Kegel Exercises for Men and Women: What They Do and How to Do Them

The pelvic floor is a group of muscles that almost everyone knows they should exercise and almost no one thinks about until something goes wrong. Leaking urine after a cough. Urgency that arrives with no warning. Reduced sensation during sex. Post-prostate surgery control problems.

By the time these symptoms appear, the pelvic floor has typically been underexercised for years. The good news is that pelvic floor muscles respond to training the same way any other muscle group does — with consistent, correctly performed exercise producing measurable improvements in strength, coordination, and function.

The bad news is that incorrect Kegel technique is extremely common — and exercising the wrong muscles, or performing Kegels in a hypertonic (chronically tensed) pelvic floor, can worsen symptoms rather than improve them.

TL;DR

• Kegel exercises target the pelvic floor — the group of muscles supporting the bladder, bowel, and in women, the uterus. They are among the most evidence-backed exercises available for both urinary incontinence and sexual function.
• A 2024 systematic review published in the American Journal of Obstetrics and Gynecology found that consistent pelvic floor muscle training improved arousal, orgasm quality, overall sexual satisfaction, and reduced pain during intercourse in women.
• Studies suggest that pelvic floor muscle training may also improve sexual function in both men and women, alongside its well-established benefits for bladder and bowel control.
• Incorrect technique is more common than correct technique. The most common error — clenching the abdomen, glutes, or thighs instead of the pelvic floor — reduces effectiveness and can increase tension elsewhere.
• Overactive or hypertonic pelvic floor muscles — where the muscles are chronically tensed rather than weak — require relaxation training rather than strengthening. Kegels can worsen symptoms in this population.
• Results typically become apparent within four to six weeks of consistent daily practice.

What the Pelvic Floor Actually Is

The pelvic floor is a hammock-like group of muscles and connective tissues stretching from the pubic bone at the front of the pelvis to the coccyx (tailbone) at the back. It supports the bladder, bowel, and — in women — the uterus, and plays a direct role in the function of all three.

These muscles work continuously — contracting to maintain continence during coughing, sneezing, and lifting; relaxing to allow urination, defecation, and (in women) vaginal penetration; and coordinating with the deep abdominal muscles and diaphragm as part of the core pressure management system.

Many factors weaken the pelvic floor over time: pregnancy and childbirth, prostate surgery, ageing and hormonal change, chronic straining, high-impact exercise, and prolonged periods of sedentary behaviour. But weakening is not the only form of dysfunction. Hypertonia — chronic low-grade tension or overactivity in the pelvic floor — is equally common and produces a different and sometimes overlapping set of symptoms.

Understanding which type of dysfunction is present is the most important step before beginning any pelvic floor training programme.

The Evidence: What Kegels Actually Achieve

Urinary Incontinence

This is the condition with the strongest evidence base for pelvic floor muscle training — and it is substantial.

Kegel exercises strengthen the pelvic floor muscles that support the bladder, rectum, and uterus, helping to stop leaks of urine, stool, or gas. Multiple systematic reviews and meta-analyses confirm that pelvic floor muscle training is the most effective conservative intervention for stress urinary incontinence — the involuntary leakage of urine during physical activity, coughing, sneezing, or laughing.

A 2023 randomised controlled trial found that Kegel exercises performed prior to resistance training reduced stress urinary incontinence to a significantly greater extent than resistance training alone — establishing that pelvic floor training enhances the ability to tolerate the intra-abdominal pressure increases of gym-based exercise without leakage. This has direct practical relevance for women who experience leaking during exercise and have been avoiding high-impact activity as a result.

For urgency incontinence — the sudden, compelling urge to urinate followed by leakage before reaching the toilet — pelvic floor training is also effective, though through a different mechanism. Contracting the pelvic floor during a sudden urge creates a reflex that suppresses the detrusor muscle — the bladder muscle responsible for the urgent contraction — reducing urgency and providing more time to reach the toilet.

If you do Kegel exercises regularly, you can expect results within a few weeks to a few months — for example, leaking urine less often. To keep getting benefits from Kegels, make these exercises a lasting part of your daily routine.

Sexual Function

The sexual health evidence for pelvic floor training is increasingly well established and is one of the most under-discussed benefits in mainstream health guidance.

A comprehensive 2024 systematic review published in the American Journal of Obstetrics and Gynecology provided compelling evidence that consistent pelvic floor muscle training improved multiple aspects of women's sexual experience, including arousal, orgasm quality, overall satisfaction, and reduction in pain during intercourse.

Kegels improve blood circulation to the pelvic floor and vagina, which may be helpful for arousal and lubrication. Strengthening the pelvic floor muscles can make the vaginal walls a little more taut — women may be better able to contract their muscles, improving sensation during intercourse.

For men, pelvic floor training has evidence for improving erectile function and ejaculatory control. The bulbocavernosus and ischiocavernosus muscles — part of the pelvic floor — play a direct role in erection rigidity and ejaculatory force. Strengthening them through Kegel exercises is associated with improved erectile function, particularly in men with post-prostate surgery incontinence and sexual dysfunction.

