Kegel exercises: do them to improve your sexual relations

With the passage of time, both women and men lose strength and muscle tone in the pelvic floor, which can lead to long -term problems such as urinary or fecal incontinence.And it is that the pelvic floor "is in charge of supporting the weight of the viscera and avoiding the losses of urine and feces", so "it is important that these muscles have the strength and tone necessary to perform their functions," they point outThe authors of the document key points in the Kegel exercises, of the Andalusian of primary care doctors.

The easiest way to strengthen this area is with the realization of the famous Kegel exercises.These, as Rocío Luque reports, Bluau's physiotherapist in Sanitas, “they were created by Arnold Kegel in the 40s - hence their name - to work the pelvic floor muscles and are based on voluntary and isolated contraction of the soil muscles of the soilpelvic and his subsequent relaxation. ”

The benefits of this practice are many and very diverse.As Luque points out, Kegel's exercises help us:

In addition, as Juan Antonio Barca, president of the Uroginecological and Obstetrics Physiotherapy Commission of the Professional College of Physiotherapists of the Community of Madrid (CPFCM), “can improve the defative function”.

But that is not all.Did you know that having a toned pelvic floor can help sexual intercourse?And, maintaining the pelvic soil "in shape", helps to have more pleasant sex and increase the intensity of orgasms."From a sexual point of view, for both sexes, performing these exercises helps improve orgasm and greater erection maintenance since it improves the state of all perineal musculature which favors excitement," says Barca."Control and work the pelvic floor helps sexual relations be better, enhancing erection in man, delaying ejaculation and improving lubrication and sensitivity in women," says Luque.

According to Landaluza experts of family and community medicine (Samfyc), "in men, these exercises improve sexual function and can prevent and treat early ejaculation."In women, on the other hand, "they help improve the toning of vaginal muscles and improve friction during penetration, which facilitates to reach orgasm, also increasing the sensitivity of the area."

A healthy pelvic floor promotes a gratifying sex life, but also vice versa.That is, to maintain sexual relations alone already has a positive effect on the pelvic floor and therefore many specialists advise having an active sex life to have this "healthy" area.And, excitement and orgasm increase blood irrigation tone the muscles and tissues.In addition, the involuntary and rhythmic contractions of the muscles that are experienced during orgasm exercise them, contributing to the decrease in the vaginal opening that could be found dilated by causes such as hypotonia or a traumatic birth.

Likewise, orgasmic contractions also strengthen involuntary muscles, which represent 80% of pelvic soil tissues.On the other hand, penetration and orgasm avoid vaginal atrophy both in menopause and after a hysterectomy (removal of the uterus) due to the stimulating massage of the penis (or a sexual toy) on the pelvic floor.

Only if they do well

Keep in mind that, in the specific case of women, "doing exercises incorrectly or with too much force can lead to vaginal muscles to tension too much and cause pain during sexual intercourse," according to Samfyc experts.

Therefore it is important to know how to do them well and, as Barca points out, with an expert who pave the exercises based on each case to "define how to do them" since, in his opinion, "Kegel should not be prescribed for all, we must assessindividually".And, "not all exercises are for everyone, nor all people know how to do them correctly."Something that is especially important especially in patients who have had or have incontinence or related problems related to the pelvic soil zone and in pregnant women.

Barca is against "coffee for all" in this type of solutions and that brochures are distributed indiscriminately to pregnant women in health centers with general information about what needs to be done to strengthen the pelvic floor, without knowing howEach concrete patient is found.

In his opinion “you have to clearly explain how to do the exercises.After delivery there is a high incidence of problems in the pelvic floor.There are women who lose proprioception, so if the exercises are not monitored, it is possible that the patient has an investment in the perineal order, which makes the correct realization of the exercises difficult, not knowing how to distinguish between pushing or contracting, what he doesthat worsen the clinical picture ”.Therefore, there are more and more personalized treatments for each patient.Do not forget that the success of these exercises in all the fields exposed will depend on the appropriate practice of the technique and a disciplinary compliance with the exercise program.

