Why we do Kegels: Pelvic floor muscles problems

The purpose of me writing this article is twofold.   (1) if you don’t have these problems yet, you can learn from this and (2) if you are experiencing (or have experienced) these problems, we can share stories and help one another.   I am in the second category, so I am also looking for help and advice as well.

Being the oldest of the three remaining CN Sisters, I get the privilege of getting to experience a few things first (not all…lol)   Over the past 9 months, I have been told that my pelvic floor muscles are getting very weak, and I now have times when my bowels protrude into my vagina.   But let me back up a bit and give you some information on what your pelvic floor muscles are and what they do.

Your pelvic floor  muscles are there to hold your pelvic organs in place.  They resemble a hammock and are at the base of your pelvis.   There are two main muscle layers, a deep muscle layer and a superficial muscle layer.  These muscles work together to help keep your organs in place and functioning properly.   Just like any muscular area of your body, exercising them helps to keep them functioning properly.  Kegel exercises are a great way to exercise these muscles.  I will get into that later in the article.

These muscles can also weaken over time when not exercised properly or from other causes such as pregnancy and childbirth,  being overweight, age, a chronic cough, or by a genetic predisposition to weak muscles.   For myself, the birth of a 9# baby with an extremely long episiotomy, being overweight for a long period of time after that, a second pregnancy (7# baby) and my age probably have a lot to do with my current condition.    Well, and probably also the fact that I have never been particularly good (or patient at) doing Kegel exercises.

So when these muscles weaken, they can cause pelvic organs to fall.   If the bladder falls, a condition called cystocele occurs, which is the falling or prolapse of the bladder.   In this case, the bladder bulges into the vaginal area.  Rectocele is where the rectum walls become weakened and protrude into the vaginal area.   An enterocele is where the small intestines protrude into the vaginal area.   Lastly is the uterine prolapse, where the uterus descends into the vaginal area.    I have linked each of these names to a corresponding article at mayoclinic.com so that you can read further into these 4 problems that can occur in the pelvic area.  I can tell you from personal experience that this in not a very comfortable situation to be in, and I wish I had paid more attention to doing Kegel exercises.   I am now researching to see if it is too late to start regaining strength in these muscles or if it is gone for good and I will need surgical help to repair any damage.

Let me move on to Kegel exercises.   What are they?  These exercises were named after  Dr. Arnold Kegel.  These exercise help strengthen and can help the blood circulate better to your pelvic regions.  In order to do Kegels, you first need to locate the correct muscles in which to exercise.   Next time you need to urinate, try to stop the flow of your urine.  If you do so successfully, you have found your pelvic floor muscles.   Another way to locate them is to stick one finger in your vagina, and try to squeeze the surrounding muscles.  You will feel your vagina tighten and your pelvic floor muscles move up.  When you relax,  you will feel the vagina relax and the pelvic floor muscles drop.  Once you’ve located the right muscles, let the kegels begin!  Start by contracting your pelvic floor muscles and hold for 3 second, then relax for three seconds.  Do this 10x.  Once you are comfortable doing it for three seconds, move on to 4 second hold and 4 second release.   Try to work up to 10 second hold and a 10 second release.  This won’t all happen on your first time!  You need to keep up with this, like I wish I had.  You will need to try to do these exercises 3x a day.

Note: Once you find the right muscles to use for Kegels, it is not recommended as a frequent practice to stop urination this way because it increases the frequency of UTIs.

As for my problems, I won’t know for sure until I go for my second opinion.  Even though the term hasn’t been used by my primary doctor, I am sure I have a rectocele.   If that is the case, a pessary can be inserted by a health care professional or surgery can be done to repair the weakness between the vagina and rectal walls by using either stitches or a mesh net to hold the organs in place.

My own doctor has mentioned the word “hysterectomy” to me for this…while I don’t understand why yet, I am waiting to see if the second opinion suggests this as well.  If so, I will definitely ask then.   I have found a website that has helped me a great deal to prepare for if this is to occur.  It is called Hyster Sisters.  While it isn’t a total Christian site, there is a section for prayer requests and I have found some Christian sisters on that site that are praying for me as well.

If I had to go back and do it all over again, I would have been doing Kegels since I was pregnant with my first.   But I have to make good with what I have now.  I will start trying to do Kegels again so that maybe I can get some strength back in my pelvic floor muscles.  If you don’t do these daily, please start doing them.  They will help you out so much in the long run.

If you have ever experienced problems such as this and you wish to comment or offer advice below, I know myself as well as others might appreciate the support.

28 Comments

  1. Please, please, please read the book “Saving the Whole Woman” before you agree to any medical procedures! It’s out of print, but I found a copy through my library. It is possible to solve the problem without invasive medical procedures.

