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Kegel exercise


Other name: Pelvic floor exercise

Description:
Kegel exercise, consists of repeatedly contracting and relaxing the muscles that form part of the pelvic floor, now sometimes colloquially referred to as the “Kegel muscles“. The exercise needs to be performed multiple times each day, for several minutes at a time, for one to three months, to begin to have an effect.

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Exercises are usually done to reduce urinary stress incontinence (especially after childbirth) and reduce premature ejaculatory occurrences in men, as well as to increase the size and intensity of erections.

Several tools exist to help with these exercises, although various studies debate the relative effectiveness of different tools versus traditional exercises.

They were first described in 1948 by Arnold Kegel.

Health effects for women:
Factors such as pregnancy, childbirth, aging, being overweight, and abdominal surgery such as cesarean section, often result in the weakening of the pelvic muscles. This can be assessed by either digital examination of vaginal pressure or using a Kegel perineometer. Kegel exercises are useful in regaining pelvic floor muscle strength in such cases.

Urinary health:
Pelvic floor exercise is the recommended first-line conservative treatment for women with urinary incontinence of the stress, urge, or mixed types.[8] There is tentative evidence that biofeedback may give added benefit when used with pelvic floor muscle training.

Pelvic prolapse:
The symptoms of prolapse and its severity can be decreased with pelvic floor exercises. Effectiveness can be improved with feedback on how to do the exercises.

Sexual function:
In 1952, Dr. Kegel published a report in which he stated that the women doing this exercise were attaining orgasm more easily, more frequently and more intensely: “it has been found that dysfunction of the pubococcygeus exists in many women complaining of lack of vaginal feeling during coitus and that in these cases sexual appreciation can be increased by restoring function of the pubococcygeus”.

Direct benefits of Kegel Exercise for woman:

*Leaks a few drops of urine while sneezing, laughing or coughing (stress incontinence)

*Have a strong, sudden urge to urinate just before losing a large amount of urine (urinary incontinence)

*Leak stool (fecal incontinence)

Kegel exercises can be done during pregnancy or after childbirth to try to prevent urinary incontinence.

One should keep in mind that Kegel exercises are less helpful for women who have severe urine leakage when they sneeze, cough or laugh. Also, Kegel exercises aren’t helpful for women who unexpectedly leak small amounts of urine due to a full bladder (overflow incontinence).

Health effects for men:
Though most commonly used by women, men can also use Kegel exercises. Kegel exercises are employed to strengthen the pubococcygeal muscle and other muscles of the pelvic diaphragm. Kegels can help men achieve stronger erections, maintain healthy hips, and gain greater control over ejaculation. The objective of this may be similar to that of the exercise in women with weakened pelvic floor: to increase bladder and bowel control and sexual function.

*Urinary health:
After a prostatectomy there is no clear evidence that teaching pelvic floor exercises alters the risk of urinary incontinence (leakage of urine).

*Sexual function:
A paper found that pelvic floor exercises could help restore erectile function in men with erectile dysfunction. There are said to be significant benefits for the problem of premature ejaculation from having more muscular control of the pelvis
How to do Kegel exercises

To get started:

*Find the right muscles. To identify your pelvic floor muscles, stop urination in midstream. If you succeed, you’ve got the right muscles. Once you’ve identified your pelvic floor muscles you can do the exercises in any position, although you might find it easiest to do them lying down at first.

*Perfect your technique. Tighten your pelvic floor muscles, hold the contraction for five seconds, and then relax for five seconds. Try it 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.
Maintain your focus. For best results, focus on tightening only your pelvic floor muscles. Be careful not to flex the muscles in your abdomen, thighs or buttocks. Avoid holding your breath. Instead, breathe freely during the exercises.

