Kegel for women: how to train your pelvic floor
The pelvic floor is a layer of muscle stretching like a hammock from the pubic bone to the sacrum and coccyx, supporting the bladder, uterus, and rectum. These muscles can be trained like any other, five minutes a day, with no equipment.
Updated November 14, 2026Compiled by UK MASTER ACADEMYFor readers aged 18 and over
- Kegel exercises involve squeezing then releasing the pelvic floor muscles in a rhythm, 10 reps per set, three sets a day.
- A 2019 Cochrane review of 31 trials involving 1,817 women concluded that pelvic floor muscle training can improve or treat symptoms of urinary incontinence.
- To locate the correct muscle, squeeze as if stopping urination, while keeping the abdomen, buttocks, and thighs fully relaxed.
- Outcomes are typically measured after 12 weeks of daily training, and these exercises do not replace seeing a doctor when symptoms persist.
Where the pelvic floor is
The diagram below is a mid-sagittal cross-section of the female pelvis, viewed from the left. The pelvic floor stretches like a hammock from the pubic bone at the front to the sacrum and coccyx at the back. The bladder, uterus, and rectum all rest on this layer of muscle, so when it contracts, the urethral opening and vagina are closed more tightly.
- 1Pubic bone: the front anchor of the pelvic floor.
- 2Bladder: stores urine. The urethra runs down from here.
- 3Uterus: sits above and behind the bladder.
- 4Vagina: the muscular canal from the cervix to the outside.
- 5Rectum: the last part of the large intestine.
- 6Sacrum and tailbone: the back anchor.
- 7Pelvic floor muscles: the layer trained by Kegel exercises.
When you squeeze, the muscle layer lifts upward.
What Western and Chinese medicine say
Western medicine
The levator ani and pubococcygeus muscles form the main part of the female pelvic floor. When strong enough, they keep the urethra closed during activities that raise abdominal pressure, such as coughing and running, and they support vaginal sensitivity.
- Urinary incontinence: a 2019 Cochrane review of 31 trials involving 1,817 women concluded that pelvic floor muscle training can improve or treat symptoms of urinary incontinence.
- Degree of improvement: a 2022 review of 2,441 women found that among 997 who trained, 50.5% improved and 21.8% were completely free of urine leakage, with 62% overall showing a positive response. The review noted low to moderate quality of evidence.
- Sexual function: a 2026 randomized controlled trial of 64 women with overactive bladder found that after 6 weeks of training, the intervention group had significantly higher sexual function scores than the control group.
Chinese medicine
Traditional Chinese medicine associates the pelvic floor region with the Kidney organ system, which belongs to the Water element. The Kidney stores essence (jing), governs reproduction, and controls the lower orifices. The Spleen generates blood and ensures that the muscles have sufficient internal strength to support the organs above.
Traditional health cultivation texts include an exercise of squeezing and releasing the anal area in rhythm with the breath, used to nourish the Kidney and preserve qi and essence. Mechanically, this exercise and Kegel work the same muscle group.
This is the traditional Chinese medicine view, which has not been validated by clinical trial standards. See the Kidney page for more.
Finding the right muscle before you start
Training the wrong muscle is the most common reason these exercises fail. Take a few minutes to identify it correctly:
- Lie on your back with knees bent and the whole body relaxed.
- Squeeze gently as if stopping urination and passing gas at the same time.
- The correct sensation: the vagina draws in and lifts, and the anus closes.
- Place one hand on the lower abdomen: the belly should not tighten, the buttocks and thighs should not squeeze, and the breath should remain steady.
Training with the timer
Select a level, press Start, then follow the circle: a filling circle means squeeze, a draining circle means release. Each session is one set of 10 reps.
Level 1: getting started
For the first two weeks. Squeeze at about half effort.
Three positions, from easiest to hardest
Lying down is easiest because the muscles do not work against gravity. Once you can contract correctly while lying, gradually move to sitting and then standing.
12-week training plan
A reference plan based on general recommendations: start holding for 3 seconds, increase gradually, at least three sets of 10 reps each day. If a level still feels tiring, stay at that level for one more week.
| Period | Rhythm | Per set | Per day | Position |
|---|---|---|---|---|
| Weeks 1 to 2 | Squeeze 3 s, release 3 s | 10 reps | 3 sets | Lying |
| Weeks 3 to 6 | Squeeze 5 s, release 5 s | 10 reps | 3 sets | Sitting |
| Weeks 7 to 12 | Squeeze 10 s, release 10 s | 10 reps, plus 10 quick reps | 3 sets | Standing |
| After week 12 | Keep the level working well | 10 reps | 1 to 2 sets | Integrated into daily life |
When to stop training and see a doctor
See a gynecologist, urologist, or pelvic floor physical therapist when:
- Urine leakage when coughing, sneezing, or exercising, lasting more than 4 weeks.
- After childbirth: pelvic organ prolapse, or a sensation of heaviness or bulging in the vaginal area.
- Pelvic pain or pain during sex, which may indicate a tight pelvic floor that needs assessment before contraction exercises begin.
- 12 weeks of consistent training with no change.
See also the article on pelvic floor release if you experience pelvic pain or tension.
Questions and answers
How long before Kegel exercises make a difference?
Most studies measure outcomes after 12 weeks of daily training. Some people notice better muscle control after 4 to 6 weeks.
Should I do Kegel exercises while urinating?
No. Stopping the urine stream should only be done once or twice to identify the muscle. Doing it regularly while urinating may prevent the bladder from emptying fully.
When can women start after childbirth?
Many specialists suggest starting after a vaginal birth as soon as there are no open wounds, but consult a doctor or pelvic floor physical therapist for a schedule suited to your specific situation.
Can Kegel exercises replace medication?
No. Kegel exercises are a supportive practice. Anyone undergoing treatment should ask their doctor before making any changes.
Sources
- Cacciari LP, Dumoulin C, Hay-Smith EJ. Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women: a cochrane systematic review abridged republication. Brazilian Journal of Physical Therapy. 2019;23(2):93-107. PubMed 30704907
- Alouini S, Memic S, Couillandre A. Pelvic floor muscle training for urinary incontinence with or without biofeedback or electrostimulation in women: a systematic review. International Journal of Environmental Research and Public Health. 2022;19(5):2789. PubMed 35270480
- Yilmaz Aladag F, Kizilkaya Beji N. The effect of pelvic floor muscle training on sexual function, depressive symptoms, and pelvic floor muscle performance in women with overactive bladder: a randomized controlled trial. BMC Women's Health. 2026;26(1):565. PubMed 42947098
- Mayo Clinic. Kegel exercises: a how-to guide for women.
This page is general health information compiled from international medical sources. It has not been reviewed by a physician and is not a diagnosis or a treatment instruction. The content is for readers aged 18 and over. If symptoms persist, please see a doctor.