Medical Officer, Psychiatrist, Sexual & Relationship Therapist at Allo Health
Answered 5 months ago
Kegels are often shown on TikTok as a quick fix for stronger orgasms or better sex. But the reality is a bit different. Kegels exercises are done to strengthen the pelvic floor muscles. These muscles give support to the bladder, bowels, and sexual organs in all genders. When these muscles become weak, people may experience leaking urine, reduced sexual sensation, erection problems, or pelvic heaviness. Kegels are really helpful in these conditions as they help in improving blood flow, muscle tone, and control. But Tik Tok does not tell who is a right candidate for Kegels. Kegels are not for everyone, some people who already have tight or overactive pelvic floor muscles may not need these exercises. This is why following a trend can place you in risk sometimes. One of the things which can help is to always consult a doctor or a healthcare professional for knowing whether your muscles require strengthening or relaxation. Another thing which can help is the correct technique. Kegels shouldn't feel like you're tightening your stomach or squeezing your buttocks. Instead, it should feel like gently lifting the muscles you'd use to stop urine mid-flow, then slowly relaxing them. Short, controlled reps are usually better than constant clenching. Kegels can be helpful, but they're not an ultimate solution for everyone. It is all about knowing your body and getting the right advice in case of need.
I'm a children's mental health expert who's spent 30 years working with dysregulation, and here's what nobody's saying about the Kegel trend: the squeeze-and-hold approach everyone's copying can actually make tension worse if your nervous system is already in a stressed state. I see this constantly with anxious kids who clench everything--jaw, fists, pelvic floor--because their body is stuck in fight-or-flight mode. In my clinical work mapping over 10,000 brains, I've learned that when someone's nervous system is dysregulated, adding more "activation" exercises backfires completely. It's like telling an already-anxious person to just focus harder--you're asking a system that's already overworking to do more work. The pelvic floor responds to your nervous system state, so if you're chronically stressed, those muscles are likely already too tight. The self-check I give parents applies here too: if you're doing something daily that creates more tension or discomfort rather than relief within two weeks, your body is telling you to stop. I had a mom in my practice doing Kegels religiously for postpartum issues, but she was so dysregulated from sleep deprivation that she was just creating more pelvic tension--once we calmed her nervous system first with PEMF therapy and breathing work, her pelvic floor symptoms actually improved without the exercises. Before you squeeze along with TikTok, ask yourself if your body feels generally tense or relaxed throughout the day. If you're clenching your jaw, holding your shoulders up, or feeling constantly "on edge," adding pelvic floor activation is probably the opposite of what you need--you need nervous system regulation first, then maybe strengthening later.
The most misunderstood trends are Kegels and TikTok wellness. While they can be beneficial, they are misunderstood and not a fix for all issues. Kegels are meant to strengthen the pelvic floor, the muscles surrounding the bladder, bowel, and reproductive organs, but only if those muscles are actually weak. The pelvic floor is often already too tense or overactive, and more contractions can make the confusion and issues worse. Kegels can improve bladder control, support postpartum recovery and core stability for all genders, and sexual function when done correctly. They can also be a benefit to those with mild pelvic floor weakness from aging, injury, or a sedentary lifestyle. However, if the pelvic floor is too tight, Kegels can lead to more pain with sex, more urinary urgency, constipation, and lower back pain. TikTok is not sharing that nuance. The biggest myth is that Kegels are for everyone. Some people actually need to do relaxation exercises or breathwork. Some physical therapy is also a good option instead of more muscles. It's also a more common misconception that Kegels are a hard squeeze. The engagement is subtle and should be coordinated with breath. The muscles can be overworked, and imbalances can be formed from overdoing Kegels. General advice for people experiencing difficulty with starting a urine stream, those with pelvic pain, and those with persistent tension is to refrain from doing Kegels until they have been assessed by a pelvic floor specialist. Relatively, Kegels may be of help for those with leakage, a sense of heaviness, or a sense of weakness—but proper Kegel technique is imperative to obtaining any favorable outcome. The Kegel technique is lifting up the muscles internally, and is NOT tightening the muscles of the abdomen or glutes. Before doing any Kegel exercises, and most importantly, before doing any TikTok trends that involve Kegel exercises, a person's baseline pelvic floor health should first be determined. Kegels may be beneficial, but only compatible with the appropriate anatomy and appropriate purpose.
