Pregnancy, childbirth, excess weight, chronic coughing and just getting older can all take a toll on your pelvic floor muscles. So can a genetic predisposition to weak connective tissue. When your pelvic floor muscles weaken, your pelvic organs descend and bulge into your vagina, a condition known as uterine or vaginal prolapse. The effects of pelvic organ prolapse range from uncomfortable pelvic pressure to leakage of urine or feces. Fortunately, Kegel exercises can strengthen pelvic muscles and delay or maybe even prevent pelvic organ prolapse. Kegel exercises are also recommended during pregnancy. Well-toned pelvic floor muscles may make you more comfortable as your due date approaches. You may be less likely to develop urine leakage and hemorrhoids - both common near the end of pregnancy and prone to persist long after you've given birth. Finally, Kegel exercises - along with counseling and sex therapy - may be helpful to women who have persistent problems reaching orgasm.

How to do Kegel exercises

It may take diligence to identify your pelvic floor muscles and learn how to contract and relax them. Here are some pointers: Find the right muscles
To make sure you know how to contract your pelvic floor muscles, try to stop the flow of urine while you're going to the bathroom. If you succeed, you've got the basic move. Or try another technique: Insert a finger inside your vagina and try to squeeze the surrounding muscles. You should be able to feel your vagina tighten and your pelvic floor move upward. Then relax your muscles and feel your pelvic floor move down to the starting position. As your muscles become stronger - and you become more experienced with the exercises - this movement will be more pronounced. A cautionary note: Don't make a habit of starting and stopping your urine stream. Doing Kegel exercises with a full bladder or while emptying your bladder can actually weaken the muscles. It can also lead to incomplete emptying of the bladder, which increases your risk of a urinary tract infection. If you're having trouble finding the right muscles, don't be embarrassed to ask your doctor for help. He or she can provide important feedback so that you learn to isolate and exercise the correct muscles. Perfect your technique
Once you've identified your pelvic floor muscles, empty your bladder and get into a sitting or standing position. Then firmly tense your pelvic floor muscles. Try it at frequent intervals for five seconds at a time, four or five times in a row. Work up to keeping the muscles contracted for 10 seconds at a time, relaxing for 10 seconds between contractions. Be careful not to flex the muscles in your abdomen, thighs or buttocks. To get the maximum benefit, focus on tightening only your pelvic floor muscles. Also, try not to hold your breath. Just relax, breathe freely and focus on tightening the muscles around your vagina and rectum. Repeat three times a day
Perform a set of 10 Kegel exercises at least three times a day. The exercises will get easier the more often you do them. You might make a practice of fitting in a set every time you do a routine task, such as checking e-mail or commuting to work. You can also vary your technique. Try doing sets of mini-Kegels. Count quickly to 10 or 20, contracting and relaxing your pelvic floor muscles each time you say a number. Or slow it down, gradually contracting and releasing your pelvic floor muscles one time. As you contract, visualize an elevator traveling up four floors. At each floor, contract your muscles a little more until you reach maximum contraction at the fourth floor. Hold the contraction and then slowly release the tension as you visualize the elevator traveling back down. Repeat 10 times. Some doctors recommend exercising the pelvic floor muscles with weighted vaginal cones about the size of tampons. By contracting your pelvic floor muscles, you hold the weight in place in your vagina. Start with a light weight and gradually work up to a heavier one.

Biofeedback may help

If you have trouble doing Kegel exercises, biofeedback training may help. In a biofeedback session, a nurse, therapist or technician will either insert a monitoring probe into your vagina or place adhesive electrodes on the skin outside your vagina or rectal area. When you contract your pelvic floor muscles, you'll see a measurement on a monitor that lets you know whether you've successfully contracted the right muscles. You'll also be able to see how long you hold the contraction. Another technique uses electrical stimulation to help you feel the muscles contract. The procedure is painless, although you'll experience a buzzing feeling as a small electrical current is applied to your pelvic floor muscles, making them contract. Once you feel this sensation a few times, you'll probably be able to duplicate the exercise on your own. Because simpler methods work for most women, this technique is rarely used.

When to expect results

If you do your Kegel exercises faithfully, you can expect to see some results, such as less frequent urine leakage, within about eight to 12 weeks. Your improvement may be dramatic - or, at the very least, you may keep your problems from worsening. As with other forms of physical activity, you need to make Kegel exercises a lifelong practice to get lifelong benefits.