*Repeat three times a day. Aim for at least three sets of 10 repetitions a day.
Don’t make a habit of using Kegel exercises to start and stop your urine stream. Doing Kegel exercises while emptying your bladder can actually lead to incomplete emptying of the bladder — which increases the risk of a urinary tract infection.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
https://en.wikipedia.org/wiki/Kegel_exercise
http://www.mayoclinic.org/healthy-lifestyle/womens-health/in-depth/kegel-exercises/art-20045283

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Pelvic prolapse

Definition:
Prolapse literally means “to fall out of place”, from the Latin prolabi meaning “to fall out”. In medicine, prolapse is a condition where organs, such as the uterus, fall down or slip out of place.

As the muscles, ligaments and supporting tissues in the pelvis become weaker, they are less able to hold in the organs of the pelvis such as the womb (uterus) or bladder.

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Gravity pulls these organs down and, in the more severe cases, may appear through the entrance to the vagina.

A variety of problems can occur, depending on where the weakness lies and which organs are able to descend, but in every case there is some degree of prolapse of the vaginal wall, which begins to invert (rather like a sock turning inside out).

•Prolapse of the womb or uterus is the most common prolapse, affecting as many as one in eight older women to some degree
•Prolapse of the bladder, known as a cystocele, is less common.
•Prolapse of the urethra (the tube that carries urine out of the bladder) is known as a urethrocele.
•Prolapse of the intestines is quite rare, and known as an enterocele or rectocele.

Some experts say up to 50 per cent of women who have had more than one child will eventually develop a prolapse .

Symptoms:
Symptoms depend on which tissues descend, and how severe the prolapse is.

They may include:
•A sense of heaviness or pressure in the pelvis.
•The appearance of a bulge of tissue in the genital area, which can be quite alarming, and is often red and sore.
•Urinary problems, such as having to urinate more frequently, feeling the need urgently, being incontinent (losing control of the bladder) or, conversely, being unable to pass urine when you need to.
•Pain in the pelvis or lower back.
•Sexual problems, including pain and decreased libido.
•Constipation.
•Vaginal discharge or bleeding.

 

Causes:

Several factors make a prolapse more likely. They include:

•Age: prolapse is rare in young women. As a woman passes the menopause and levels of the female hormone oestrogen decline, the supporting tissues of the pelvis can lose their elasticity and strength very quickly.

•Pregnancy and childbirth: this is one of the most important risk factors for prolapse. Pregnancy stretches and strains the tissues of the abdomen and pelvis. Then during labour and delivery of the baby, the pelvic floor is stretched as the baby passes through. Trauma, tears or lacerations during delivery compound the problem.

•Genetics: research has shown that younger women who develop a prolapse have up to 30 per cent lower levels of collagen (the fibres that form the internal scaffolding of the tissues). This suggests there may be a genetic predisposition, and it certainly seems to run in some families. It is also more common in certain inherited conditions such as Marfan’s syndrome and Ehlers-Danlos syndrome, where there’s abnormal collagen production.

•Muscular defects: uterine prolapse can occur very occasionally in tiny babies who have a weakness of the pelvic muscles or problems with the nerve supply to the area.

•Wide pelvic inlet: this is the round gap in the base of the pelvic bones, through which the baby passes during birth and women with this are more at risk because the tissues bridging the gap have to work even harder to hold the organs above in.

•Chronically increased pressure inside the abdomen: due to obesity or lung disease, for example, helps push the organs down and out.

 

Risk Factors:
Some of the risk factors for pelvic prolapse include, multiple vaginal births, especially large babies, prolonged labor, chronic conditions such as diabetes, COPD (chronic obstructive pulmonary disease), obesity, and finally genetic factors.

 

Treatment:
Pelvic prolapse in women is a very common condition that is sometimes avoided by patients and their caretakers. This is a general terms that describes the weakening of the tissues, and ligaments that give support to the uterus, vagina, bladder, and rectum.

Treatment will depend on the type of pelvic organ prolapse you have. Your doctor may recommend first treating some types without surgery. However, in most people, surgery is eventually necessary.

*Medications. Menopause results in lower estrogen levels, which weakens the muscles of the vagina. Estrogen replacement therapy (ERT) may strengthen these muscles. However, some people shouldn’t use ERT. If you develop symptoms of one type of prolapse, you’re more likely to develop other types.

