Kegels-on-Demand: Use Them As Needed

Andrew Siegel MD   3/24/2018

The concept of pelvic floor muscle training is not just to develop a strong and flexible pelvic floor, but also to put that capacity into practical use.  By knowing how to use your pelvic floor in real-life situations, you can improve your quality of life and many pelvic floor-related issues that may have surfaced over the years. This is the  essence of “functional fitness.”   Although this entry is primarily geared towards females, Kegels-on-demand on equally useful for men who have overactive bladder, stress incontinence, tension myalgia and premature ejaculation.



Putting Your Pelvic Floor Muscle Training Into Action: Kegels-on-demand

Functional pelvic fitness is the practical and actionable means of applying pelvic floor muscle (PFM) proficiency to common everyday activities to improve pelvic function. This encompasses the knowledge of how to contract and relax PFM muscles through their full range of motion in the real world (as opposed to isolated, out-of-context contractions), when to do so, how often do so and why to do so.  For many women, this is the essence of PFMT–having stronger and more durable PFM to improve their quality of life.  These purposeful and consciously applied PFM contractions are not intended as exercise or training—although they will secondarily serve that purpose—but as management of the various pelvic floor dysfunctions at the times and moments that the problems become apparent.  When practiced diligently, these targeted PFM contractions can ultimately become automatic and reflex behaviors.

“Gotta” Go: Urgency Management

When you feel the sudden and urgent desire to urinate or move your bowels, snap your PFM several times, briefly but intensively. When your PFM are so engaged, the bladder muscle reflexively relaxes and the feeling of intense urgency should disappear. Understand that this is most effective when the bladder or bowels are not full, but are contracting involuntarily.

Staying Dry

For urgency incontinence, prior to exposure to the specific provoking trigger—hand washing, key in the door, running water, entering the shower, cold or rainy weather, etc.—snap your PFM rapidly several times to preempt the involuntary bladder contraction before it occurs (or diminish or abort the bladder contraction after it begins).

With respect to stress urinary incontinence (SUI), by actively contracting the PFM immediately before exposure to the activity that prompts the SUI, the incontinence can be improved or prevented. For example, if changing position from sitting to standing results in SUI, do a brisk short duration PFM contraction prior to and when transitioning from sitting to standing to brace the PFM and pinch the urethra shut.

Keeping Your Insides In

If you have pelvic organ prolapse (POP) and have defined activities that cause the prolapsed pelvic organ to drop or protrude—often standing, bending or straining—engage the PFM prior to or during these triggers. If you need to manually reduce the POP (by pushing the prolapse in with your fingers), after doing so, consciously engage the PFM to maintain the prolapsed pelvic organ in its proper anatomical position.

Better Sex for You and Your Partner

Integrate your newfound PFM powers in the bedroom and intensify your sensation as well as his by tightening your vaginal “grip” around his penis during sexual intercourse.  Alternatively, you can pulse your PFM rhythmically while pelvic thrusting or pulse your PFM without pelvic thrusting, the snapping providing penile stimulation in the absence of active thrusting.

As you develop increasing PFM proficiency, you may be able to selectively contract individual PFM in isolation, simultaneously, or in such a sequence that can result in a titillating experience for both you and your partner. You may be able to develop as much fine motor control of your vagina as you have of your fingers and hands! At the time of sexual climax, focus on the involuntary rhythmic contractions of your PFM and try to heighten the experience by explosively contracting them.

Try This: “Pompoir” is a technique in which a woman contracts her PFM rhythmically to stimulate the penis without the need for pelvic motion or thrusting. Women who diligently practice Kegel training can develop powerful PFM and become particularly adept at this, resulting in extreme vaginal “dexterity” and the ability to refine pulling, pushing, locking, gripping, pulsing, squeezing and twisting motions, which can provide enough stimulation to bring a male to climax. 

Relaxing the High-strung Pelvic Floor

If you suffer with tension myalgia of the PFM, focus on consciously unclenching the PFM over the course of your day. Be particularly aware of the natural PFM relaxation that occurs when urinating or moving your bowels and strive to replicate that feeling of PFM release.

 Limber hip rotators,

A powerful cardio-core,

But forget not

The oft-neglected pelvic floor.


Wishing you the best of health!

2014-04-23 20:16:29

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Dr. Andrew Siegel is a physician and urological surgeon who is board-certified in urology as well as in female pelvic medicine and reconstructive surgery.  He is an Assistant Clinical Professor of Surgery at the Rutgers-New Jersey Medical School and is a Castle Connolly Top Doctor New York Metro Area, Inside Jersey Top Doctor and Inside Jersey Top Doctor for Women’s Health. His mission is to “bridge the gap” between the public and the medical community.

Dr. Siegel has authored the following books that are available on Amazon, iBooks, Nook and Kobo:

 MALE PELVIC FITNESS: Optimizing Sexual & Urinary Health

THE KEGEL FIX: Recharging Female Pelvic, Sexual and Urinary Health 

PROMISCUOUS EATING: Understanding and Ending Our Self-Destructive Relationship with Food


These books are written for educated and discerning men and women who care about health, well-being, fitness and nutrition and enjoy feeling confident and strong.

Dr. Siegel is co-creator of the male pelvic floor exercise instructional DVD (female version is in the works): PelvicRx




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