THE KEGEL EXERCISES


Robert W. Birch, Ph.D.
Sexologist & Adult Sexuality Educator

A LITTLE HISTORY

      A band of muscles stretch between the legs of both men and women, stretching from the pubic bone in front to the coccyx (tail) bone in back. Playfully, we could say that with out these muscles, all of our internal organs would fall out! Along their way, this sling of muscles includes the sphincter of the bladder, the sphincter of the anus, and, in a woman, the sphincter surround the opening of her vagina. These muscles are clinically known as the pubococcygeus (pronounced pew-bo-kak-se-gee'-us) muscles, but this group of muscles is more commonly called the "PC muscle." To talk as though there is just one muscle is an over-simplification, for there are actually a number of muscle groups that collectively make up this pelvic floor sling. We'll use the plural and call them the PC muscles.

     Many younger women have been introduced to their PC muscles during a pregnancy or during a postpartum exam when they were advised to exercise these muscles in order to restore muscle tone following childbirth. Many older women have been introduced to their PC muscles because these are the muscles that are exercised to correct the condition known as urinary incontinence (the involuntary loss of urine when coughing, sneezing, etc.). In fact, the exercise of these PC muscles as a medical treatment for urinary incontinence was first proposed in1950 by the surgeon Arnold Kegel, for whom the exercises have been named.

     In 1952, Dr. Kegel published a report in which he claimed that the women doing his exercises were becoming more easily, more frequently and more intensely orgasmic! As these are the muscles that contract rhythmically during orgasm in both males and females, it is not surprising, therefore, that sex therapists have emphasized the importance of these pelvic floor muscles that surround the vaginal opening and play a major role in the orgasmic response.

     Thirty years after Dr. Kegel's article, sex therapist Bryce Britton wrote a book titled "THE LOVE MUSCLE," calling her publication "Every Woman's Guide to Intensifying Sexual Pleasure." Many people still refer to the PC muscles as the love muscle. Now, almost 50 years after Dr. Kegel published his discovery, and after several decades of "prescribing" the Kegel exercises as a component in teaching women to become orgasmic (or more easily orgasmic), what can we say about "Kegeling" the love muscle? We can say that doing the exercises will tone up the sphincter of the bladder and might tighten the muscles around the opening of the vagina. We can also assume that any well-toned muscle will contract more powerfully than would a flabby muscle, and hence the likelihood of stronger orgasms with stronger PC muscles. We can report with confidence that some women squeeze their PC muscles, forcing blood down into their genital tissue, and in so doing turn themselves on. A very small minority of women might even be able to bring themselves to orgasm exclusively with voluntary pelvic floor contractions. Finally, it is safe to say that a woman can add novelty to a sexual encounter by voluntarily squeezing her well-toned vaginal sphincter around her partner's penis, and this might be fun for both giver and receiver.

     What can most confidently be said about the entire "PC muscle controversy" is that in doing Dr. Kegel's exercises, a woman will achieve closer contact with her pelvis, is more likely to take ownership of her internal and external genitalia, will strengthen the muscles that contract during orgasm, and is probably making an investment in her lifelong urinary control! Is it a major component in a woman becoming orgasmic? Probably not, but it is certainly something non-orgasmic women should include in their quest for the "Big O." It is a part of the learning package.

DOING THE KEGEL EXERCISES

     In getting started with the Kegel exercise of the PC muscles, the first task for many women is to locate them. The best advice for finding the muscles is to do so while urinating. Sitting on the toilet with legs slightly spread, try to interrupt the flow of urine without bringing your legs together. Stop and start the flow, trying to sense those muscles that are involved. Once you can control the flow of your urine and can also find and squeeze them when not on the toilet, you have identified this band of important pelvic floor muscles.

     Remember, these muscles are not located in your abdomen, nor are they in your thighs! Try to isolate the muscles so you can tighten them without flexing your "abs" and without putting tension in your legs. It might take time to fine-tune your ability to find, isolate and contract the muscles, so do not become discouraged if you have difficulty at first.

     Once you know you have found your PC muscles, you will find that you can flex them ("Kegeling") most any time you choose and without being noticed by others who might be around you. Doing a series of Kegel exercises each day in the course of typical activities is most helpful. For women who drive or ride to and from work each day, a practical plan is to do a series of contractions at each red light encountered, or at each gas station passed, or in response to some other reminder. While watching TV, squeeze your PC muscles during each commercial. Contract the muscles and hold them tight for a slow count to five. At first you might not make it to five, but keep trying. As with any muscle, the more you exercise that muscle, the less effort is required to tighten it and the longer you will be able to keep them tight.

     In addition to taking advantage of opportunities in your daily life, set aside specific times when you can be alone at home. Lay down and relax. Starting with a warm bath might help. In your mind, find those PC muscles. Then begin tightening and relaxing five times, each time holding the contraction for a slow count of five. Your goal over a period of time is to increase the number of contractions and the length of time held (although there is a limit to which the PC muscles can be tightened before they automatically begin to relax). Work at it, each time striving to improve your count. If the muscles feel tired, stop and relax for a few seconds and then start in again.

      While on your back, also try to do a series of quick Kegels, tightening and relaxing the PC muscles as rapidly as possible, initially five times. Relax for a minute and then do another series of these quick rapid contractions. Work to increase the number of contractions in each series, and work to increase the number of series. You might think of this as "fluttering" your PC muscles. Rest when you need to.

     It is important to exercise often and it is helpful to add a variety of physical positions. It has also been suggested that it would be helpful to pull in the entire pelvic floor, imagining that you are able to draw water up into your vagina. Then bear down as though you are pushing this imaginary water out. Do that five times to start, and more often as you gain strength.

     Initially you might want to do the exercises clothed (certainly those series performed on your way to work). At home, however, when you will be comfortable and will have the time, it might be helpful to begin doing the exercises nude. Combine your "Kegeling" with other activities designed to increase body awareness and sexual sensitivity. You might find that doing your Kegels while masturbating increases the level of your arousal and might even trigger an orgasm.

KEGELING WITH YOUR PARTNER

     With a partner present and with sufficient arousal and lubrication, have your partner insert two fingers into your vagina. Once inside, your partner should open the fingers up like scissors, and you try to close them with your vaginal sphincter muscles. Repeat this five times on each occasion that you do it. If you are uncomfortable with two fingers, have your partner put in just one and then curl this finger upward. You try to straighten it out!

     If you are a heterosexual woman with a partner, you might also want to use the PC muscles that surround the opening of your vaginal during intercourse. Grip and relax, grip and relax five times, saying nothing to see if your partner will acknowledge feeling you tighten around him. You could think of it as a flirtatious "vaginal wink." Have fun learning about your pubococcygeus muscles and share!!

    

     This article is an adaptation of a chapter in the Appendix of PATHWAYS TO PLEASURE: A Woman's Guide to Orgasm (© 2000) by Sexologist Robert W. Birch, Ph.D. & Sexuality Counselor Cynthia Lief Ruberg, M.S.Ed.



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