Pelvic Organ Prolapse

In women, pelvic organ prolapse — where pelvic organs descend from their normal anatomical position into or through the vagina — is a significant and common condition, particularly following childbirth. Pelvic floor muscle training is the primary conservative management strategy, both for preventing progression and reducing symptoms. It is not a complete reversal of prolapse but reduces the symptomatic impact and may slow progression, particularly in mild-to-moderate cases.

Men After Prostate Surgery

Urinary incontinence after radical prostatectomy — the surgical removal of the prostate for prostate cancer — is one of the most distressing post-surgical consequences for men. Pelvic floor muscle training is the most evidence-based conservative intervention for improving continence recovery after prostate surgery, with multiple trials showing faster return to continence in men who begin pelvic floor training before surgery and continue postoperatively.

Kegels help men with overactive bladder symptoms, stress, gas, or faecal incontinence symptoms. Men who undergo prostate surgery may particularly benefit from Kegel exercises. The Prostate Reset covers the broader lifestyle, nutritional, and recovery foundations that support prostate and pelvic health.

The Overactive Pelvic Floor: When Kegels Make Things Worse

This is the most important clinical nuance in pelvic floor training — and the one most often omitted from general guidance.

Not all pelvic floor problems are caused by weakness. In hypertonia — sometimes called an overactive or tight pelvic floor — the muscles are chronically contracted, unable to fully relax. Symptoms include pelvic pain, pain during sex (dyspareunia), painful periods, difficulty emptying the bladder or bowels fully, and a paradoxical sense of urgency or incomplete voiding even with a small bladder volume.

In this population, Kegel exercises — which involve repeated contraction of already overcontracted muscles — worsen symptoms. The appropriate treatment is pelvic floor relaxation training, often guided by a pelvic health physiotherapist using biofeedback.

Common causes of pelvic floor hypertonia include chronic stress and anxiety (through the same HPA axis-musculoskeletal tension pathway that produces neck and shoulder tension), previous pelvic trauma, prolonged sitting in poor posture, and high-intensity exercise without adequate pelvic recovery. The Stress Reset addresses the chronic stress patterns that underpin much of this tension.

If any of the following apply, a pelvic health physiotherapist assessment before starting Kegels is advisable: pain during sex, pelvic pain between periods, difficulty emptying the bladder completely, or a sense that the pelvic floor is always "on."

How to Identify the Pelvic Floor Muscles Correctly

The most common reason Kegels fail to produce results is exercising the wrong muscles. Most people, when asked to do a Kegel, tighten their abdomen, glutes, or inner thighs — muscles that are adjacent to but not part of the pelvic floor.

Method 1 — Imagine stopping gas. Squeeze the muscles you would use to prevent passing wind. If you feel a lifting and squeezing sensation around the rectum and vagina (women) or rectum and base of the penis (men), you have found the right muscles.

Method 2 — Stopping urine flow. When urinating, try stopping the flow midstream. The muscles you use to do this are the pelvic floor muscles. This method is useful for finding the muscles initially but should not be used as a regular training method — regularly interrupting urination can disrupt normal bladder function over time.

What to avoid: Holding the breath, tightening the abdomen, squeezing the buttocks, or pressing the thighs together. These compensatory patterns are extremely common and indicate the pelvic floor muscles are not being isolated correctly.

The Correct Technique

Once the correct muscles are identified, the basic Kegel involves three components: contraction, hold, and relaxation.

Contraction — squeeze the pelvic floor muscles upward and inward. Think of it as a lift rather than simply a squeeze.

Hold — maintain the contraction for three to ten seconds depending on current strength. Start with three seconds if the muscles fatigue quickly and build gradually.

Relaxation — release the contraction fully and allow the muscles to rest for an equal time before the next repetition. The relaxation phase is as important as the contraction — full relaxation between repetitions allows the muscles to recover and prevents the hypertonic pattern.

A standard protocol is ten repetitions, held for five to ten seconds each, performed two to three times per day. This can be done in any position — lying, sitting, or standing — and at any time during daily activities.

Quick flicks — rapid, sharp contractions without a hold — train the fast-twitch fibres responsible for the reflex contraction during sudden increases in pressure (coughing, sneezing, laughing). These should be added to the routine alongside the sustained holds.

Building Functional Pelvic Floor Training

Beyond isolated Kegels, functional pelvic floor training integrates pelvic floor engagement with daily movement — which is ultimately how the muscles need to work in real life.

The knack — contracting the pelvic floor just before and during a cough, sneeze, or lift. This anticipatory contraction — which should become automatic — prevents the pressure spike from overwhelming the pelvic floor and causing leakage.

Pelvic floor in exercise — engaging the pelvic floor during squats, deadlifts, and other resistance exercises recruits the deep core system correctly and reduces the risk of exercise-induced leakage. Exhaling during the exertion phase naturally facilitates pelvic floor engagement in coordination with the diaphragm.

Breathing and posture — the pelvic floor coordinates with the diaphragm through the breathing cycle. Poor posture — prolonged slouching, forward head position — disrupts this coordination. Improving posture and diaphragmatic breathing habits supports pelvic floor function independently of specific Kegel training. Restorative sleep also plays a role, as overnight recovery is when muscle and connective tissue repair occur.

