Kegel exercises: A how-to guide for women
Kegel exercises can prevent or control urinary incontinence and other pelvic floor problems. Here’s a step-by-step guide to doing Kegel exercises correctly.
By Mayo Clinic Staff
Kegel exercises strengthen the pelvic floor muscles, which support the uterus, bladder, small intestine and rectum. You can do Kegel exercises, also known as pelvic floor muscle training, just about anytime.
Start by understanding what Kegel exercises can do for you — then follow these instructions for contracting and relaxing your pelvic floor muscles.
Why Kegel exercises matter
Female pelvic floor muscles
Female pelvic floor muscles
A woman’s pelvic floor muscles work like a hammock to support the pelvic organs, including the uterus, bladder and rectum. Kegel exercises can help strengthen these muscles.
Many factors can weaken your pelvic floor muscles, including pregnancy, childbirth, surgery, aging, excessive straining from constipation or chronic coughing, and being overweight.
You might benefit from doing Kegel exercises if you:
- Leak 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 urge incontinence)
- Leak stool (fecal incontinence)
Kegel exercises can also be done during pregnancy or after childbirth to try to improve your symptoms.
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).
How to do Kegel exercises
To get started:
- Find the right muscles. To identify your pelvic floor muscles, stop urination in midstream. 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. To do Kegels, imagine you are sitting on a marble and tighten your pelvic muscles as if you’re lifting the marble. Try it for three seconds at a time, then relax for a count of three.
- 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 to 15 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.
When to do your Kegels
Make Kegel exercises part of your daily routine. You can do Kegel exercises discreetly just about any time, whether you’re sitting at your desk or relaxing on the couch.
When you’re having trouble
If you’re having trouble doing Kegel exercises, don’t be embarrassed to ask for help. Your doctor or other health care provider can give you important feedback so that you learn to isolate and exercise the correct muscles.
In some cases, vaginal weighted cones or biofeedback might help. To use a vaginal cone, you insert it into your vagina and use pelvic muscle contractions to hold it in place during your daily activities. During a biofeedback session, your doctor or other health care provider inserts a pressure sensor into your vagina or rectum. As you relax and contract your pelvic floor muscles, a monitor will measure and display your pelvic floor activity.
When to expect results
If you do Kegel exercises regularly, you can expect results — such as less frequent urine leakage — within about a few weeks to a few months. For continued benefits, make Kegel exercises a permanent part of your daily routine.
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- Wein AJ, et al., eds. Conservative management of urinary incontinence: Behavioral and pelvic floor therapy and urethral and pelvic devices. In: Campbell-Walsh Urology. 11th ed. Philadelphia, Pa.: Elsevier; 2016. https://www.clinicalkey.com. Accessed Sept. 18, 2018.
- Ferri FF. Kegel exercises strengthening your pelvic floor muscles. In: Ferri’s Clinical Advisor 2019. Philadelphia, Pa.: Elsevier; 2019. https://www.clinicalkey.com. Accessed Sept. 18, 2019.
- Kegel exercises for your pelvic muscles. American Academy of Family Physicians. https://www.clinicalkey.com. Accessed Sept. 18, 2019.
- Kegel exercises. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/urologic-diseases/bladder-control-problems-women/kegel-exercises. Accessed April 4, 2018.
See more In-depth
Pelvic floor exercises strengthen the muscles around your bladder, bottom, and vagina or penis.
Strengthening your pelvic floor muscles can help urinary incontinence, treat pelvic organ prolapse, and make sex better too.
Everyone can benefit from doing pelvic floor exercises.
Find your pelvic floor muscles
You can feel your pelvic floor muscles if you try to stop the flow of urine when you go to the toilet.
It’s not recommended that you regularly stop the flow of urine midstream as it can be harmful to your bladder.
Pelvic floor exercises
To strengthen your pelvic floor muscles, sit comfortably and squeeze the muscles 10 to 15 times.
Do not hold your breath or tighten your stomach, bottom or thigh muscles at the same time.
When you get used to doing pelvic floor exercises, you can try holding each squeeze for a few seconds.
Every week, you can add more squeezes, but be careful not to overdo it, and always have a rest between sets of squeezes.
