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CIRCUMVAGINAL MUSCLE EXERCISE INSTRUCTIONS
(KEGEL EXERCISES)

The muscles that surround the vagina, called the circumvaginal muscles (CVM), help support the pelvic organs. Exercises for the CVM were popularized by Dr. Arnold Kegel and are often called Kegel exercises. Most health professionals agree that strengthening the CVM through exercise is beneficial to women. Weakening of the CVM often results in loss of urine when there is an increase in abdominal pressure. This can occur when laughing, coughing, etc.

Begin by emptying your bladder. Adjust your clothing so that you can be comfortable and relaxed. Lie down with your head slightly elevated (at a 20 degree angle), and your knees bent and comfortable. Try to relax completely. To aid in achieving a relaxed state, try repeating this relaxation technique: First, tense your fist into a tight ball and count to five. Then completely relax your fist. Can you feel the difference between the two states? It is important that you are able to do so. Now contract your abdominal muscles tightly for a few seconds; then relax them completely. This is the way your stomach muscles should feel when you do exercises: Relaxed.

Try to think about the area around your vagina. You want to draw the muscles quickly and deliberately together as though you were trying to stop urination or bowel movement. Once you have pulled the muscles together, hold the contraction for 10 seconds. Then relax completely. Let approximately 10 seconds elapse before beginning another CVM contraction.

When you contract or tighten your circumvaginal muscles, you want to keep your abdominal, buttock, and thigh muscles relaxed. This is extremely important and often difficult to do. Should you note a problem with tightening too many muscles, take a deep breath, and focus on relaxing your whole body before proceeding.

Often when you begin to exercise these muscles, you will note that your muscles tire easily, or that you are not able to hold the contraction for the complete 10 seconds. As you continue to exercise, this will happen less frequently. It is very important that if you think that you are no longer tightening or contracting your muscles, you do NOT retighten them to "see" if you are contracting. The goal is to maintain constant effort in an active squeeze in order to gain control and strength in the muscles. Retightening or "flicking", in contrast, will not help build muscle control. In fact, it is more important to maintain a strong, active squeeze for a shorter period of time than to "flick" the muscle for 10 seconds. You may need to work up to a full 10-second squeeze gradually.

Example of a CVM Contraction or "Kegel"
 

To the count of 10 seconds:

  1. Contract deliberately, quickly and hard.
  2. Hold it.
  3. Hold it.
  4. Hold it.
  5. Hold it.
  6. Hold it.
  7. Hold it.
  8. Hold it.
  9. Hold it.
  10. Relax completely for 10 seconds.

Start the program by exercising three times a day, starting with 10 at a time. Each week, add 5 contractions to your regimen until you reach 30 contractions three times a day, so by the fifth week you should be up to 30 contractions, 3 times a day. Try to do the exercises at a set time each day, preferably when you are not too tired.

 

For example:
 

Morning
 


Mid-Day
 


Evening
 
Week 1 10 Kegels 10 Kegels 10 Kegels
Week 2 15 Kegels 15 Kegels 15 Kegels
Week 3 20 Kegels 20 Kegels 20 Kegels
Week 4 25 Kegels 25 Kegels 25 Kegels
Week 5 30 Kegels 30 Kegels 30 Kegels

As you become more proficient and more comfortable with the Kegel exercise, you do not need to do them only in a lying or sitting position, nor do you need to limit them to only three sessions per day. Do them whenever you think of it - driving, standing in lines, at the kitchen sink, in the shower -- just be sure you get in your 90 Kegels per day.

Kegel Exercises for Bladder Control


What are Kegel exercises?
 

Kegel exercises are exercises that strengthen your pelvic floor muscles. These are the set of muscles and ligaments that support your bladder and help close your urethra, the tube that drains your bladder. Kegel exercises are named for the doctor who developed them in the 1940s.

Why are they used?
 

Strengthening your pelvic floor muscles will lessen and possibly prevent stress incontinence (leakage of urine when you cough, laugh, sneeze, or strain).

What causes stress incontinence?
 

Your pelvic floor muscles can become stretched and slack as a result of childbirth, aging, lack of hormones, or a hereditary weakness. The sagging muscles change the relationship between your bladder and urethra, which allows urine to leak.

If you have gone through menopause and have low levels of the female hormone estrogen, you may develop stress incontinence because of decreased tone in the urethra and surrounding tissue.

Also, stress incontinence can be caused by problems such as diabetese mellitus, extreme obesity, and chronic and recurrent urinary tract infections.

How do you do SUPER Kegel exercises?
 

  • First, practice starting and stopping your urine stream while urinating so that it is clear which muscles you will use for these exercises.
  • When you are not urinating, tighten your pelvic floor muscles as if to stop yourself from urinating. Isolate just the pelvic floor muscles. Hold these muscles as tight as possible. Be sure to breathe. Sustain this contraction for 10-20 seconds. If you feel the contraction fading away, even without deliberately letting go, consciously bring it back.
  • Super Kegels are more effective if done one at a time. Repeat 10 times a day.

Performing fewer repetitions than this will lower the effectiveness of the exercises. You may have to do the exercises faithfully for 2 to 3 months before you notice any improvement. You can do Kegel exercises anywhere: while sitting at a desk, waiting for a bus, washing dishes, driving a car, waiting in line, or watching television. No one will know you are doing them.

Are there any other benefits of Kegel exercises?
 

An added benefit of Kegel exercises is that they also improve vaginal muscle tone and sensation, making you more sexually responsive.





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