  2. While you “can” do them anywhere, doing kegels often makes me feel like I need to urinate. So I don’t do them in public, or when I don’t have the time/inclination to make a pit stop.

  3. For me it was really tough to actually remember to do them. I’m a younger mom with 4 little ones…busy busy busy! By the time I would actually remember to do them, I was finally in bed ready to fall asleep…too tired!
    So I found out something that really helped, I began associating kegels with something. For example, every time I sit down to feed the baby (infant) I do them, and every time I wash the dishes I make myself do a few sets. It becomes so that every time I start washing the dishes or feeding the baby my brain tells me “Kelels!!!” It has really helped me remember each day. :-)

  4. I had all four of the types of prolapse and had 3 surgeries including a hysterectomy when I was in my early 30s for it. As spicynutmeg said, it is very uncomfortable. I think I always have had weak pelvic muscles because I had very small babies and have never been overweight. I was never able to wear tampons properly either and I’m sure that had to do with the weak muscles. Anyways, because I have weak connective tissue, I was told Kegels wouldn’t have helped me, but in someone with normal tissue they can be beneficial. Even though my surgery was less than five years ago, I am already experiencing another rectocele and cystocele. It isn’t enough for me to want to go through surgery again but I will probably have to at some point.

    The reason the doctor is suggesting a hysterectomy is probably because the uterus can drag down the other organs and contribute to the prolapse, if it hasn’t already starting prolapsing itself. I can tell you that recovering from such a surgery as I had was not easy, but the benefits make it worth it. My friends are all jealous I don’t need to deal with periods anymore!

    Sex with all those issues was not good. I would joke with my husband that I was a 30 year old with the vagina of a 90 year old. Our sex life since the surgery has been much better.

    I hope that my story is helpful. If anyone has any questions about it I am very open to discussing it.

  5. Since your doc. told you that kegels would not have helped you, did he have any suggestions as to how to avoid all of these problems/ or strengthen things?

  6. I know I need to do kegels, particularly as I have trouble sustaining orgasm for more than a split second (supposedly strength in the pelvic floor can help with that), but I have found doing them gets me aroused basically every time. Any suggestions? Think about baseball? :P

  7. Lol! The same thing happens to me. :-) I just usually go with the flow and think of it as revving myself up for my DH later on that night! It’s kinda cool if you think about him while you’re exercising, b/c you’re not only strengthening your muscles but keeping your sex drive up at the same time! :-)

  8. I have vaginismus/pelvic floor dysfunction among other things, and learning how to Kegel (and then maintaining kegel exercises,) is part of my treatment. I find they do help. I was able to have intercourse after I started learning how to do them.

    For me it’s more important to learn how to relax those muscles, than it is to strengthen them. They’re already too tight to begin with.

    So that’s another angle.

  9. No, there was nothing else I could have probably done, unless I would have maybe started doing kegels when I was a young teen. Doing kegel’s won’t hurt me at all, but because of the nature of my tissue, it is not going to take care of the problem.

  10. Same thing happens to me as well!

  11. I will try to see if I can find a copy of this book. If surgery of any kind can be avoided, then I am all for it!

  12. Well, I went to the second opinion this past Monday, and this doctor said I had a rectocele. The only reason he said I would need a hysterectomy is if I didn’t want the periods. I have also what he called a stage 1 uterine prolapse…my cervix is barely entered the vagina.

    If I can be honest with all of you, I really think that if the uterus is removed, I am asking for more pelvic problems. I have a lot of praying to do. I really don’t want the hysterectomy….I’ll have to see if I can find that recommended book to see what it has to say.

  13. Interesting article and posts. These are very real issues for women. I work in surgery and can tell you they are also all very common. I wish medical personnel would stress the importance of maintaining good female/sexual health.
    I was glad to see you mention that we should never start/stop our urine stream. It is also important to know that Kegels should always be done lying down.(Both of these things came from a “female urinary incontinence specialist.)
    I think it’s also a good idea to avoid surgery if at all possible. However sometimes it is necassary. While surgical procedures are often life savers there are always risks involved. My opinion.