I'm going to come at this from a completely different angle than you'd expect--as someone nine years sober who spent years absolutely destroying my pelvic floor through chronic alcohol abuse without even knowing it. Here's what nobody tells you: alcohol is a massive diuretic that wreaks havoc on bladder control over time. During my drinking years, I'd wake up multiple times a night desperate to pee, sometimes not making it. I thought strengthening exercises would fix the leaking, but the real issue was inflammation and irritation from years of dehydration and alcohol's impact on my nervous system. I was squeezing muscles that were already in spasm from stress and poor sleep. The TikTok Kegel trend misses something critical--you can't exercise your way out of systemic problems. I work with people in early recovery who come in panicking about incontinence issues, and nine times out of ten, it improves dramatically within weeks of stopping drinking as their body rehydrates and inflammation reduces. One client was doing 100 Kegels daily while still drinking a bottle of wine nightly--complete waste of effort addressing the symptom instead of the cause. If you're dealing with pelvic floor issues and you drink regularly (even "moderately"), that's your starting point--not squeezing along to a 15-second video. Your pelvic floor is connected to your entire nervous system, and alcohol disrupts that connection in ways no exercise can override.
Kegels are basically exercises for your pelvic floor muscles, the ones that support your bladder, bowel, and reproductive organs. Doing them regularly can help with bladder control, core strength, and even sexual performance. They're simple but actually work if you stick with them consistently.
When looking at Kegel exercises for the physical medicine and rehabilitation side of things, Kegels are not just squeezing; they involve a targeted isometric contraction of the levator ani muscle group, which acts as the anatomical 'hammock' for the pelvis. The purpose of Kegel exercises, in terms of how they work, is to increase the neuromuscular control and hypertrophy (muscle growth) of the pelvic floor muscles to counteract gravity, as well as the intra-abdominal pressure, for all individuals to maintain continence and stability of the core. The most dangerous misperception being propagated by social media is that there is a blanket statement that 'everyone should perform Kegels.' Kegel exercises, when performed on a pelvic floor that is hypertonic (i.e., tight all the time, or in spasm), will cause a significant increase in pelvic pain, increased urgency to urinate, and sexual dysfunction. Kegels are used clinically for patients with true hypotonicity (weakness), such as stress urinary incontinence, but Kegel exercises would not be appropriate for the large population of individuals with high-tone pelvic floor dysfunction that presents as either hip pain or pain in the tailbone. In order to determine whether or not an individual is moving their pelvic floor muscles effectively, they should attempt to isolate the pelvic floor without moving the gluteal, adductor (inner thighs) or abdominal muscles, and a complete and correct repetition of a Kegel exercise will include the lifting of the perineum up and in and a full and complete relaxed phase of the perineum. It is important for individuals who are following trends to understand that a 'tight' pelvic floor does not necessarily equate to a 'strong' pelvic floor; and to contract an already short and tight muscle is comparable to gripping your hand into a fist but never releasing the grip, which leads to muscle fatigue and pain rather than muscle strength.
What Kegels Actually Do for Pelvic Floor Health (All Genders): Pelvic floor exercises (Kegels) are primarily designed to contract and relax the muscles of the pelvic floor, which support the pelvic organs. The strength of these muscles can contribute to pelvic floor dysfunction, including conditions such as pelvic organ prolapse, where an organ has shifted from its normal position. Thus, by contracting and relaxing the pelvic floor muscles through Kegel exercises, the pelvic floor is strengthened in order to support optimal function and control of the pelvic floor. When They're Helpful: -Postpartum recovery, when the pelvic floor muscles may have become elongated or weakened during pregnancy and delivery. -In men who experienced temporary muscle weakening after prostate surgery resulting in urinary leakage, Kegels may provide relief. -For athletes, individuals with chronic constipation or other health issues that may increase their risk of developing pelvic floor dysfunction, Kegels can provide preventative benefits. When They're Overhyped or Even Harmful: -When used as a blanket solution without proper assessment, not all incontinence or pelvic issues stem from weakness; some come from coordination problems or overactivity -During active pelvic floor dysfunction, like severe prolapse or nerve damage, where Kegels alone won't address the underlying structural or neurological issues -As a TikTok trend without context, when people follow generic advice without understanding their own pelvic floor status, they risk doing more harm than good How People Can Tell If They're Doing Them Correctly: -Use a mirror while lying down to see a slight inward lift around the perineum (the area between your genitals and anus). -As a one-time test, try stopping your urine flow mid-stream—if it works, you're targeting the right muscles (but don't make this a habit). -Check that your belly, thighs, and buttocks stay relaxed—no bulging or tensing elsewhere means you're isolating properly. Myth-Busting Guidance: Not every individual should perform kegels. Obtain a professional assessment prior to beginning any type of strengthening program. The pelvic floor is unique to each individual. Just as we would not randomly begin a shoulder-strengthening regimen without first identifying whether our shoulder issues were caused by weakness, tightness, or instability, the same logic applies to your pelvic floor.