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Home / Living Well / Are Kegels really necessary?
In this recurring guest column, Kate White, M.D., of Boston Medical Center, answers your questions on all things gynecology. As the author of the Mayo Clinic Press book Your Sexual Health, she’s ready to dole out wisdom on sex, periods, menopause and more. Submit a question here.
A: Let’s just admit it: Exercise is hard for most of us. It’s tough to find the time, it can be difficult to do the exercises without cheating (which doesn’t help us in the end), and it’s one more thing that tires us out.
So why do doctors universally recommend exercise such as Kegels? In the same way that most of us need more vegetables in our diets, most of us could benefit from strengthening our pelvic floor muscles. These muscles, which support the uterus, bladder, small intestine and rectum, can get weak over time. And weakness in these muscles can lead to leakage of urine.
You can’t change most of your risk factors for a weak pelvic floor, which include aging, pregnancy and childbirth, and surgery. But you may be able to prevent muscle weakness by:
If you have urine leakage when you cough or laugh (stress incontinence) or have to race to get to the bathroom before you leak (urge incontinence), Kegels may be especially helpful. But if you’re experiencing a great deal of urine leakage, your gyno may recommend other measures like a pessary — a silicone device you insert into your vagina to prevent leakage — or surgery instead.
To do Kegel exercises, imagine you’re sitting on a marble and you want to lift the marble up into your body. Another way to think about it: Tense the muscles you use to stop yourself from passing gas. If you’re not sure you’re doing it right, ask your primary care provider or gyno for tips. In some cases, you may be referred to a pelvic floor physical therapist.
If you’ve decided to gut it out and try to introduce Kegels into your lifestyle, here’s what I recommend to my patients:
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Kate White, M.D., OB-GYN
Dr. White, author of Your Guide to Miscarriage & Pregnancy Loss and Your Sexual Health, is an associate professor of obstetrics and gynecology at the Boston University School of Medicine and the vice chair of academics in the OB-GYN department at Boston Medical Center. She is a fellow of the American College of Obstetricians and Gynecologists, a fellow of the Society of Family Planning, and a member of the American Public Health Association. As a board-certified OB-GYN, mother and pregnancy loss survivor, Dr. Kate has been caring for women for more than 20 years, helping them navigate every stage leading up to menopause, including periods, childbirth and pregnancy loss. She also conducts research in contraception, has been continuously grant funded for 15 years, and frequently lectures regionally and nationally on topics related to women’s reproductive health. Dr. Kate lives outside of Boston with her husband and their three children.
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