*Physical therapy. Physical therapy can include electrical stimulation and biofeedback.

*Electrical stimulation. During electrical stimulation, the doctor applies small electrical currents to certain muscles in your vagina or pelvic floor. The current causes your muscles to contract, which strengthens them.

*Biofeedback. As you perform pelvic floor exercises, a sensor monitors muscular contractions to determine if the exercises affect certain muscles.

*Surgery.  Doctors may use robot-assisted surgery to treat some types of pelvic organ prolapse. Robotic surgery allows your surgeon to make smaller incisions and can shorten your hospital stay. There are different strategies for various types of prolapse.

*Rectal prolapse (rectocele). Your surgeon will secure the tissue between your vagina and rectum to keep the organ in its proper position. Your surgeon also removes excess tissue.

*Bladder prolapse (cystocele). Your surgeon will push your bladder up and secure the connective tissue between your bladder and vagina to keep the organ in its proper position and remove excess tissue. If you have urinary incontinence, your doctor will use a bladder neck suspension or sling to support your urethra.

*Uterine prolapse. If you’re postmenopausal or don’t want more children, your surgeon may perform a hysterectomy to correct uterine prolapse.

*Vaginal vault prolapse and herniated small bowel (enterocele). These often occur high in the vagina, so your surgeon may perform the surgery through the vagina or abdomen (for severe vaginal vault prolapse). Your surgeon will attach the vagina to the tailbone at the base of the spine (vaginal vault suspension).

Kegel exercise or pelvic floor exercise:-   This exercise consists of repeatedly contracting and relaxing the muscles that form part of the pelvic floor, now sometimes colloquially referred to as the “Kegel muscles”. The exercise needs to be performed multiple times each day, for several minutes at a time, for one to three months, to begin to have an effect.


Non-surgical pelvic prolapse treatment can be 60 to 70% successful if the prolapse is identified early. These non-invasive pelvic prolapse repair modalities include Kegel exercises, biofeedback, and the use of pessaries.
Prevention:
Women need to be aware of the risks of prolapse and the steps they can take to avoid it, including maintaining a healthy weight, eating plenty of fruit and vegetables to avoid constipation, and learning correct lifting techniques.

There are also specific exercises to keep the pelvic floor muscles strong, sometimes known as Kegel exercises. For example:

•Empty your bladder fully and then, while still sitting on the toilet, practice squeezing your pelvic muscles as if you were trying to stop the flow of urine (don’t do this while actually urinating as it can cause a potentially harmful backflow within the urinary system).

•Practise holding specially designed weighted cones within the vagina.

•Once you have some awareness of the ‘feel’ of the pelvic floor muscles, repeatedly contract them (but not the gluteal or buttock muscles) 50 to 200 times a day for a few seconds at a time.

•Some women find it hard to become aware of, and so exercise, their pelvic floor muscles. There are a number of devices that can help. These are put in the vagina where they either mechanically or electrically trigger the muscles to contract automatically. They are fairly simple to use, very discreet and have been shown to improve continence.

You can get expert advice on pelvic floor exercises from a physiotherapist, who’ll be able to teach you the techniques involved. Your GP may be able to refer you to one, or to a local incontinence clinic where the nurses are also trained on this issue.

It’s also important to aim to minimise trauma to the pelvic tissues during childbirth. Some physiotherapists and also some midwives specialise in teaching women how to strengthen their pelvic floor muscles before giving birth, and retrain them after the stretching of the tissues that occurs during delivery of the baby.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose

 

Resources:

http://www.mayoclinic.org/pelvic-organ-prolapse/treatment.html

http://my.clevelandclinic.org/ob_gyn/womens_health/urogynecology_pelvic_floor_disorders/pelvic_organ_prolapse.aspx

http://www.bbc.co.uk/health/physical_health/conditions/pelvic_prolapse.shtml

http://en.wikipedia.org/wiki/Prolapse

Managing Symptoms of Menopause

The following tips may be beneficial for these common symptoms of menopause:

Hot Flashes:
1.Wear fabrics that breathe, such as cotton. Do not wear silk, polyester and other synthetics that tend to trap body heat.

