In the Press
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July 15, 2014
Kegel exercises have long been considered women's work.
Because they tone the pelvic floor muscles that support the uterus, doctors encourage women to do them during pregnancy and continue them for life. Done for a few minutes a day, Kegels can ease childbirth, help with recovery, prevent incontinence - even improve your sex life.
But Kegels are not just for women anymore. Pelvic floor exercises can help treat incontinence and perhaps sexual dysfunction in men, too, studies have found. Now the rush is on to persuade middle-aged men to get on the bandwagon.
"People do cardio exercises for their heart, and they do strength training and work on their six-pack, but the pelvic floor is neglected," said Dr. Andrew Siegel, a urologist and author of a paper in the July issue of Urology that reviews the benefits of Kegels for men. "These muscles are the backboard of sexual and urinary health."
Siegel is a co-founder of Private Gym, a company marketing a new pelvic-floor exercise system for men that includes an instructional DVD as well as a rather unusual device: small, ultralight weights on a silicone band that fits around the penis, intended for men who want to add a bit of resistance training to their routines.
Men have the same network of pelvic floor muscles that women do, extending like a hammock from the tailbone to the pubic bone. The muscles support the back, abdomen, bladder and bowel, and help maintain fecal and urinary continence. In men, these muscles surround the base of the penis; they are activated during erection, orgasm and ejaculation, and are responsible for the surge of blood flow to the penis.
Like all muscles, these weaken with age, doctors say. In order to strengthen them, men are told to tighten the muscles they might normally use to cut off the flow of urine midstream or prevent passing gas in a closed space. The contractions are held for a few seconds, then released, with the motion repeated 10 to 15 times for each workout.
While some proponents believe Kegels can enhance erections and orgasms, there's little evidence to support the claim. But clinical trials have found they can be helpful for men with one of the most common sexual disorders, premature ejaculation. And some trials suggest Kegels may help restore potency in men with erectile dysfunction.
"It's as good as Viagra, without the costs and the side effects," said Grace Dorey, a professor emerita of physiotherapy and urology at the University of the West of England and an enthusiastic proponent of Kegels for men. "The pelvic floor muscles provide the base for the erection - for the penis to sit on, if you will."
One of the main selling points of Private Gym is that healthy men can enhance their sexual function through a Kegel exercise regimen that includes those tiny weights. A small clinical trial is under way, but so far there's no proof and some experts are skeptical.
"I'd be very cautious about claims of enhancing sexual function and orgasm," said Dr. Roger Dmochowski, a professor of urologic surgery at Vanderbilt University Medical Center who specializes in incontinence. "There are other important factors that affect sexual function, like obesity and diet, over-consumption of alcohol, and smoking, which impacts blood flow and can have a negative impact."
For most men, he said, lifestyle changes are the surest route to better sex. Yet there is strong evidence that pelvic floor exercises are important for men who undergo a radical prostatectomy and are at high risk for incontinence.
Studies showing that Kegels can hasten recovery from prostate surgery have been so convincing that surgeons now routinely recommend patients start Kegels before or shortly after the surgery. In one clinical trial of men about to undergo prostate surgery, patients were randomly assigned to start doing Kegels before the operation or to get standard care without exercises.
The difference in outcomes was startling, said Dr. Patricia Goode, medical director of the incontinence clinic at the University of Alabama at Birmingham and one of the authors of the study, published in 2006.
"We were measuring the median time until the men were totally continent after the surgery, and in the trained group it was 3 1/2 months," she said. In the untrained group, half the men were not dry by six months, she added.
The American Urological Association also recommends Kegels, along with other behavioral modifications, for both men and women who have overactive bladders. Men with severe back pain should avoid Kegels, however, and anyone who has undergone surgery should consult their doctor. While many women have long experience with Kegel exercises, doctors find many men initially are baffled by them. Some have trouble simply locating the appropriate muscles.
Dorey has this simple advice: "It's the area you sit on when you're sitting on a horse."