- You should have been instructed in the office how to contract these muscles at home; you can insert two fingers into the vagina and feel the contraction of these muscles. We call these muscles the "Pelvic Floor" because they help support the pelvic organs, especially during coughing or sneezing. Squeezing the pelvic floor while standing feels like you are "lifting" the area around the vagina, and will interrupt the stream of urine while voiding. Once you are certain which muscles to use, you will exercise the pelvic floor without interrupting the urine stream or having to insert two fingers into the vagina. Make sure you are not bearing down, squeezing your buttocks, or straining abdominally -- these are not the muscles to be exercised. You may wish to place your hands on your buttock muscles to keep these muscles relaxed while performing the exercises.
- Squeeze these muscles as hard as you can for a slow count of five, eventually working up to a slow count of ten. Rest for 15 seconds, and then start another contraction. At first, these muscles may feel sore, just as other muscles feel sore after exercise.
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- You should perform 50 squeezes every day: make every squeeze count by contracting as hard as you can! Many women try to do these exercises in sets of five or ten at a time. Remind yourself to do these exercises by starting them every time you are waiting at a red light, watching a television commercial, or "on hold" on the telephone. If you are having trouble concentrating, you may want to set aside a special time to perform sets of pelvic floor exercises.
- In addition to the long, hard contraction you are doing, try doing some "quick flicks" of these muscles throughout the day.
- You should be seen in the clinic soon after starting theses exercises to make sure you are performing the contraction correctly. You may have never known how to contract these muscles before stating pelvic floor exercises, and many patients mistakenly exercise the wrong muscles. If you still feel frustrated about which muscles to use, ask your doctor for help. There are several aids available to help you to correctly exercise the pelvic floor muscles.
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- Work hard! As with any exercise program, improvement often is related to how faithfully you adhere to your exercise program. Pelvic floor exercises do not have the side effects and expense associated with other treatment for urinary incontinence, and have been shown to help even with severe stress incontinence. It may take several months to see the full effect of your exercise program; if you are easily discouraged, see your doctor or nurse at regularly visits to assess what progress you are making.
- For increasing resistance, vaginal weights are available.
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