Pelvic Floor Exercises: A Beginner’s Guide for Men and Women
Pelvic floor exercises are the quietest workout you will ever do. Nobody can see them, they need no equipment, and you can do them sitting at a desk or waiting for the kettle. They are also among the best-researched exercises in this whole site, with decades of trials behind them.
I ignored mine for years, on the vague idea that the pelvic floor was something only women after childbirth needed to think about. Then a physiotherapist explained, while I was being treated for a back problem, that men have exactly the same sling of muscles, that it works with the deep core every time you lift or cough, and that most people who think they are doing the exercises are squeezing the wrong muscles. She was right about me.
This guide covers how to find the muscles, how to do pelvic floor exercises properly, a 12-week plan, breathing and Pilates moves that help, and when to see a specialist. It is written for men and women, because the basics are the same for both.
At a glance
- The pelvic floor is a sling of muscles at the base of the pelvis that supports the bladder and bowel, and the womb in women
- Pelvic floor exercises are squeeze-and-lift movements of those muscles, sometimes called Kegels
- Do two kinds: slow holds for endurance and quick squeezes for fast reactions
- A common starting dose is 10 slow holds and 10 quick squeezes, three times a day
- Most people need about 12 weeks of regular practice to notice a clear change
- Breathing, Pilates and whole-body exercises support the pelvic floor but do not replace the specific squeezes
- If you have pain, leaking that is getting worse, or a feeling of heaviness, see a doctor or pelvic health physiotherapist
What the pelvic floor is
Your pelvic floor is a group of muscles that stretches like a hammock from the pubic bone at the front to the tailbone at the back, and from one sitting bone to the other. It closes the bottom of the pelvis.
| Job | What it means in daily life |
|---|---|
| Support | Holds the bladder, bowel and, in women, the womb in place |
| Control | Keeps the bladder and bowel closed until you choose to go |
| Pressure management | Tightens automatically when you cough, sneeze, laugh, lift or jump |
| Sexual function | Contributes to sensation and function in both men and women |
| Stability | Works as the floor of your deep core, with the deep abdominal muscles, the back muscles and the diaphragm |
Like any muscle, it can become weak, slow to react or, less often, too tight. Weakness is the most common problem, and it is the one pelvic floor exercises are designed to fix.
Signs your pelvic floor needs attention
- Leaking a little urine when you cough, sneeze, laugh, run or lift
- A sudden urge to pass urine that is hard to hold
- Dribbling after you have finished passing urine (common in men)
- Difficulty holding wind
- In women, a feeling of heaviness or dragging in the vagina
- Pain in the pelvis, during sex or when passing urine or stools
The first four are classic signs of weakness. Pain and heaviness need a professional assessment before you start, for reasons explained further down.
Who should do pelvic floor exercises?
Almost everyone benefits, but some people benefit a lot.
| Group | Why pelvic floor exercises help |
|---|---|
| Women during and after pregnancy | Pregnancy and birth stretch and strain the pelvic floor |
| Women around menopause | Falling oestrogen affects the pelvic tissues |
| Men after prostate surgery | Surgery affects the muscles that control the bladder |
| Men with dribbling after urinating | The muscles help clear the last drops |
| Runners, lifters and people who jump | High-impact training puts repeated pressure on the pelvic floor |
| People with a long-term cough or constipation | Repeated straining weakens the muscles |
| Older adults | Muscle strength declines with age, including here |
| Anyone carrying extra weight | More weight means more downward pressure |
Do pelvic floor exercises work?
Yes, and the evidence is unusually strong for an exercise.
A Cochrane review pooled 31 trials involving 1,817 women with urinary incontinence. Women who did pelvic floor muscle training were considerably more likely to report that they were cured or improved than women who had no treatment, and they reported better quality of life. The effect was clearest for stress incontinence, the leaking that happens with coughs and sneezes.
For men, the research is smaller but points the same way. A review of the male pelvic floor describes how training these muscles is used for leaking after prostate surgery, for dribbling after urination and in some cases of erectile difficulty.