2.If you feel a hot flash coming on, drink a glass of cold water.

3.If troubled by night sweats, keep a cold facecloth or ice pack by your bed.

4.Instead of pantyhose, wear cotton pants or thigh high stockings.

5.Decrease your intake of caffeine and alcohol.

6.Avoid spicy foods and hot drinks.

7.Avoid tobacco.

8.Try eating and drinking more soy products.

9.Some women claim that taking vitamin E daily helps.
Vaginal Dryness/Urinary Problems
(urinary tract infections, incontinence)

10. Use a vaginal cream or lubricant (avoid petroleum jelly) to help reduce pain from dryness during sexual intercourse.

11.Urinate before and after sexual intercourse to help prevent bladder infections.

12.Drink plenty of fluids and empty your bladder frequently.

13. Try Kegel exercises (tighten and relax the muscles you use to stop urination) daily. They strengthen the vaginal muscles, enhance orgasm, and help prevent incontinence.

Psychological Problems
(anxiety, irritability, depression)

1.Communicate openly with your partner about your symptoms and ask for support.

2.Join or even start a support group specific to menopause or other life changes you are experiencing.

3.Find and share support with colleagues at work who are going through the same thing.
Seek counseling.

4.Medication such as tranquilizers and antidepressants may help.

5.Identify which sources of stress you can eliminate from your life.

Forgetfulness
1.Write things down.

2.Use appointment books, calendars, post-it notes, alarm clocks and timers.

3.Ask other people for reminders.

Weight Gain:
1.Engage in an aerobic or Yoga exercise at least three times per week for at least 30 minutes per session.

2.Find ways to incorporate more exercise into your daily routine, such as taking the stairs instead of the elevator.

3.Decrease your intake of fat and calories.

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Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.

 

Source:www.beliefnet.com

You can exert control your bladder

Incontinence should not be summarily dismissed as an inevitable consequence of ageing. Basic tests should be done to rule out any correctable cause Dr Gita Mathai

The urge to urinate is under voluntary control and can be suppressed until a suitable opportunity appears…...click & see
Coughing, sneezing and laughing are normal, unavoidable day-to-day activities which cause a transient increase in intra abdominal pressure. Young people are unaffected, but in 25 per cent of women and 15 per cent of men above 65 years of age, the actions involuntarily produce embarrassing dribbling of urine or stress incontinence.

The bladder can normally accommodate 500 ml of urine. The urge to void appears when it contains 200 ml. If there is an obstruction to free voiding due to an enlarged prostate, an uterine or ovarian tumour, or even constipation, the bladder becomes overfilled. The urine can then leak from the full bladder in small quantities leading to overflow incontinence.

The urge to urinate is under voluntary control; it can be suppressed until a suitable opportunity appears. Hyperactivity of the muscles in the bladder can allow urine to escape even if the bladder is not overfilled, as soon as the urge is felt, before reaching the toilet. This can occur with increasing age especially if the person also has diabetes, stroke, dementia or Parkinson’s disease. It may be secondary to stones in the bladder or an urinary tract infection.

Incontinence is commoner in women. Statistics show that 50 per cent of women have occasional urinary incontinence and 10 per cent have frequent incontinence. The incidence increases until 20 per cent of women over the age of 75 years experience daily urinary incontinence.

This is because anatomically, women have a shorter urethra and weaker pelvic muscles. Damage can also occur as a result of childbirth. The onset of menopause decreases the levels of the female hormones, causing atrophy of the vaginal mucosa and loss of pelvic muscle tone. This causes the bladder to protrude into the vaginal space increasing incontinence.

Incontinence should not be summarily dismissed as an inevitable consequence of ageing. Basic tests should be done to rule out any correctable cause .