When to Seek Professional Support

Pelvic health physiotherapy is the most effective route to correct Kegel technique and appropriate programme design. A pelvic health physiotherapist can assess whether the primary problem is weakness or hypertonia, identify compensatory patterns, and use biofeedback to provide real-time confirmation of correct muscle engagement.

Another technique that may help is electrical stimulation, where a device releases a mild electric current that causes pelvic muscles to squeeze as they would during Kegels. This approach is used for people who cannot voluntarily isolate and contract the pelvic floor muscles independently.

NHS pelvic health physiotherapy is available on referral from a GP. Waiting times vary between areas. Private pelvic health physiotherapy is available without referral across most of the UK.

Seeking professional assessment is particularly advisable for: persistent urinary incontinence not responding to self-directed Kegel training; any pelvic pain symptoms; post-prostate surgery incontinence; post-childbirth pelvic floor rehabilitation; and pelvic organ prolapse symptoms. For women navigating midlife hormonal change, the Perimenopause Reset covers the broader systemic factors that influence pelvic floor function during this stage.

Frequently Asked Questions

What do Kegel exercises actually do?

Kegel exercises strengthen the pelvic floor — the group of muscles supporting the bladder, bowel, and in women the uterus — improving their strength, coordination, and timing. The evidence-backed benefits include reduced urinary incontinence (both stress and urgency types), improved sexual function and sensation, pelvic organ prolapse symptom management, and post-prostate surgery continence recovery in men. A 2024 systematic review confirmed improvements in arousal, orgasm quality, and sexual satisfaction in women from consistent pelvic floor training.

How do I know if I am doing Kegels correctly?

Correct Kegels involve an upward lift and squeeze of the pelvic floor without tightening the abdomen, buttocks, or inner thighs. If you are holding your breath or feel tension in these surrounding muscles, you are likely compensating rather than isolating the pelvic floor. The midstream urine stop method is a useful one-off test for finding the correct muscles, but should not be used as a regular training method.

Can Kegels make things worse?

Yes — in people with an overactive or hypertonic pelvic floor, where the muscles are chronically tense rather than weak, Kegels worsen symptoms by adding contraction to already contracted muscles. Symptoms of hypertonia include pelvic pain, pain during sex, difficulty fully emptying the bladder, and pelvic pressure. Relaxation training with a pelvic health physiotherapist is the appropriate intervention in this case, not more Kegels.

How long does it take for Kegels to work?

Most people notice improvement within four to six weeks of consistent daily practice — typically two to three sets of ten repetitions daily. Full benefit typically develops over three to six months. Consistency matters more than intensity — daily practice at correct technique outperforms occasional high-repetition sessions.

Do Kegel exercises benefit men?

Yes — pelvic floor muscles are equally relevant to male continence and sexual function. Men benefit from pelvic floor training for post-prostate surgery incontinence, overactive bladder, post-void dribbling, erectile function, and ejaculatory control. The same technique applies — isolating the pelvic floor rather than clenching abdomen or glutes — though men often find muscle identification harder initially and may benefit from physiotherapy guidance.

Should I do Kegels during pregnancy?

Yes — pelvic floor muscle training during pregnancy reduces the risk of urinary incontinence during and after pregnancy and supports pelvic floor recovery after childbirth. A randomised controlled trial found pelvic floor training during pregnancy significantly reduced stress urinary incontinence in the prenatal period. Starting in the first trimester and continuing throughout pregnancy is the evidence-aligned approach. If any pelvic pain, pressure, or discomfort is present, a pelvic health physiotherapist should assess before beginning.

The Bottom Line

The pelvic floor is the most consistently underexercised muscle group in the body — and one of the most consequential for quality of life across the lifespan. The evidence for pelvic floor muscle training is strong, spanning urinary continence, sexual function, pelvic organ prolapse, and post-surgical recovery.

The most important caveat is technique. Correct pelvic floor isolation — without compensatory glute, abdominal, or thigh tension — is what produces results. And assessment of whether the primary problem is weakness or overactivity determines whether Kegels are the right starting point at all.

For people with persistent symptoms — leakage, urgency, pain, or sexual dysfunction — a pelvic health physiotherapist assessment is the most efficient route to a programme that actually works. For everyone else, consistent daily practice of correct Kegels, integrated with functional movement and postural habits, produces meaningful improvement within weeks.

For a structured approach to the sleep, stress, and hormonal foundations that support pelvic floor health, the Sleep Reset, Stress Reset, Perimenopause Reset and Prostate Reset from the Reset Series™ address the systemic factors most relevant to pelvic floor function across the lifespan. Pair any of these with the Reset Companion for daily, personalised guidance as you build the habit.

Related reading: Perimenopause in Your 30s and 40s: Early Symptoms Explained · The Sperm Health Guide: What's Driving the Decline — and What Men Can Actually Do About It · Cortisol Explained — and How to Reduce It Without Making Things Worse

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