Kegel Exercises

by the Mayo Clinic

Kegel (KAY-gul or KEY-gul) exercises strengthen the pelvic floor muscles, supporting such organs as the uterus, bladder and bowel. Doing Kegel exercises regularly can keep your pelvic floor muscles tight and toned and may reduce the risk of urinary incontinence as well as similar problems often associated with aging.

Who can benefit from doing Kegel exercises? Because many conditions can put stress on your pelvic floor muscles, you may want to consider doing them when you are:

- as you age
- have a chronic cough
- during childbirth
- if you are overweight
- are pregnant
- have a genetic predisposition to weak connective tissue

When your pelvic floor muscles are weak, Kegel exercises are recommended especially during pregnancy. Well-toned pelvic floor muscles may make you more comfortable as your due date approaches. You may be less likely to develop urine leakage, which often happens near the end of pregnancy and prone to persist after you've given birth.

Pelvic Organ Prolapse - this condition occurs when the pelvic organs push downward descend into the vagina, a condition known as Pelvic Organ Prolapse . The effects of pelvic organ prolapse range from uncomfortable pelvic pressure to leakage of urine or feces. Fortunately, Kegel exercises can strengthen pelvic muscles and delay or maybe even prevent Pelvic Organ Prolapse .

Persistent problems reaching orgasm - Kegel exercises along with counseling and sometimes therapy may be helpful to women who have a problem reaching climax.

Urinary Incontinence - can occur in both men and women and therefore, Kegel exercises are very important to do throughout the day.

How to do Kegel exercises

It takes diligence to identify your pelvic floor muscles and learn how to contract and relax them. Here are some pointers:

Find the right muscles.

To make sure you know how to contract your pelvic floor muscles, try to stop the flow of urine while you're in the restroom. If you succeed, you've got the basic move. Feel your pelvic floor move down to the starting position. As your muscles become stronger and you become more experienced with the exercises, this movement will be more pronounced. Once you've found your pelvic floor muscles, empty your bladder and sit or lie down.

Exercise

1. Contract your pelvic floor muscles.
2. Hold the contraction for three seconds then relax for three seconds.
3. Repeat 10 times.
4. To get the maximum benefit, focus on tightening only your pelvic floor muscles or isolating your pelvic floor muscles.

Try it now for four seconds at a time, alternating muscle contractions with a four-second rest period.

Work up to keeping the muscles contracted for 10 seconds at a time, relaxing for 10 seconds between contractions.

Try sets of mini-Kegels. Counting quickly to 1 to 20, contracting and relaxing your pelvic floor muscles each time you say a number.

Do not hold your breath. Use the power of the breath, Do not flex the muscles in your abdomen, thighs or buttocks. Just relax, breathe freely and focus on tightening the muscles around your vagina and rectum. Repeat three times a day.

Perform a set of 10 Kegel exercises three times a day. The exercises will get easier the more often you do them. You might make a practice of fitting in a set every time you do a routine task, such as checking e-mail or commuting to work.

Kidney Stones

by Andrew Pacholyk, MS. L.Ac.

Kidney stones are hard masses that can grow from crystals forming
within the kidneys. Doctors call kidney stones "renal calculi," and
the condition of having such stones "nephrolithiasis."

Most kidney stones are made of calcium oxalate. People with a history
of kidney stone formation should talk with their doctor to learn what
type of stones they have—approximately one stone in three is made of
something other than calcium oxalate and one in five contains little
if any calcium in any form. Calcium oxalate stone formation is rare
in primitive societies, suggesting that this condition is
preventable.1 People who have formed a calcium oxalate stone are at
high risk of forming another kidney stone.

Highly recommended for its efficiency are Magnesium citrate and
Potassium citrate in combination.

Magnesium is needed for bone, protein, and fatty acid formation,
making new cells, activating B vitamins, relaxing muscles, clotting
blood, and forming ATP—the energy the body runs on. The secretion and
action of insulin also require magnesium.

Magnesium also acts in a way related to calcium channel blocker
drugs. This effect may be responsible for the fact that under certain
circumstances, magnesium has been found to potentially improve vision
in people with glaucoma.1 Similarly, this action might account for
magnesium's ability to lower blood pressure.

Since magnesium has so many different actions in the body, the exact
reasons for some of its clinical effects are difficult to determine.
2 For example, magnesium has reduced hyperactivity in children in
preliminary research.3 Other research suggests that some children
with attention deficit-hyperactivity disorder (ADHD) have lowered
levels of magnesium. In a preliminary but controlled trial, 50 ADHD
children with low magnesium (as determined by red blood cell, hair,
and serum levels of magnesium) were given 200 mg of magnesium per day
for six months.4 Compared with 25 other magnesium-deficient ADHD
children, those given magnesium supplementation had a significant
decrease in hyperactive behavior.