First step: find the pelvic musculature

Although it may seem easy to find this area and know how it contracts and relaxes, the reality is that not everyone knows how to do it.According to Samfyc data "more than 40% of patients do not easily located pelvic muscles."There are people who take longer to learn to locate it than others, as Barca indicates.“Some patients have a hard time doing well even with the help of specialists.Little by little they get it, but if not, ”sometimes physiotherapists use“ electrotherapies to contract the muscle through stimuli.This is used when the person has no contraction capacity. ”

Apart from these specific patients, to know if a woman does it well, boat has a trick: “introduce the finger yolk in the vagina to see if the contraction is done correctly and with the force up and not downward”

Luque resorts to other formulas: “We can place the palm of one hand in the perineum, in order to feel the contraction and relaxation in it, in addition, if we close our eyes when making them we will increase our concentration.We can also help us with a mirror in which we can perfectly see how our perineal holes close and how the perineum "hides" when contracting. "

Throughout the process it is important not to make "parasitic contractions, that is, contractions from other parts that are not the pelvic floor such as buttocks or legs," says Barca.And, as Luque points out, among the errors that occur most is that of “contracting adjacent musculature (buttocks, abdomen or adductors).In some cases we also found that the patient pushes the muscles out when making the contraction generating hyperpression. ”

How to do them

Kegel exercises consist of strengthening pelvic soil through voluntary contractions made on a regular and appropriate manner."We have to voluntarily and voluntarily contract the pelvic floor musculature and then relax it," says Luque who to their women's patients recommend "to make the gesture of wanting to" hide "that pelvic floor muscles, as if they wanted to suck it inwards”

In the case of men, the physiotherapist in their consultations indicates that "they imitate the gesture of interrupting urine, retaining a gas or making the gesture of raising the penis."It is important to highlight the word imitate, since in no case patients should cut the PIS stream to perform the exercises.Kegel exercises do not consist of cutting the urine jet repeatedly."This is important because, making this gesture can generate retrograde urination and urinary tract infections."

When the technique has been learned, the exercises will focus on “making contractions with different rhythms and durations, to work the different types of muscle fibers existing in the musculature,” says Luque.

As for the best posture to do them (standing, sitting, lying ...), Luque advises "start in lying position, whether face up or side, and with your legs flexed so that there is no tension in the lumbar area".

They would also be good positions to start “in quadruped or squatting, supporting our arms and chest on some support (bed, sofa, fitball)”, although Barca remembers that it is best to stand them when you already have control of the contraction "Because gravity does its effect and is the posture in which we spend most of the time.Doing the standing exercises provides a greater effort in the area when making the contraction of the pelvic soil so it will be more effective, although it will depend on each patient. ”

Another advice of Luque is to do the exercises "at a time when we are relaxed and concentrated exclusively in this work."

Regarding the use of Chinese balls to exercise the area instead of the exercises, Samfyc experts remember that “introducing devices in the vagina conical with different weights and making contractions of the pelvic musculature to prevent them from leaving can help", Although they indicate that" it has not been shown that they have better results than the realization of Kegel's exercises. "These tools can be "an option for women who consider it appropriate."

Daily routine

As for the routine that can be done to achieve good results, Luque explains that “it is not the same to perform them by prevention than when there is an established pathology.Each person is a world, and it is very important to make a previous assessment by a professional before being able to make a specific recommendation. ”

From Samfyc they remember that "there is no established protocol on the duration of contractions, rest time or the number of repetitions or series suitable for everyone."In general, "it could be effective to make 3 series of 8-12 contractions held for 6-8 seconds."

Other exercises options recommended by experts are “slowly contracting the muscles inside as strong as possible, enduring tension for 5 seconds and relaxing at 10 seconds and repeating this sequence 10 times tomorrow, late and night.The same can be done quickly contracting and relaxing without waiting.Progressively increase to 15 contractions (some slow and other fast) three times a day, then to 20 contractions three times a day, to continue with 20 contractions four times per day plus 20 extra when possible. ”

In addition to the pelvic floor, Luque believes that it is important to "integrate those Kegel exercises into the abdominal-perineal complex."To do this, "other areas of the body, such as Core, buttocks, lumbar musculature and diaphragm."Depending on the state we start from and the objective that we have "we can complement them with a hypopressive work, perineal massage, respiratory exercises, myofascial release or work with electrotherapy."