Beginner’s guide to Kegels

Do you leak a little urine when you laugh or exercise? Bladder weakness can be embarrassing, and it’s actually super common in women. It’s a side effect of childbirth and can also appear after menopause. In fact, 53% of women have trouble controlling their pee (known as urinary incontinence), according to a study in The Journal of Urology.

Exercises that strengthen the pelvic floor muscles can help you prevent urine from leaking. These are known as Kegels. Here’s what you need to know to take control.

What exactly are pelvic floor muscles?

These muscles are kind of like a hammock. “They hold and support the pelvic organs like the bladder and bowels,” says Brittany Robles, MD. She’s an OB-GYN associated with Wyckoff Heights Medical Center in New York City. Your pelvic floor muscles also help prevent urine leakage.

Certain life events and risk factors can cause urinary incontinence. Your body may change and weaken the pelvic floor muscles. When that happens, the muscles may have a hard time stopping urine from escaping. You may notice pee dripping out when you laugh, sneeze or jump.

During pregnancy, for example, the uterus puts stress on the pelvic floor. That leads to stretching and weakening of the pelvic floor muscles. “Childbirth may also damage the nerves in these muscles,” Dr. Robles says. Other risk factors include:

• Menopause
• Surgery
• Being overweight
• Chronic coughing
• Genetics
• Aging

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The benefits of Kegels

Kegels can help build strength in these muscles, says Celeste Compton. She’s a physical therapist with Origin in Los Angeles, California. Doing Kegels involves tightening the pelvic floor muscles and then relaxing them fully. This teaches your pelvic floor muscles how to contract with greater strength and endurance over time.

By keeping your pelvic floor muscles “fit,” you can keep urine from leaking during exercise and daily living. You can also prevent the accidental passing of poop and gas.

How to do Kegels

The quickest way to learn Kegels is to practice while you’re peeing. Begin urinating and then stop the flow of urine midstream. Notice the muscles you’re tightening to stop the flow. Those are your pelvic floor muscles.

You can stop doing them on the toilet once you get used to how it feels to activate your pelvic floor muscles. (Regularly stopping and starting your urine flow can create other health issues in the long run, according to the Cleveland Clinic.) Instead, do the exercises at other times each day. Work up to at least 30 repetitions twice a day, recommends Compton. You can do them seated, standing or lying down.

The beauty of Kegels is that you can do them almost anywhere and no one will know. You can perform them during commercial breaks, waiting in line, while brushing your teeth or before going to sleep.

Keep these tips in mind while doing Kegels:

• Don’t hold your breath.
• Focus on relaxing your pelvic floor muscles completely in between contractions.
• Take a 10-second break if you get tired and then try again.
• Try not to tighten your butt, thigh or stomach muscles as you do them.

Managing minor wetness

It can take weeks or even months to rebuild your pelvic floor muscles. Still, many women notice less urine leakage within 12 weeks of starting a Kegel exercise routine.

In the meantime, you can do other things to manage pee leakage. Try these:

Wear a panty liner. These can help if you normally leak just a few drops.  Or you can try reusable underwear specifically designed for bladder leaks.

Follow a regular peeing schedule. “Timed voiding” is the practice of sitting down on the toilet every 2 hours, even if you don’t have to urinate. This helps retrain your bladder to get into a regular schedule, says Dr. Robles.

Check your diet. Some foods and beverages can increase your need to pee. Cut back on or stop eating foods that irritate the bladder. These include:

• Coffee
• Alcohol
• Spicy foods
• Tomato-based products
• Chocolate

Empty your bladder. Make sure to pee before you work out. This can lower your chance of bladder leaks.

Try an exercise called “the knack.” When you feel the urge to cough or sneeze, squeeze your pelvic floor muscles. Try to hold the contraction until it passes. “You may be able to avoid leaking on the first sneeze,” Compton says. “But don’t be frustrated if you leak after 3 sneezes in a row. Your muscles are trying.”

If you don’t see improvement or you’re concerned about your bladder leakage, talk to your doctor or OB-GYN. They may refer you to a physical therapist who specializes in pelvic health.

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Additional sources
Statistic:The Journal of Urology (2021). “Prevalence of Urinary Incontinence among a Nationally Representative Sample of Women, 2005–2016: Findings from the Urologic Diseases in America Project”
Pelvic exercises: Cleveland Clinic (2020). “Kegel Exercises (Pelvic Floor Exercises)”