A physical pelvic examination to rule out abnormalities of the pelvic organs.

Blood tests to rule out diabetes.

Urinalysis and culture if infection is suspected.

A few simple lifestyle interventions can help to reduce stress incontinence .

Reduction in weight, such that the BMI (body mass index) is around 25.

Control over volume of fluids drunk and reduction in the quantity if it is more than two-three litres per day.

Prevention of constipation as hard faecal matter acts as an obstruction that aggravates stress incontinence.

Regular voiding, so that the bladder is never too full.

Women can increase the strength and tone of the pelvic muscles and re-train their pelvic musculature with Keegle’s exercises.

To perform these exercises correctly, the right muscles first need to be located. To do this, stop and start urination without using the stomach, leg or buttock muscles.

Squeeze these muscles. Hold for a count of 10. Relax for a count of 10. Do this 20 times, three-four times a day.

Alternatively, each time you go to the toilet to pass urine, stop and restart the process voluntarily several times, so that you exert control over the action.

The bladder can also be re-trained by consciously increasing the time between voiding.

Within four weeks, 70 per cent of women markedly improve and 15 per cent are permanently cured. The benefit disappears within a few days if the exercises are not consciously continued.

Medications can be used as an adjuvant to exercises. Tricyclic antidepressants and other groups of medications can be used to treat stress incontinence in patients with mild-to-moderate symptoms. Fifty per cent of the people respond favourably.

Oestrogen replacement, either taken orally as part of HRT (hormone replacement therapy) or applied locally in the vagina as a cream, improves urinary frequency, urgency, stress incontinence and burning in postmenopausal women.

Surgical treatment can be considered after a thorough evaluation, examination and investigation to determine the exact cause of the urinary incontinence. Surgery can help by correcting the anatomical abnormalities, supporting the bladder and urethra in the proper position, and tightening the urethral sphincter. This helps to achieve voluntary control. Surgery has a 75-95 per cent cure rate if the patients are carefully selected. The procedure involves anaesthesia and hospital stay and is not totally risk free. The eventual outcome is unsatisfactory in people .

With prior surgical failures

If there are other genital or urinary problems

In case of other complicating diseases that may prevent adequate healing or make the technical aspects of the surgery more difficult.

As age advances, the bladder capacity reduces; the urinary stream becomes weaker, and visits to the toilet more frequent. This does not, however, mean that urinary frequency, urgency and stress incontinence have to be accepted as an inevitable part of ageing.

Most incontinence problems, provided they do not require corrective surgery, can be cured by motivation, weight loss, dedicated re-training of the bladder and pelvic exercises.

Source:The Telegraph (Kolkata,India)

Bicycle Seats Can Cause Impotence in Women

THE FACTS For several years, scientists have known that traditional bicycle seats can cause sexual dysfunction in men. Although female cyclists had not been studied directly, it was widely assumed that they, too, could suffer that fate.

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But that may not be the case. For the first time, a study this month looked at avid female cyclists and found that bike seats may affect them differently. Like male riders, many women in the study experienced tingling, pain and decreased genital sensation. But they did not show symptoms of impaired sexual function, possibly reflecting a lower susceptibility to sexual side effects than men.

The study, published in the journal Sexual Medicine, looked at 48 healthy, premenopausal cyclists who biked about three to four days a week for two hours at a time, then compared them with 22 runners.

In men, traditional bike seats compress an artery and nerve that supply the genitals with blood and sensation, increasing the risk of impotence over time. Because the same artery and nerve are crucial to sexual function in women, assumptions about female cyclists are often extrapolated from studies on men.

But Dr. Marsha K. Guess, an assistant professor at Yale medical school and the lead author of the new study, said female cyclists may benefit from anatomical differences that produce less compression. She also stressed the possibility that sexual side effects in female cyclists might be noticeable only in longer-term studies.

THE BOTTOM LINE Bicycle seats can cause decreased genital sensation in avid female cyclists, but the latest study suggests they may not cause sexual dysfunction.

Source:New York Times