Source: Dorey, Male pelvic floor: history and update, Urologic Nursing (2005)
Step 1: find the right muscles
This is the step most people get wrong. Many squeeze their buttocks, thighs or stomach instead.
For everyone
- Sit comfortably on a firm chair, leaning slightly forward, feet flat
- Imagine you are trying to stop yourself passing wind. Squeeze the muscles around your back passage
- Now imagine you are also trying to stop the flow of urine. Squeeze the muscles at the front
- Do both together and feel a gentle lift upward and inward
- Let go completely and feel the muscles drop back down
Extra cues for women
- Imagine drawing the vagina upward and inward, like sipping through a straw
- Some women find it easier lying on their back with knees bent
Extra cues for men
- Imagine pulling the base of the penis back toward the body
- Look in a mirror: when you squeeze correctly, the base of the penis draws in slightly and the scrotum lifts
How to check you are doing it right
| You should feel | You should not feel |
|---|---|
| A lift and squeeze inside the pelvis | Your buttocks clenching |
| Your stomach staying soft, or tightening only slightly low down | Your stomach bracing hard or pushing out |
| Normal breathing | Yourself holding your breath |
| Your legs relaxed | Your thighs squeezing together |
Do not practise by stopping your urine flow mid-stream more than once, as a test. Doing it regularly can upset normal bladder emptying.
Step 2: how to do pelvic floor exercises
There are two types of squeeze, because the muscles do two different jobs.
Slow holds, for endurance
- Breathe normally
- Squeeze and lift the pelvic floor
- Hold, counting out loud so you keep breathing
- Let go fully and rest for the same length of time
- Start with whatever hold you can manage, even three seconds, and build up to ten
Quick squeezes, for fast reactions
- Squeeze and lift as quickly and strongly as you can
- Let go straight away
- Rest for a second, and repeat
Quick squeezes train the reflex that needs to happen when you cough or sneeze.
| Type | Starting point | Goal after about 12 weeks |
|---|---|---|
| Slow holds | 3 to 5 seconds, repeated 5 to 10 times | 10 seconds, repeated 10 times |
| Quick squeezes | 5 to 10 | 10 in a row, each one strong |
| How often | 3 sessions a day | 3 sessions a day |
| Position | Lying down or sitting | Sitting, standing, then during everyday movements |
The letting go matters as much as the squeeze. A muscle that never fully relaxes gets tired and can become uncomfortable.
Progress the positions
Start where it is easiest, lying down, because gravity is not working against you. Then move on.
- Lying on your back, knees bent
- Sitting on a firm chair
- Standing
- During everyday actions: lifting a bag, standing up from a chair, climbing stairs
The knack: squeeze before you cough
The most useful everyday skill is called the knack. Before anything that raises pressure in your belly, such as a cough, a sneeze, a laugh, lifting a box or standing up, squeeze and hold your pelvic floor until it is over.
It feels deliberate at first. With practice it becomes automatic, which is the whole aim of the training.
A 12-week plan for beginners
| Weeks | Slow holds | Quick squeezes | Position | Times a day |
|---|---|---|---|---|
| 1 to 2 | 5 x 3 seconds | 5 | Lying down | 3 |
| 3 to 4 | 8 x 5 seconds | 8 | Lying or sitting | 3 |
| 5 to 6 | 10 x 5 seconds | 10 | Sitting | 3 |
| 7 to 8 | 10 x 7 seconds | 10 | Sitting and standing | 3 |
| 9 to 10 | 10 x 10 seconds | 10 | Standing | 3 |
| 11 to 12 | 10 x 10 seconds | 10 | Standing, plus the knack during daily tasks | 3 |
Each session takes about five minutes. Link the sessions to things you do every day anyway, such as brushing your teeth, your first coffee and getting into bed, because pelvic floor exercises are easy to forget. The Workout Streak Tracker works well for ticking them off.
If a step feels hard, stay on it for another week. There is no prize for speed.
Pelvic floor breathing exercises
Your pelvic floor and your diaphragm, the main breathing muscle, work as a pair. When you breathe in, the diaphragm moves down and the pelvic floor gently stretches down with it. When you breathe out, both rise. Research measuring muscle activity has shown that the pelvic floor is active during normal breathing and adjusts to changes in breathing and posture.
