Pelvic floor dysfunction is an umbrella term for a multitude of conditions related to the pelvic floor musculature. Both treatment and prevention will depend on the functional changes of the pelvic floor muscles and your current risk factors. The functional changes are separated into three main categories: hypertonic or non-relaxing, hypotonic, and problems with coordination.

When not to do Kegel Exercises

If the muscles are hypertonic, that means they have trouble relaxing. This may cause constipation, incontinence, difficulty with urination, pain, and other symptoms. For people suffering from hypertonic pelvic floor dysfunction, it’s recommended not to do Kegel exercises. Since the problem lies with an inability to relax the muscles, repeated contractions might make the problem worse.

“For people suffering from hypertonic pelvic floor dysfunction, it is strongly recommended not to do Kegel exercises.”

Some risk factors for hypertonic pelvic floor dysfunctions include urogynecolgical surgery, a history of depression, a musculoskeletal spine injury, a transobturator mid-urethral sling, and menopause. If you’re experiencing some of the symptoms listed above or have any of the mentioned risk factors, talk to your doctor about possible treatment options and prevention techniques. Pelvic floor muscle therapy will most likely be recommended but will focus more on relaxing the muscles.

When to do Kegel Exercises

On the other hand, if your muscles are hypotonic, or weakened, you may have trouble with fecal or urinary incontinence and prolapse. This is where Kegel exercises can be especially helpful. There are many reasons why this happens, but the most common cause of hypotonic pelvic floor dysfunctions is vaginal childbirth. So if you’re pregnant, planning a pregnancy, or have already delivered then prevention is the best medicine.

According to studies, women who practice pelvic floor exercises before and during their pregnancy have a significant reduction in symptoms of urinary incontinence both during and after pregnancy. There’s strong evidence that the effect is long-lasting. Even if you’ve already delivered a child, doing pelvic floor exercises postnatally may improve quality of life, reduce urogenital distress and urinary symptoms after delivery.

“According to studies, women who practice pelvic floor exercises before and during their pregnancy have a significant reduction in symptoms of urinary incontinence both during and after pregnancy.”

When pelvic floor exercises are started early, there could also be a reduction in prolapse symptoms; though this is difficult to measure because of increased heavy-lifting and a return to a pre-pregnancy lifestyle after the child is born. So, though Kegel exercises can be important, it helps to add other preventative methods, which include proper lifting techniques.

“So, though Kegel exercises can be important, it helps to add other preventative methods, which include proper lifting techniques.”

In order for Kegel exercises to be effective, they have to be done properly. A doctor or pelvic floor physical therapist can assist you in finding the correct muscles to contract.

Though there’s no consensus about the ideal amount of exercise to do per day, it’s usually good to start slow and increase the number of repetitions as your muscles get stronger. With regular exercise, it can take a few weeks to a few months to notice results. But just like any muscle of your body, the pelvic floor can fatigue quickly so don’t over do it!

The end goal is to reduce the chance of developing urinary incontinence and keep those pelvic floor muscles strong against the force of gravity as you get older. Kegel exercises are easy and convenient to do and are generally recommended as a routine part of exercise programs.

On the same topic:

• What are the main pelvic floor dysfunctions and how to treat them
• 5 common mistakes when doing Kegels
• Kegel 101: How do you do Kegel exercises?
• Maintaining your pelvic health with good habits
• The 5 Best Kegel Exercises

Discover the magic behind a healthy pelvic floor:

• Enhance your intimate wellbeing and reconnect with your partner
• Pelvic floor and your sex life
• Treat an overactive bladder
• Stop stress incontinence
• Pelvic Floor Exercises for Postpartum Recovery
• Prevent and Reduce Prolapse without Surgery

References :

• Romeikienė, Karolina Eva, and Daiva Bartkevičienė. “Pelvic-Floor Dysfunction Prevention in Prepartum and Postpartum Periods.” Medicina (Kaunas, Lithuania) vol. 57,4 387. 16 Apr. 2021, doi:10.3390/medicina57040387. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8073097/
• Faubion, Stephanie S et al. “Recognition and management of nonrelaxing pelvic floor dysfunction.” Mayo Clinic proceedings vol. 87,2 (2012): 187-93. doi:10.1016/j.mayocp.2011.09.004. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3498251/
• Marques, Andrea et al. “The status of pelvic floor muscle training for women.” Canadian Urological Association journal = Journal de l'Association des urologues du Canada vol. 4,6 (2010): 419-24. doi:10.5489/cuaj.10026. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2997838/
• Cameron B, Sabourin J, Sanaee MS, Koenig NA, Lee T, Geoffrion R. Pelvic floor hypertonicity in women with pelvic floor disorders: A case control and risk prediction study. Neurourol Urodyn. 2019 Feb;38(2):696-702. doi: 10.1002/nau.23896. Epub 2018 Dec 21. PMID: 30576003. https://pubmed.ncbi.nlm.nih.gov/30576003/