  14. I am currently in physical therapy for pelvic floor issues. I have a rectocele, cystocele and a stage 1 uterine prolapse. I HIGHLY, STRONGLY recommend finding a qualified PT who can work w/ you. Mine has helped wonders in the 4 short weeks I have seen her. We use a bio-feedback type of machine that helps me actually visualize if I am doing Kegels correctly and the strength of them. It has improved the blood flow to my pelvic region and for the first time in months, I am not having my post-ovulation dryness/itchiness that I usually get b/c my pelvic region is alive again. I only do Kegels 3 times a day. She says you should never have to do more than that. I also found out that my whole pelvic floor was in a state of spasm and she works on my sacrum and lower back to help get it to relax. I can’t speak any more highly of how this therapy has given me so much hope. Please, before you even consider a hysterectomy (which in most cases will cause more pelvic floor problems b/c it’s not the uterus that is the problem, it’s the pelvic floor muscles)get a referral to a qualified PT. Do your homework and ask around who is the pelvic floor ninja PT in your area.

  15. My pelvic floor is the same way…spasm.

  16. Second on the physical therapist & biofeedback device. They can be hard to find but if you’re having major problems it might be worth it.

  17. Love your site! I am a PT that specializes women’s health, and a Christian. Just wrote a blog about a new twist on the old Kegel http://interiorfitness.wordpress.com/ . The tips may help you feel more confident that your pelvic floor work is doing the job. The pelvic floor closes to help stop urine but it also lifts up and in, which is important in a prolapse. As you learn to use your pelvic floor better, another way to be sure you’re using the right muscles is during sex (with a very patient partner). Feedback from him will let you know if you are performing them correctly! See if he can feel you perform a Kegel, if not you aren’t using the right muscles. Be happy to answer any questions you might have. I agree with desert gal seek the help of a PT locally before you go for surgery.

  18. How did you find your particular therapist? Neither of the doctors I have visited mentioned this possibility at all, so I am intrigued!

  19. Spicy Nutmeg, I pray for great health for you and that God will lead you to make the right decision for your body.

  20. Great article!

  21. I found my therapist by referral from the birth center I had my last child at and by asking local PTs who they recommend for women’s health PT. They all led me to the same PT.

  22. I am having issues myself. I have not had children and my kegals were working very well until about five months ago. I was doing regular exercises and my husband and I did not have any problems. One day I felt an odd shift in what seemed to be the rectal area during sex and now my ability to “squeeze” has gone. It started only after I could reach orgasm and was like that for a while but now I don’t have any muscle tone left. The only thing we can think of is that my tailbone (which I’ve broken before) shifted and has caused nerve damage. Right now were at ends and I was just wondring ifanyone here had any thoughts on this… Thanks, V.

  23. Hey V,
    I am 47 and have a fear of doctors yet in this situation I would not hesitate to get myself checked out. Why wait until something else ‘shifts’.

    If you are talking nerve damage, I get chills down my spine! Literally.

    Nerve damage is nothing to be sniffed at and should be medically assessed as soon as you can get to a physician. There are certain medical conditions which should not be tampered with and nerve problems are top of the list in my opinion.

    Spinal issues are really tricky to self-diagnose so I hope you take care of yourself really well and figure out a remedy for this problem before it has gone too far to either reduce the inflammation or whatever is prescribed.
    Thinking of you during this time.

  24. Thanks. We’re going to the doctor on Tuesday so I’ll let you know if anything comes up. We want to have children but this may put a damper on it. V

  25. I have the same problem, so I cannot relate to the need to do Kegels either. I actually had physical therapy for the problem. It helped a lot but was humiliating. I had very painful endometreosis and my uterus was basically dangling backwards. The pain was horrible. I also had ovarian cysts which were pretty painful, so I ended up having a hyst and had my ovaries removed as well. I think I was having the PF spasms back then, but now that I have no ovaries, I have dryness on top of it. To say that I don’t enjoy sex would be an understatement.

  26. Hello interiorfitness,
    YYYYEEEESSSSS, finally advice I can learn from. Roved all over your site. Amazing and a direct answer to much prayer.
    I am so sick of getting teaching on kegels and then being unable to incorporate the info into my working out.
    Talk about total frustration finding that I oftimes cannot jump and go wild with excitement as I am wont to do without feeling a horrible, old granny, urine leak! Grrr. Now, I can take concrete tutoring and get results FINALLY. Thanks so much.

  27. Thanks S-P for your feedback! I am on a mission to change the way the pelvic floor health is addressed. There isn’t another muscle in the body that we train the way women have been told to train their pelvic floors. A fitness or rehab person would never tell you to do 10 bicep squeezes 3x/day every day for the rest of your life, yet that is what we tell women to do with their pelvic floor. I am working on a pelvic floor plyometrics program (that means a jumping program, creates POWER!!) to try to foster a more functional program for women to use the pelvic floor as it was designed to function! Best! Julie

  28. ienjoyed your write up.i have tried the kegel but stopped.i have had my uterus removed and now the pains have increased even with my buttocks. will kegel exercise still help? please lt me know what to do . God blessu


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