Pelvic floor breathing exercises use that link. They are a good warm-up for the squeezes and a good way to learn to relax the muscles.
1. Diaphragmatic breathing
- Lie on your back with your knees bent, one hand on your chest and one on your belly
- Breathe in slowly through your nose, letting the belly and the lower ribs widen. The chest hand barely moves
- Feel the pelvic floor soften and drop slightly
- Breathe out slowly through pursed lips
Do 5 to 10 slow breaths.
2. Breathe out and lift
- Breathe in and let the belly and pelvic floor relax
- As you breathe out, gently squeeze and lift the pelvic floor
- Breathe in and let it go completely
Do 8 to 10 breaths. This pairs the squeeze with the natural rise of the breath.
3. Long exhale relaxation
Breathe in for a count of four and out for a count of six to eight, focusing only on letting the pelvic floor, the buttocks and the jaw soften. This one is especially useful if your pelvic floor tends to feel tight.
Pilates pelvic floor exercises
Pilates is often recommended for the pelvic floor, and it has real value, but it is worth knowing what the evidence says.
A systematic review looked at whether general exercise methods, including Pilates and hypopressive exercises, strengthened the pelvic floor on their own. They did not, unless they were combined with specific pelvic floor muscle training. The specific squeezes remain the core of any plan.
So the best way to use Pilates pelvic floor exercises is to add a deliberate pelvic floor squeeze to each move. Done that way, a randomised trial in postmenopausal women with stress urinary incontinence found no difference between a Pilates programme and standard pelvic floor muscle training, provided the women deliberately contracted the pelvic floor during the Pilates moves.
1. Bridge with a pelvic floor lift
- Lie on your back, knees bent, feet hip-width apart
- Breathe in to prepare
- Breathe out, squeeze and lift the pelvic floor, then lift your hips
- Hold for two breaths, keeping the squeeze
- Lower slowly and let the pelvic floor relax
Sets and reps: 2 sets of 8 to 10.
Our glute bridge vs hip thrust guide covers bridge technique in detail.
2. Pelvic tilt
- Lie on your back with knees bent
- Breathe out, gently squeeze the pelvic floor and flatten your lower back into the floor by tilting the pelvis
- Breathe in and return to neutral
Sets and reps: 2 sets of 10.
3. Heel slides
- Lie on your back, knees bent
- Breathe out, lift the pelvic floor and slowly slide one heel away until the leg is straight
- Breathe in and slide it back
- Alternate legs, keeping the pelvis still
Sets and reps: 2 sets of 6 per leg.
4. Clamshell
- Lie on your side, hips and knees bent, heels together
- Breathe out, lift the pelvic floor and open the top knee without rolling the hips back
- Breathe in and close
Sets and reps: 2 sets of 10 per side. See our clamshell exercise guide for form tips.
5. Bird dog
- Kneel on all fours
- Breathe out, lift the pelvic floor and reach one arm forward and the opposite leg back
- Hold for a breath, then return
Sets and reps: 2 sets of 6 per side.
6. Dead bug, toe taps version
- Lie on your back with knees bent at 90 degrees above your hips
- Breathe out, lift the pelvic floor and lower one foot to tap the floor
- Breathe in and return
Sets and reps: 2 sets of 6 per leg.
Our guide to transverse abdominis exercises explains how the deep abdominal muscle works with the pelvic floor.
Whole-body exercises that support the pelvic floor
Once the basic squeezes are comfortable, bring the pelvic floor into bigger movements.
| Exercise | How to involve the pelvic floor | Note |
|---|---|---|
| Squats | Lift the pelvic floor as you stand up | Breathe out on the way up |
| Glute bridges | Lift before the hips rise | Covered above |
| Wall sits | Gentle lift during the hold | Keep breathing |
| Walking | No squeeze needed | Regular walking supports general fitness and weight |
| Lifting objects | Use the knack before the lift | Breathe out as you lift |
| Inner thigh squeezes | Squeeze a cushion between the knees with a gentle pelvic floor lift | See our inner thigh exercises |
Our beginner core workout is a good next step, done with the same breathe-out-and-lift pattern.