Magnesium levels have been reported to be low in those with chronic
fatigue syndrome (CFS),5 while magnesium injections have been
reported to improve symptoms.6 Oral magnesium supplementation has
also improved symptoms in those people with CFS who had low magnesium
levels in another report, although magnesium injections were
sometimes necessary.7 However, other research reports no evidence of
magnesium deficiency in people with CFS.8 9 The reason for this
discrepancy remains unclear. People with CFS considering magnesium
supplementation should have their magnesium status checked beforehand
by a doctor. Only people with magnesium deficiency appear to benefit
from this therapy.

People with diabetes tend to have lower magnesium levels compared
with those who have normal glucose tolerance.10 Supplementation with
magnesium overcomes this problem11 and may help some diabetics
improve glucose tolerance.

Magnesium may be beneficial for bladder problems in women, especially
common disturbances in bladder control and the sense of "urgency." A
double-blind trial found that women who took 350 mg of magnesium
hydroxide (providing 147 mg elemental magnesium) twice daily for four
weeks, had better bladder control and fewer symptoms than women who
took a placebo.12

Magnesium supplementation may reduce dehydration of red blood cells
in sickle cell anemia patients. Administration of 540 mg per day of
magnesium pidolate to sickle cell anemia patients was seen after six
months, to reverse some of the characteristic red blood cell
abnormalities and to dramatically reduce the number of painful days
for these patients.13 This preliminary trial was not blinded, so
placebo effect could not be ruled out. Magnesium pidolate is also an
unusual form of magnesium. It is unknown whether other forms of
magnesium would produce similar results.

Magnesium is found in nuts and grains are good sources of magnesium.
Beans, dark green vegetables, fish, and meat also contain significant
amounts.

Potassium is needed to regulate water balance, levels of acidity,
blood pressure, and neuromuscular function. This mineral also plays a
critical role in the transmission of electrical impulses in the
heart. People with low blood levels of potassium who are undergoing
heart surgery are at an increased risk of developing heart
arrhythmias and an increased need for cardiopulmonary
resuscitation.13 Potassium is also required for carbohydrate and
protein metabolism.

Found in most fruits, these are excellent sources of potassium.
Beans, milk, and vegetables contain significant amounts of potassium.


Some citrate research conducted with people who have a history of
kidney stones involves supplementation with a combination of
potassium citrate and magnesium citrate. In one double-blind trial,
the recurrence rate of kidney stones dropped from 64% to 13% for
those receiving high amounts of both supplements.14 In that trial,
people were instructed to take six pills per day—enough potassium
citrate to provide 1,600 mg of potassium and enough magnesium citrate
to provide 500 mg of magnesium. Both placebo and citrate groups were
also advised to restrict salt, sugar, animal protein, and foods rich
in oxalate. Other trials have also shown that potassium and magnesium
citrate supplementation reduces kidney stone recurrences.15

Citric acid (citrate) is found in many foods and may also protect
against kidney stone formation.16,17 The best food source commonly
available is citrus fruits, particularly lemons. One preliminary
trial found that drinking 2 quarts of lemonade per day improved the
quality of the urine in ways that are associated with kidney stone
prevention.18 Lemonade was far more effective in modifying these
urinary parameters than orange juice. The lemonade was made by mixing
4 oz lemon juice with enough water to make 2 liters. The smallest
amount of sweetener possible should be added to make the taste
acceptable. Further study is necessary to determine if lemonade can
prevent recurrence of kidney stones.


REFERENCES

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visual field and peripheral vasospasm in glaucoma. Ophthalmologica
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2. Kawano Y, Matsuoka H, Takishita S, Omae T. Effects of magnesium
supplementation in hypertensive patients. Hypertension 1998;32:260–5.

3. Starobrat-Hermelin B, Kozielec T. The effects of magnesium
physiological supplementation on hyperactivity in children with
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magnesium oral loading test. Magnes Res 1997;10:149–56.

4. Starobrat-Hermelin B, Kozielec T. The effects of magnesium
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attention deficit hyperactivity disorder (ADHD). Positive response to
magnesium oral loading test. Magnes Res 1997;10:149–56.

5. Moorkens G, Manuel y Keenoy B, Vertommen J, et al. Magnesium
deficit in a sample of the Belgian population presenting with chronic
fatigue. Magnes Res 1997;10:329–37.

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11. Eibl NL, Schnack CJ, Kopp H-P, et al. Hypomagnesemia in type II
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12. Gordon D, Groutz A, Ascher-Landsberg J, et al. Double-blind,
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13. Wahr JA, Parks R, Boisvert D, et al. Preoperative serum potassium
levels and perioperative outcomes in cardiac surgery patients. JAMA
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14. Ettinger B, Pak CY, Citron JT, et al. Potassium-magnesium citrate
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nephrolithiasis. J Urol 1997;158:2069–73.

15. Pak CY. Medical prevention of renal stone disease. Nephron 1999;81
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16. Pak CY. Nephrolithiasis from calcium supplementation. J Urol
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18. Seltzer MA, Low RK, McDonald M, et al. Dietary manipulation with
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