Kegel exercises (or pelvic floor exercises) are done to strengthen the muscles in the pelvic floor, which support the urinary bladder, bowel and sexual organs.
The pelvic floor is composed of layers of muscles and connective tissue that span the lower end of pelvis forming a partition that separates the pelvic cavity above from perineum below (which contains the genitals and anus).
Three structures make up the pelvic floor:
• Levator ani muscles (has three parts- pubococcygeus, puborectalis and iliococcygeus).
• Coccygeus muscle.
• Connective tissue coverings of the muscles.
These muscle layers extend across the pelvis like a hammock. In men, the pelvic floor muscles support the bladder and last part of the intestine. In men, there are two gaps in the muscle layer, one for the urethra (urine tube) and one for the rectum. The strength of the pelvic floor muscles play an important role in urine and stool control, and possibly in sexual function.
How do Kegel exercises help men?
The pelvic floor muscles can weaken in men due to some causes including ageing, obesity and prostate surgery, resulting in reduced ability to control urine flow (urinary incontinence) and erectile dysfunction.
If you perform Kegel exercises regularly, you can overcome the pelvic floor weakness. Kegel exercises may help in men who have:
• Overactive bladder
• Urinary incontinence (including urinary incontinence seen after prostate surgery)
• Post-urination dribbling of urine
• Faecal incontinence
• Erectile dysfunction
How can men do Kegel exercises?
Identifying your pelvic floor muscles
You must identify your pelvic floor muscles so that you know which muscles to contract. These muscles cannot be seen, but can be felt by certain manoeuvres.
• Imagine your urinary bladder is full, and you are feeling the urge to pass urine, but there is no toilet. You subconsciously tighten the muscles that you use to control the urination. The muscles which you feel contracted, are your pelvic muscles.
• When you are passing urine, try to stop the stream of the urine. The muscles you squeeze to stop the flow are part of your pelvic muscles. This procedure is done to identify your pelvic muscles for future exercising and do not try it repeatedly.
• Imagine you are feeling the urge to pass stools or gas, but have to hold back. Tighten the muscles which you use to stop passing stool or gas. These are part of pelvic floor muscles.
Exercising the pelvic floor muscles
Once you have identified your pelvic muscles, you can try the exercises in different positions; the lying position may be the easiest to try initially.
• In lying position
Lay on your back with the knees bent and slightly apart. Tighten your pelvic floor muscles for 10 seconds and then slowly relax for 10 seconds.
• In sitting position
Sit with your knees apart on a chair and tense your pelvic floor muscles to lift it up without raising your buttocks off the chair. Hold the contraction for 10 seconds and then relax for 10 seconds.
• In standing position
Stand with the feet apart and contract your pelvic floor muscles as if you were trying to stop the urine flow or gas from escaping. If you are looking in a mirror, you may be able to notice the base of your penis moving nearer to your abdomen and your testicles rising. Hold the contraction for 10 seconds and then relax for 10 seconds.
Things to note while doing Kegel exercises
• Avoid holding your breath. Breathe deeply and relax your body as you do the exercises.
• Do not push down the muscles but imagine you have to lift up the muscles.
• Do not tighten the muscles in the abdomen, buttocks or thighs. If you begin noticing discomfort in the back, abdomen or thigh, while doing the exercises, you may be doing it wrong.
• Relax the pelvic floor muscles between each squeeze.
• Try the exercise in different positions, including lying, sitting and standing.
• Do not try to achieve quick results by overdoing the exercises that is by increasing the repetitions or frequency of the exercises. The muscle fatigue caused by over-exercising can increase the urine leakage.
How many repetitions?
Each contraction you do is one Kegel exercise and the subsequent ones are called repetitions. You must plan to do 10-20 such repetitions three to four times every day. With adequate practice, Kegel exercises can be done anytime at convenient places.
Most people like to start doing the exercises in lying down or sitting in a chair. It may take 4-6 weeks to notice any improvement in symptoms and around three months for any significant change.
Once you are comfortable doing the exercises in these positions, you can start trying the exercise in situations where urine may dribble such as:
• Starting to walk
• While on the way to the bathroom
• Before sneezing or coughing
• When changing from sitting to standing position
Variation of Kegel exercises
• Fast pumps: Tighten the muscles fast and the release without holding much and doing this in quick succession.
• Holds: Tighten the pelvic floor muscles and hold the tension for as much time as possible.
• Reverse Kegel: Instead of tensing the muscles, relax the muscles, similar to the pushing feeling when squeezing out urine or stools.
• While walking: When walking, try to lift the pelvic floor muscles to 50% of maximum possible contraction.
• After urinating: After passing urine, tighten the pelvic muscles to prevent the post-urination dribble.
• During sex: Tighten the pelvic floor muscles rhythmically during sexual activity to maintain the rigidity of penis.
• To delay ejaculation: Men with premature ejaculation can try tensing the pelvic floor muscles to delay ejaculation.
Can Kegel exercises work for impotence in men?
A research study recruited 55 men (of average age 59.2 years) with erectile dysfunction and made 28 of them do only pelvic floor exercises while the remaining 27 were treated with only lifestyle changes. These two groups were then compared.
Among the men who did pelvic floor exercises:
• 40% recovered normal erectile function.
• 34.5% reported improvements in their erection.
• 25.5% had no difference.
The researchers who did the study concluded that pelvic floor muscle exercises were an effective therapy for men with erectile dysfunction.
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- Dorey G. Restoring pelvic floor function in men: review of RCTs. Br J Nurs. 2005 Oct 27-Nov 9;14(19):1014-8, 1020-1.
- Dorey G, Speakman M, Feneley R, Swinkels A, Dunn C, Ewings P. Randomised controlled trial of pelvic floor muscle exercises and manometric biofeedback for erectile dysfunction. Br J Gen Pract. 2004 Nov;54(508):819-25.
- UCLA Health – Urology department. Kegel Exercises for Men. Accessed at http://urology.ucla.edu/workfiles/Prostate_Cancer/Kegel_Exercises_for_Men.pdf
- Medline Plus. Medical encyclopedia – Kegel exercises. Accessed at https://www.nlm.nih.gov/medlineplus/ency/patientinstructions/000141.htm