What Conditions Can Kegels Actually Help?

There are a lot of different theories about the problems Kegels can solve, but your knowledge of pelvic floor exercises may begin and end with that "Sex and the City" episode. But what conditions can Kegels actually help?

Conditions Kegels can actually help

Kegels are a pelvic floor-strengthening exercise, or basically "push-ups" for your pelvic floor muscles, said Ashley Rawlins, D.P.T., a physical therapist and the clinical learning and development lead at Origin Physical Therapy in Dallas.

Kegels are ideal for anyone who has underactive pelvic floor muscles which could function better and offer more support if they were strengthened.

"In general, they are aimed to help prevent uterine prolapse and urinary stress incontinence in women," said Tara Scott, M.D., the medical director at Forum Health in Akron, Ohio.

"Common symptoms Kegels can help include bowel or bladder leakage, pelvic heaviness [pelvic organ prolapse] or pelvic/low back pain related to joint instability," Rawlins said. "With that said, not everyone with these symptoms automatically needs Kegels. When symptoms come up, a full assessment by your healthcare provider would be the best first step."

In order to see any benefits of Kegels, you need to make sure you are doing them correctly. To locate the pelvic floor muscles, men can stop their urine midstream and women can pretend they're tightening their vagina around a tampon. Once you've located the muscles, flex them for three to five seconds and then relax for five seconds. Do this 10 times, three to four times a day, every day.

Can Kegels help with labor?

If you're pregnant, you may have heard Kegels can help with labor, but is it actually true?

"I'm not certain it helps with labor," Scott explained. "Kegel exercises are aimed at tightening the pelvic floor, and for labor and delivery, you want these muscles to relax and stretch easily to allow the baby to pass through the birth canal."

There was no correlation found between pelvic floor muscle strength and total length of labor, a 2011 randomized controlled trial suggested.

"Kegels don't seem to impact birth outcomes negatively," Rawlins said. "They don't necessarily make a vaginal delivery more difficult or increase [the] risk of tearing. But training your pelvic floor for birth is so much more extensive than Kegels and requires learning to push and lengthen/open your pelvic floor muscles to support birth outcomes as much as possible."

Should I do Kegels before labor?

If you are pregnant, doing Kegels before you go into labor can be helpful for you after birth.  

"It helps to do [Kegels] before labor, but it may not help with actual labor. Kegels help you control and strengthen the pelvic floor, which can help prevent or treat any urinary incontinence or pelvic organ prolapse which may occur after labor and delivery," said Michael Simoni, M.D., a reproductive endocrinologist with Reproductive Medicine Associates of New Jersey.

Can Kegels help with postpartum conditions?

While it seems you need to do more than just Kegels to prepare for labor, practicing Kegels during your pregnancy is helpful with postpartum urinary incontinence.

"Kegels help those with incontinence in pregnancy or those without who are hoping to prevent [it], and with childbirth being an additional risk factor for urinary incontinence, then Kegels may be able to help your postpartum outcomes," Rawlins suggested.

"If your muscles are in shape by the time you reach labor, it helps the recovery process afterward," Simoni said. "It helps to keep doing Kegels in the postpartum period as well to enforce pelvic floor strength."

Can Kegels help with urinary incontinence?

There are many different types of urinary incontinence. Kegels are often suggested to patients who have stress urinary incontinence, which is incontinence during instances of increased intra-abdominal pressure. Your bladder and urethra muscles are not supportive or strong enough, so when you cough, jump or laugh, urine can slip out. Kegels can help improve the support and position of the bladder and closure of the urethra to keep urine where it is supposed to stay until you mean to empty it, Rawlins explained.

"Kegels [are] aimed at strengthening your pelvic floor, and these muscles stay contracted to keep the urine in your bladder," Scott said. "By relaxing the urethral sphincter, you can urinate. Coughing, sneezing and jumping can put pressure on a weak pelvic floor and contribute to incontinence. Strengthening these muscles helps prevent this.

"If doing Kegels makes you urinate, that is a sign of a bigger, underlying issue and you should see a doctor," Scott warned.

Can Kegels improve my sex life?

Practicing Kegels could improve your sex life. Kegels' ability to strengthen your pelvic floor muscles could help reduce premature ejaculation, Scott explained.

There is a connection between pelvic floor muscle strength, sexual activity and orgasms, but the exact correlation is unclear. For example, we cannot say Kegels increase your frequency of orgasms, Rawlins said.

"Research is for sure lacking with respect to this. But it is likely if your pelvic floor muscles need to be strengthened—underactive, weak muscles—Kegels may help with blood flow to the nerves in the area, improve muscle tone and sensation, and will reduce your chances of having bowel or bladder leakage during sexual activity, which may be a libido killer," Rawlins said. "The muscles are already active during orgasm, so you may be able to boost your orgasm with a little active Kegeling."

The pelvic floor can get "stretched out" during pregnancy and delivery. Practicing Kegels can help strengthen your pelvic floor after birth. Some people may think sex feels better when they have more muscle tone, so pelvic floor muscles strengthened by Kegels may make sex more enjoyable, Scott explained.

Kegels can help with a variety of conditions, but before practicing Kegels to solve a problem, check with your pelvic physical therapist to make sure they are right for you, Rawlins suggested.