Pelvic floor therapy exercises: when to see a specialist
Pelvic floor therapy is treatment from a physiotherapist who specialises in the pelvic floor, sometimes called a pelvic health or women’s health physiotherapist. Pelvic floor therapy exercises are tailored to you after an assessment, rather than the general routine in this guide.
When to book an appointment
- You cannot feel the muscles working, even after practising
- You have done pelvic floor exercises regularly for three months with no improvement
- You have pelvic pain, pain during sex or pain when emptying your bladder or bowel
- You feel heaviness, a bulge or dragging in the vagina
- Leaking is getting worse, or you have started leaking from the bowel
- You are a man with leaking after prostate surgery
What a pelvic health physiotherapist does
| Part of the appointment | What happens |
|---|---|
| Questions | About symptoms, bladder and bowel habits, pregnancy, surgery and exercise |
| Assessment | Checking how well the muscles contract and relax, often with an internal examination if you agree to it |
| Biofeedback | Sometimes a small sensor shows on a screen how hard the muscles are working |
| Personal plan | Pelvic floor therapy exercises set at the right hold time, number and position for you |
| Follow-up | Reviews to progress the plan |
A Cochrane review comparing different approaches to training found that direct training, meaning sets of deliberate, isolated pelvic floor squeezes, may improve quality of life slightly more than indirect training through general exercise. Whether the supervision happened one to one or in a group probably made little difference. What matters is that someone checks you are doing the right squeeze.
When the pelvic floor is too tight
Some people have a pelvic floor that is overactive: it stays tense and struggles to relax. Symptoms can include pelvic pain, pain during sex, constipation and difficulty starting to pass urine. Strengthening squeezes can make this worse. The focus is on relaxation, breathing and gentle stretching instead, and it should be guided by a professional.
This article is general information, not medical advice. See a doctor or pelvic health physiotherapist if you have pelvic pain, a feeling of heaviness or a bulge, blood in your urine or stools, leaking that is getting worse, or any new bladder or bowel symptoms. See our medical disclaimer.
Pelvic floor exercises for men
Men often assume this topic is not for them. It is.
- After prostate surgery. Leaking is common at first. Many surgeons recommend starting pelvic floor exercises before the operation and continuing afterward, under guidance
- Dribbling after urinating. A strong squeeze straight after you finish helps empty the urethra
- Heavy lifting and high-impact sport. A strong, responsive pelvic floor handles pressure better
- Ageing. Like other muscles, the pelvic floor weakens over time without use
The method is the same as above. The most helpful cue is to imagine pulling the base of the penis back toward the body and lifting the scrotum.
Pelvic floor exercises for women
During pregnancy and after birth
Pelvic floor exercises are generally recommended throughout pregnancy and can usually be restarted gently soon after a straightforward birth. After a caesarean or a difficult birth, or if you have stitches, follow the advice of your midwife or doctor about when to begin.
Around menopause
Hormone changes can make leaking and urgency more likely. Regular pelvic floor exercises are a sensible first step, alongside a conversation with your doctor about other options.
With mild prolapse
Prolapse is when one of the pelvic organs drops down into the vagina. A large multicentre trial found that women with prolapse who received individualised pelvic floor muscle training from a physiotherapist reported fewer symptoms than women who were only given a leaflet.
If you think you have a prolapse, get it assessed first, so the plan suits you.
Pelvic floor exercises and your other training
If you lift weights, run or do high-impact workouts, your pelvic floor is working hard.
- Breathe out on the effort of each lift, instead of holding your breath and bearing down
- Use the knack before heavy lifts
- Build impact gradually after pregnancy or a long break. Walking before jogging, jogging before jumping
- Stop if you leak during an exercise, and choose a lower-impact version for now. Our low-impact workout for beginners has options
- Do not do sit-ups to fix leaking. They raise pressure on the pelvic floor without training it
How long until pelvic floor exercises work?
| Timescale | What usually happens |
|---|---|
| 2 to 4 weeks | Better awareness. The squeeze feels easier to find |
| 6 to 8 weeks | Longer holds. Some people notice less leaking |
| About 12 weeks | A clear improvement for many people with mild symptoms |
| After that | Keep going a few times a week to maintain the gains |
These are typical patterns rather than guarantees. If nothing has changed after three months of regular practice, see a pelvic health physiotherapist.