After a few months, you should start to notice results. You should keep doing the exercises, even when you notice they’re starting to work.
To find out more about pelvic floor exercises, watch a video about pelvic floor strengthening on the Health and Care Video Library.
Pregnancy and pelvic floor exercises
If you’re pregnant or planning to get pregnant, you can start doing pelvic floor exercises immediately.
The exercises will lower your chance of experiencing incontinence after having your baby.
Find out more about exercise in pregnancy, including pelvic floor exercises.
How pelvic floor exercises can help with sex
Strong pelvic floor muscles can also mean increased sensitivity during sex and stronger orgasms.
Strengthening and training the pelvic floor muscles can help also reduce the symptoms of erectile dysfunction.
Page last reviewed: 14 April 2020
Next review due: 14 April 2023
Pelvic floor muscle training exercises are recommended for:
- Women with urinary stress incontinence
- Men with urinary stress incontinence after prostate surgery
- People who have fecal incontinence
Pelvic floor muscle training exercises can help strengthen the muscles under the uterus, bladder, and bowel (large intestine). They can help both men and women who have problems with urine leakage or bowel control.
A pelvic floor muscle training exercise is like pretending that you have to urinate, and then holding it. You relax and tighten the muscles that control urine flow. It is important to find the right muscles to tighten.
The next time you have to urinate, start to go and then stop. Feel the muscles in your vagina, bladder, or anus get tight and move up. These are the pelvic floor muscles. If you feel them tighten, you have done the exercise right. Do not make it a habit to do the exercises each time while you urinate. Once you can comfortably identify the muscles, perform the exercises while seated, but NOT when you are urinating.
If you are still not sure whether you are tightening the right muscles, keep in mind that all of the muscles of the pelvic floor relax and contract at the same time. Because these muscles control the bladder, rectum, and vagina, the following tips may help:
- Women: Insert a finger into your vagina. Tighten the muscles as if you are holding in your urine, then let go. You should feel the muscles tighten and move up and down.
- Men: Insert a finger into your rectum. Tighten the muscles as if you are holding in your urine, then let go. You should feel the muscles tighten and move up and down. These are the same muscles you would tighten if you were trying to prevent yourself from passing gas.
It is very important that you keep the following muscles relaxed while doing pelvic floor muscle training exercises:
- Abdominal
- Buttocks (the deeper, anal sphincter muscle should contract)
- Thigh
A woman can also strengthen these muscles by using a vaginal cone, which is a weighted device that is inserted into the vagina. Then you try to tighten the pelvic floor muscles to hold the device in place.
If you are unsure whether you are doing the pelvic floor muscle training correctly, you can use biofeedback and electrical stimulation to help find the correct muscle group to work.
- Biofeedback is a method of positive reinforcement. Electrodes are placed on the abdomen and along the anal area. Some therapists place a sensor in the vagina in women or anus in men to monitor the contraction of pelvic floor muscles.
- A monitor will display a graph showing which muscles are contracting and which are at rest. The therapist can help find the right muscles for performing pelvic floor muscle training exercises.
PERFORMING PELVIC FLOOR EXERCISES:
Follow these steps:
- Begin by emptying your bladder.
- Tighten the pelvic floor muscles and hold for a count of 10.
- Relax the muscles completely for a count of 10.
- Do 10 repetitions, 3 to 5 times a day (morning, afternoon, and night).
You can do these exercises at any time and place. Most people prefer to do the exercises while lying down or sitting in a chair. After 4 to 6 weeks, most people notice some improvement. It may take as long as 3 months to see a major change.
After a couple of weeks, you can also try doing a single pelvic floor contraction at times when you are likely to leak (for example, while getting out of a chair).
A word of caution: Some people feel that they can speed up the progress by increasing the number of repetitions and the frequency of exercises. However, over-exercising can instead cause muscle fatigue and increase urine leakage.
If you feel any discomfort in your abdomen or back while doing these exercises, you are probably doing them wrong. Breathe deeply and relax your body when you do these exercises. Make sure you are not tightening your stomach, thigh, buttock, or chest muscles.
When done the right way, pelvic floor muscle exercises have been shown to be very effective at improving urinary continence.
There are physical therapists specially trained in pelvic floor muscle training. Many people benefit from formal physical therapy.
