Harvard Women's Health Watch

In Brief: Kegels hold up as urinary continence treatment

In Brief

Kegels hold up as urinary continence treatment

A review of studies confirms that women with urinary incontinence can benefit from pelvic floor muscle training, better known as Kegel exercises. The review appeared in The Cochrane Library (2006, issue 1), published by The Cochrane Collaboration, an international organization that evaluates medical research. The authors examined randomized trials comparing pelvic floor exercises with no treatment, a placebo, a sham treatment, or some other type of control treatment. Women who did the exercises were more likely to report being cured or improved compared with the women who did not. The Cochrane review also suggests that receiving training in how to identify and exercise the right muscles boosts the effectiveness of a Kegel regimen.

Urinary incontinence — the involuntary loss of urine — is a problem for as many as 30% of women in the United States. The most common type is stress incontinence, which can occur with coughing, sneezing, laughing, and physical activities such as jumping. Another form, urge incontinence, is the inability to hold back urine after feeling the urge to urinate. Some women have both types. Kegel exercises (named for Arnold Kegel, the physician who first described them) are usually recommended for stress incontinence but only sometimes for urge and mixed incontinence. The Cochrane review found that they helped with all three types of incontinence. Trials of women with stress urinary incontinence suggested greater benefit for those in their 40s and 50s who were in a supervised program lasting at least three months. But further study is needed to explore these factors.

Pelvic floor muscles run from the pubic bone to the tailbone, with openings for the urethra, vagina, and anus. They're the muscles you use to hold back urination and thus are important in maintaining continence. They may weaken due to age and, possibly, the loss of estrogen at menopause. Many experts believe that damage during vaginal childbirth also places a woman at risk for urinary incontinence. But not all studies support this idea. For example, in a study of pairs of postmenopausal sisters — in each pair, one sister had given birth vaginally and the other had never given birth — researchers found no difference in the incidence, type, or severity of incontinence (Obstetrics and Gynecology, December 2005).

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