Common mistakes
- Squeezing the buttocks, thighs or stomach instead of the pelvic floor
- Holding your breath during the squeeze
- Bearing down (pushing out) instead of lifting up
- Not relaxing fully between squeezes
- Doing too many too soon, which tires the muscles and can cause aching
- Stopping the flow of urine as a regular exercise
- Giving up after two weeks. These muscles take months to change
- Doing only slow holds, or only quick squeezes, instead of both
- Training a tight pelvic floor with more squeezes when it needs to relax
A 10-minute daily routine
| Part | What to do | Time |
|---|---|---|
| Breathing | 5 slow diaphragmatic breaths, then 8 breathe-out-and-lift breaths | 2 minutes |
| Slow holds | 10 holds, as long as you can manage up to 10 seconds, with equal rest | 3 minutes |
| Quick squeezes | 10 quick squeezes, then rest, then 10 more | 1 minute |
| Movement | Bridge with a lift x 8, pelvic tilt x 10, clamshell x 10 per side | 4 minutes |
Do the full routine once a day, and short sets of squeezes at two other times. If you like having a plan on paper, our printable workouts page is a good model to copy.
The bottom line
Pelvic floor exercises strengthen the sling of muscles that supports your bladder and bowel. They are well supported by research, especially for leaking when you cough or sneeze, and they are just as relevant for men as for women.
Find the right muscles first. Then do slow holds and quick squeezes, three times a day, letting go fully after each one. Use pelvic floor breathing exercises to learn the rhythm, and Pilates pelvic floor exercises and everyday movements to put it to work. Give it about 12 weeks.
If you have pain, heaviness, worsening symptoms or no improvement after three months, book an appointment for pelvic floor therapy exercises with a specialist physiotherapist. Getting the right muscles working is far easier with someone to check.
Frequently asked questions
How do I do pelvic floor exercises correctly?
Squeeze the muscles you would use to stop passing wind and to stop the flow of urine, and lift them upward and inward. Keep breathing and keep your buttocks and stomach relaxed. Hold, then let go fully. Do slow holds and quick squeezes, three times a day.
How long does it take for pelvic floor exercises to work?
Most people need about 12 weeks of regular practice to notice a clear improvement. Awareness and control often improve within the first few weeks. If nothing has changed after three months, see a pelvic health physiotherapist.
Can men do pelvic floor exercises?
Yes. Men have a pelvic floor too, and the exercises help with dribbling after urinating, leaking after prostate surgery and general bladder control. The cue is to pull the base of the penis back toward the body and lift the scrotum.
How many pelvic floor exercises should I do a day?
A common target is 10 slow holds of up to 10 seconds and 10 quick squeezes, three times a day. Beginners can start with fewer and shorter holds and build up over several weeks.
What are pelvic floor therapy exercises?
They are pelvic floor exercises set by a specialist physiotherapist after assessing how your muscles contract and relax. They may include biofeedback, specific hold times and positions, and relaxation work if the muscles are too tight.
Do pilates pelvic floor exercises work?
Pilates helps when it is combined with a deliberate pelvic floor squeeze in each movement. On its own, general exercise does not reliably strengthen the pelvic floor, so the specific squeezes should stay at the centre of your routine.
What are pelvic floor breathing exercises?
They use the link between the diaphragm and the pelvic floor. The pelvic floor relaxes as you breathe in and lifts as you breathe out. Practising slow breathing with a gentle lift on the out-breath helps you find, train and relax the muscles.
Can pelvic floor exercises make things worse?
They can if your pelvic floor is already too tight, or if you squeeze the wrong muscles or overdo it. Pain, heaviness or worsening symptoms are signs to stop and see a doctor or pelvic health physiotherapist.
What’s next?
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