Sixteen female volunteers participated in a study comparing the effects of Kegel exercises to an attention placebo and a waiting list control condition. All subjects had a low (<30%) frequency of coital orgasm but were not severely sexually anxious or low in sexual arousal. The Kegel program led to an average increase in pubococcygeal strength of 10 mm; there was a trend for this change to be greater than that in the control groups. Nevertheless, the Kegel exercise group clearly did not show differential improvement on coital orgasmic frequency at posttest when compared to the other two groups. Furthermore, notable compliance problems were encountered with the instructions for 20 min of daily exercise. On the basis of these findings and prior research, it is concluded that Kegel exercises are unlikely to contribute to positive outcome in the treatment of orgasmic dysfunction in women.Kegel exercises for strengthening the pubococcygens (the muscle surrounding the anus, urethra, and vagina) have been commonly prescribed in the treatment of female orgasmic dysfunction (e.g., Barbach, 1980;Kline-Graber & Graber, 1975). Their use has been based on uncontrolled reports by Kegel (1951Kegel ( , 1952 that women who practiced these exercises for urinary incontinence often reported increased vaginal sensation and ability to reach coital orgasm. Kegel's findings were buttressed by a retrospective correlational study (Graber & Kline-Graber, 1979) in which pubococcygeal (PC) strength was found to be higher in orgasmic than anorgasmic women. Nevertheless, in the only controlled, prospective investigation to date Chambless and her colleagues failed to find the predicted relationship between PC strength and orgasmic responsiveness (Chambless et al., 1982). Consequently, these investigators hypothesized that to the extent that Kegel exercises facilitate attaining orgasm, the effect might well be due to non-The authors wish to thank Alan Goldstein for his contributions to the design of this study, Anna J. Williams for her assistance in developing the attention placebo, Marsha Bancroft for serving as nurse practitioner, and Leona Aiken and Craig Caputo for their consultation on data analysis.

The relationship of pubococcygeal condition to orgasmic responsiveness in 102 women from a university community was examined in a controlled, prospective investigation. Pubococcygeal strength was measured with a perineometer while responsiveness was assessed by a standardized interview yielding reliable measures of self-reported orgasmic response. Subjects whose responsiveness might have been impaired by such factors as alcohol consumption, inadequate stimulation, and high sexual anxiety were excluded from analyses. Excellent within-session but poor across-session test-retest reliability of the perineometer measures was noted. Initial Strength Contracting proved to be the most reliable measure. Though the majority of the parous women had performed Kegel exercises after delivery, parity was negatively related to pubococcygeal strength on most measures. Contrary to experimental hypotheses, pubococcygeal strength was not found to be positively related to frequency or self-reported intensity of orgasm. Furthermore, women with higher pubococcygeal strength did not report that vaginal stimulation contributed more to attainment of orgasm, nor did they rate vaginal sensations during coitus as more pleasurable. Only in the case of pleasurability of orgasm through clitoral stimulation was a significant, though low, relationship obtained. Possible factors contributing to the discrepancy between these findings and previous uncontrolled investigations are discussed, as are the implications of these findings for the use of Kegel exercises in the treatment of orgasmic dysfunction.

A survey concerning the recommendation of self-help books to clients was completed by 209 psychologists (66.5% male, 94.3% White, mean age = 45 years). Most of the respondents indicated that they did prescribe self-help books infrequently. The likelihood of prescribing books was significantly related to the psychologist's gender, with women recommending books more often than did men, and to employment setting, with private practitioners recommending books more often than did academicians. Psychologists had little familiarity with popular self-help books but thought favorably of the ones of which they knew. Respondents' evaluations of 29 best-selling self-help books are provided.Self-help activities are firmly established in contemporary American society (Chaplin, 1989;Starker, 1989). Whether one joins a group, reads a book, watches a videotape, listens to an JUDITH A. MARX received her PhD from the University of Maryland in 1983 and is currently in private practice in Washington, DC. She is a past member of the Committee on Women of the Division of Counseling Psychology for the American Psychological Association. ZSUZSANNA K. GYORKY received her PhD from the University of Minnesota in 1982. She is currently the coordinator of training at the University Counseling Center, The George Washington University, Washington, DC. She is a past member of the Committee on Women of the Division of Counseling Psychology for the American Psychological Association. GEORGIA M. ROYALTY received her PhD from the University of Maryland in 1982. She is currently in private practice in College Park and Towson, Maryland, and is a former chair of the Committee on Women of the Division of Counseling Psychology for the American Psychological Association. TINA E. STERN received her PhD from the University of Georgia in 1982. Currently, she is an assistant professor at DeKalb College in Atlanta, Georgia. She is also a former chair of the Committee on Women of the Division of Counseling Psychology for the American Psychological Association.

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