvic floor muscles and pelvic organs

Pelvic Floor Muscle Identification

If you are not sure which muscles are pelvic floor muscles, there are several ways to identify them.

Imagine that you are urinating. Tighten the muscles that you use to interrupt the flow of urine while urinating. Do not exercise your pelvic muscles by stopping the flow of urine in real life, especially when your bladder is full. This can weaken your pelvic muscles and cause your bladder to not empty completely when you urinate, which increases your risk of a urinary tract infection (UTI).
Tighten the muscles you use to hold back a bowel movement or the passage of intestinal gases, but do not contract the muscles in your buttocks, abdominals (abdomen) or inner thighs. If you do it right, your body should not rise at all. If you feel that your body is slightly lifted, you are most likely using the muscles of the buttocks.
Insert a finger or vaginal dilator into the vagina, and then squeeze the pelvic floor muscles around the finger or dilator. You should feel the muscles in your vagina tense up and your pelvic floor move up.

Be sure to completely relax your pelvic floor muscles after contracting them. If you have difficulty identifying your pelvic floor muscles, contact your doctor.

Performing Kegel Exercises

Instructions

Before you begin, get into a comfortable position so that your body is relaxed. Most people prefer to do Kegel exercises while lying in bed or sitting in a chair. Once you are familiar with the exercises, you can do them in any position and anywhere, such as standing somewhere and waiting in line.

From a comfortable position, follow the instructions below:

Inhale deeply through your nose to contract your abdominal muscles and fill your lungs with air. During inhalation, the pelvic floor muscles should be relaxed.
Inhale slowly and deeply through your mouth while gently contracting your pelvic floor muscles.
Hold the pelvic floor muscles in a contracted state for 3-6 seconds (until they begin to tire) while you exhale. This is called a cut.
Inhale again and stop contracting the muscles. This will allow the muscles to relax.
Relax your pelvic floor muscles completely for 6-10 seconds. It is very important to completely relax the muscles between each contraction and not hold your breath. Always keep the muscles relaxed for the same amount of time as they were contracted, or a little longer.

Do this exercise for 10 repetitions per session.

When to increase the duration of contractions

Try to achieve the goal of holding a strong contraction for 10 seconds 10 times in a row.

If you have difficulty doing Kegel exercises, a pelvic floor physiotherapist can help. Ask your healthcare provider to refer you to such a specialist.

Sexual health and intimacy support and information

If you need more support or information about sexual health and intimacy, talk to your healthcare provider about the Female Sexual Medicine & Women's Health Program at Memorial Sloan Kettering (MSK). For more information or to make an appointment, call 646-888-5076.

Services under the Female Sexual Medicine & Women’s Health Program are available at the following locations:

Rockefeller Outpatient Pavilion
160 East 53 ^rd Street
New York, NY 10022
Breast Center Evelyn H. Lauder Breast Center
300 East 66 ^th Street,
New York, NY 10065

What to do if your pelvic pain and incontinence persists

If you continue to have problems with pelvic pain or incontinence, contact your healthcare provider to be referred to one of MSK's specialist physical therapists for pelvic health. This specialist will be able to understand the causes of pain or problems in the pelvic floor. You can also ask for a referral if you need help or advice with vaginal dilator therapy or if you have difficulty doing Kegel exercises.

MSK Physical Therapists provide services at the following address:

Sillerman Center for Rehabilitation
515 Madison Avenue (entrance from 53 ^rd Street, between Park Avenue and Madison Avenue)
4th floor ^{New York, NY 10022}

The Sillerman Rehabilitation Center can be called at 646-888-1900.

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