Kegels: The 30-second exercise that can improve incontinence and sex

Woman sitting in chair on purple background

If there was an exercise that took 30 seconds, didn’t require equipment, didn’t require a doctor’s appointment before starting, and had physical and possibly even sexual benefits — you’d do it, right?

Then it’s time to learn about kegel exercises. A kegel (pronounced kee-gull) is a pelvic floor muscle exercise that can strengthen pelvic muscles, support pelvic organs, and help control incontinence of urine, bowels and gas. While there’s little scientific evidence to prove it, some doctors believe it also has potential to make sex more pleasurable.

We spoke with gynecologist Juraj Letko, MD, who specializes in female pelvic medicine and reconstructive surgery, and is co-director of the Center for Pelvic Health at the University of Chicago Medicine, to learn more about kegels, who should do them, and why they’re part of a leading-edge treatment for many conditions.

Q: What are the benefits of doing kegels?

Dr. Letko: They help with the leakage from urine, gas or fecal incontinence. They also can improve the symptoms of pelvic organ prolapse (a herniation that causes the vaginal walls to collapse and protrude, causing the pelvic organs to descend from their normal anatomical position).

Can kegels improve sex?

Kegels improve blood circulation to the pelvic floor and vagina, and this may be helpful for arousal and lubrication. A lot of women, after childbirth, feel like their vagina is not as tight as it was before and they want to have surgery for that. But strengthening the pelvic floor muscles with kegel exercises can make it a little bit more taut. It might be tighter because women are better able to contract their muscles, and that might improve sensation. Even if it’s psychological, it can help women feel better about their pelvic floor, so there’s a positive benefit.

Are kegels only for women? Or are they beneficial to men, too?

They’re beneficial to men, too. They help men with overactive bladder symptoms, and stress, gas, or fecal incontinence symptoms. For example, men who undergo prostate surgery may benefit from these.

Are kegels only for people with pelvic problems? Or can anyone do them?

They’re not harmful to anyone. It’s like any muscle in our body. We go to a gym to address muscles in our arms and legs, but we neglect the pelvic floor muscles. Keeping up with pelvic floor health is good. During pregnancy, women can benefit from them if they do them correctly. A lot of women do them wrong and that can exacerbate certain problems.

What can happen if you do a kegel incorrectly?

Women often incorrectly contract their buttocks or gluteal muscles, or inner thighs, and basically squeeze their thighs together. Many strain and increase their abdominal pressure. That’s not good for two reasons. One, it’s ineffective. And two, straining results in the opposite effect. Chronic straining is a risk factor for developing and worsening problems like pelvic organ prolapse or stress incontinence.

Do you recommend them to all your patients?

They are pretty much beneficial for all patients. There are very rare situations when they’re not recommended, such as in patients with urinary retention problems. They have incomplete bladder emptying, so you don’t want them to further strengthen their pelvic floor muscles and possibly worsen their bladder emptying.

Can physical therapists help with kegels?

Absolutely. Pelvic floor physical therapists can teach you how to do kegels in a correct and more effective way. They use different techniques for monitoring and provide feedback. It’s like having a personal trainer at the gym. You can find instructions for kegels online and do them on your own, but if you have someone who teaches you how to do them, and gives you professional feedback, it helps you do the exercises correctly and more effectively. It’s been proven in research studies that it’s more effective than doing them on your own. We have a very good physical therapy team at UChicago Medicine specializing in pelvic floor issues.

What types of things does UChicago Medicine’s Center for Pelvic Health do that make it stand out from other hospitals?

We’re lucky that our center is truly a multispecialty group, so we are able to manage a very wide spectrum of conditions. We can provide care for any condition related to the pelvic floor. We have a very strong colorectal team, which is focused on pelvic floor dysfunction. All the members of the center are very dedicated and cherish very collaborative relationships. That’s really our strength. We include urogynecologists, urologists, colorectal surgeons, pelvic floor physical therapists, pain specialists, minimally invasive gynecological surgeons, radiologists and more.

How to Do Kegel Exercises

Pelvic floor muscle exercises, also known as kegels, can be done discreetly and at any time during the day. Our experts explain some dos and don'ts for how to do a proper kegel.
  • Make sure your bladder is empty.
  • Find the right muscles. They’re the same muscles you’d use to stop urine midstream.
  • Squeeze and hold those muscles for 10 seconds, and then relax for 10 seconds.
  • Do three sets of per day, 10 to 15 kegel exercises each.
  • Don’t do the exercises while you’re urinating and repeatedly stop
    urine flow.
  • Don’t hold your breath. Breathe freely during the exercises.
  • Don’t squeeze your thigh, abdomen or buttocks muscles.