Pelvic Floor Muscle (Kegel) Exercises for Women to Improve Sexual Health

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This information describes how to do pelvic floor muscle (Kegel) exercises to improve your sexual health and pleasure.

About Kegel Exercises

Doing Kegel exercises can help strengthen your pelvic floor muscles. This can help you manage or prevent physical problems such as incontinence. Incontinence is leakage of urine (pee) or stool (poop) that you can’t control.

Kegel exercises can also help improve your sexual health and pleasure by:

  • Relaxing your vaginal muscles, which lets your vagina be more open. This is helpful if you have pain during sexual intercourse, pelvic exams, or both.
  • Improving blood circulation to your vagina and pelvic floor. This can help increase sexual arousal.
  • Making it easier for you to reach orgasm.
  • Increasing vaginal lubrication (wetness).
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About Your Pelvic Floor Muscles

Your pelvic floor muscles form the bottom of your pelvis and support your pelvic organs (uterus, bladder, and bowel). Your pelvic floor muscles are the muscles you would use to stop your stream of urine or keep yourself from passing gas or having a bowel movement (pooping). They’re also the muscles that can contract (tighten) during an orgasm. Figure 1 shows your pelvic muscles and organs.

Figure 1. Pelvic floor muscles and pelvic organs

Figure 1. Pelvic floor muscles and pelvic organs

Identifying your pelvic floor muscles

If you’re not sure which muscles are your pelvic floor muscles, here are some ways you can identify them:

  • Imagine you’re urinating (peeing). Contract the muscles you would use to stop the stream of urine. Don’t actually practice stopping your urine stream, especially if your bladder is full. This can actually weaken your muscles and lead to your bladder not emptying completely. This increases your risk for a urinary tract infection (UTI).
  • Contract the muscles you use to hold back a bowel movement or keep yourself from passing gas, but don’t contract your buttock (butt), abdomen (belly), or inner thigh muscles. If you do it correctly, your body shouldn’t lift up at all. If you notice that your body lifts slightly, you’re probably using your buttock muscles.
  • Insert a finger or vaginal dilator into your vagina, then contract your pelvic floor muscles around your finger or the dilator. You should feel your vagina tighten and your pelvic floor move upward.

Try not to use your abdomen, leg, or buttock muscles when you contract your pelvic floor muscles. Exercising these muscles won’t help you strengthen your pelvic floor muscles. To find out if you’re also contracting your abdomen, leg, or buttock muscles, you can place one hand on your stomach and your other hand underneath your buttocks or on your leg. Squeeze your pelvic floor muscles. If you feel your abdomen, leg, or buttocks move, you’re using the wrong muscles.

Be sure to release your pelvic floor muscles completely after you contract them. If you’re having trouble identifying your pelvic floor muscles, contact your healthcare provider.

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Doing Kegel Exercises

Once you learn to correctly contract your pelvic floor muscles, do 2 to 3 sessions of Kegel exercises every day to get the best results. It’s best to spread the sessions out during the day.

Instructions

Before you start, get into a comfortable position so your body is relaxed. Most people prefer doing Kegel exercises when lying down on a bed or sitting in a chair. Once you’re familiar with the exercises, you should be able to do them in any position and in any place, such as standing and waiting in a line.

Once you’re comfortable, follow these steps:

  1. Breathe in deeply through your nose, letting your abdomen rise as it fills with air. Keep your pelvic floor muscles relaxed as you breathe in.
  2. Breathe out slowly and smoothly through your mouth as you gently contract your pelvic floor muscles.
  3. Keep your pelvic floor muscles contracted for 3 to 6 seconds (until your muscles start to get tired) while you breathe out. This is called a contraction.
  4. Breathe in again and release the contraction. This relaxes your muscles.
  5. Relax your muscles completely for 6 to 10 seconds. It’s very important that you relax fully between each contraction and that you don’t hold your breath. Always spend the same amount of time or longer relaxing your muscles as you did contracting them.

Repeat this exercise 10 times per session.

If you have pain when you do Kegel exercises, stop doing the exercises right away. Kegel exercises aren’t harmful, but they aren’t appropriate for everyone. When done correctly, most people find them relaxing. They shouldn’t be painful. If you feel pain during or after Kegel exercises, you may not be doing the exercise correctly, or Kegel exercises may not be appropriate for you. Contact your healthcare provider to discuss this.

When to progress to longer contractions

If your pelvic floor muscles don’t start to get tired after a 3 to 6 second contraction, or if your pelvic floor muscles aren’t tired after you do 10 Kegel exercises in a row, you can progress by holding the contractions for 6 to 10 seconds, then relaxing your muscles completely for 10 seconds. Make sure you keep breathing while you hold the contractions.

Your goal should be to hold a strong contraction for 10 seconds 10 times in a row.

If you’re having difficulty with the Kegel exercises, seeing a physical therapist that specializes in the pelvic floor can help. You can contact your healthcare provider for a referral.

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Support and Information About Sexual Health and Intimacy

If you need more support or information about sexual health or intimacy, you can also talk with your healthcare provider about MSK’s Female Sexual Medicine & Women’s Health Program. For more information or to make an appointment, call 646-888-5076.

The Female Sexual Medicine & Women’s Health Program provides services at the following locations:

  • Rockefeller Outpatient Pavilion
    160 East 53rd Street
    New York, NY 10022
  • Evelyn H. Lauder Breast Center
    300 East 66th Street
    New York, NY 10065
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What to Do if You Have Continued Pelvic Pain or Incontinence

If you’re continuing to have problems relating to pelvic pain or incontinence, ask your healthcare provider for a referral to one of MSK’s physical therapists who specializes in pelvic health. They can address the causes of pain or problems in your pelvic floor muscle area. You can also ask for a referral if you want support or guidance with vaginal dilator therapy or if you’re having trouble with your Kegel exercises.

MSK’s physical therapists provide services at the following location:

Sillerman Center for Rehabilitation
515 Madison Avenue (entrance on 53rd Street between Park and Madison Avenues)
4th Floor
New York, NY 10022

You can reach the Sillerman Center by calling 646-888-1900.

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Contact your healthcare provider if you:

  • Are having trouble identifying your pelvic floor muscles.
  • Have pain when you do Kegel exercises.
  • Have trouble doing Kegel exercises.
  • Have concerns about your bowel, bladder, or sexual function.
  • Have pelvic pain.
  • Want help with your vaginal dilator therapy.
  • Want a referral to a physical therapist who specializes in pelvic health.
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