How to do kegels right: steps, mistakes and a 12-week plan for women

Why kegels matter

Your pelvic floor is a hammock of muscles at the base of your pelvis. It supports your bladder, uterus and bowel, helps keep you dry when you cough or jump, and plays a part in sexual sensation. Pregnancy, birth, menopause, heavy lifting, chronic cough and constipation can all make it weaker or slower to react.

Kegels — also called pelvic floor muscle training — are the most studied way to train these muscles. A Cochrane review, which pools randomized trials, found that women with stress leaking who did pelvic floor training were eight times more likely to report that their leaking had stopped than women who did no training. That’s why NICE, the UK body that writes clinical guidelines, recommends supervised pelvic floor training as the first step for stress and mixed leaking.

How to find the right muscles

Try one of these, sitting or lying down:

• Gas: imagine you’re trying to stop yourself from passing gas. Squeeze the muscles you’d use. You should feel a pull around the anus.
• Pee: imagine stopping your urine midstream. Those are the muscles around the urethra and vagina. (You can try this once on the toilet to find them, but don’t practice it regularly while you pee.)
• Close and lift: put both together — close the front and back passages, then draw them up and in, as if picking up a marble.

You shouldn’t feel your belly pull in hard, your glutes clench, your thighs squeeze together, or your breath stop. A small movement inside is all it takes.

How to do a kegel, step by step

1. Get set. Empty your bladder. Lie on your back with knees bent, or sit upright.
2. Breathe in and let your belly relax.
3. Squeeze and lift as you breathe out: close the back and front passages and draw them up and in.
4. Hold for as long as you can keep a good squeeze — start with 3–5 seconds. Keep breathing normally.
5. Let go fully. Relax for at least as long as you held — feel the muscles drop back down.
6. Repeat. Then do a set of quick squeezes: squeeze and lift fast and strong, then let go right away.

NHS leaflets describe building up to holds of up to 10 seconds, up to 10 times, plus a set of quick squeezes. NIDDK suggests doing them in three positions — lying, sitting and standing — to train the muscles for real life.

Common mistakes

In a classic 1991 study, only 49% of women who got brief verbal instructions did an ideal kegel, and 25% did it in a way that could actually make leaking worse. So it’s worth checking:

Mistake	What happens	Fix
Pushing down instead of lifting	Adds pressure on the bladder and pelvic organs	Think “close and lift”, not “push out”. Try it lying down first
Squeezing glutes, thighs or belly	The pelvic floor does less of the work	Put a hand on your belly and glutes; keep them soft
Holding your breath	Raises pressure in the belly	Count out loud or breathe normally during the hold
Not relaxing between squeezes	Muscles get tired and tense, sometimes painful	Rest at least as long as you squeeze
Doing hundreds a day	Fatigue, soreness, sometimes more tension	Fewer, better-quality squeezes
Only doing them lying down	Muscles don’t learn to work when you’re upright	Progress to sitting, standing and moving

A 12-week progression

Start where you are. The strength self-test gives you a baseline hold time and number of quick squeezes.

Weeks	Slow holds	Quick squeezes	Position	Add
1–2	8 × 3–5 seconds, full rest between	8	Lying down	Technique check; find a daily anchor (brushing teeth, feeding the baby)
3–4	8–10 × 5–6 seconds	8–10	Lying and sitting	Use “the knack”: squeeze before you cough, sneeze or lift
5–8	10 × 6–8 seconds	10	Sitting and standing	Squeeze during everyday movements — standing up, picking up bags
9–12	10 × up to 10 seconds	10	Standing and moving	Squeezes during squats, lunges or before a jump
12+	Maintain 3–5 days a week	10	All positions	Keep it up for life, like brushing your teeth

Do each session up to 3 times a day. The kegel timer paces holds and rests with sound and vibration, and the printable 30-day plan is handy for the fridge.

How long until you notice a difference

Everyone is different. Some women feel stronger or leak less within a few weeks; for others it takes longer. NICE recommends at least 3 months of supervised training before deciding whether it’s working. If nothing has changed by then, or you’re not sure you’re doing it right, that’s the time to see a pelvic health physical therapist — not to give up.

When kegels aren’t the right place to start

Kegels strengthen. That helps when the pelvic floor is weak. But some women’s pelvic floor is already tense — “hypertonic” — and adding more squeezing can make things worse. NICE’s guideline says pelvic floor programs should be tailored to a woman’s ability to both contract and relax the muscles and to any discomfort she feels.

Consider relaxing first if you have:

• pain with sex, tampons, menstrual cups or exams
• pelvic, hip, low back or tailbone aching, worse after sitting
• a slow stream, trouble starting to pee, or feeling you haven’t emptied
• constipation or straining
• more pain or symptoms after starting kegels

If that sounds like you, read about reverse kegels for women and pelvic pain and a tight pelvic floor.

Kegels at different stages of life

• Pregnancy: NICE guidance encourages pelvic floor training during pregnancy; if you have complications, check with your midwife or doctor first. Pair every squeeze with a full release — you’ll need to let go during birth too.
• After birth: start gently in the first days if it’s comfortable and any catheter is out, then build up over months. See your pelvic floor after birth.
• Perimenopause and menopause: hormonal changes affect pelvic tissues, and leaking or urgency can appear for the first time. Training still works at any age; a doctor can also discuss vaginal estrogen if dryness or urgency is part of the picture.
• Active women: leaking with running, jumping or heavy lifts is common even without children. Train the muscles in the positions you use in sport — see leaking during exercise.

Where to go next

• Leaking when you sneeze, cough or laugh: stress incontinence
• Recently had a baby: your pelvic floor after birth
• Leaking on runs, jumps or heavy lifts: leaking during exercise

Frequently asked questions

How many kegels should I do a day?

NICE guidance for women with stress or mixed leaking describes programs of at least 8 contractions, 3 times a day. Many NHS leaflets suggest building up to 10 slow holds of up to 10 seconds plus 10 quick squeezes. Quality matters more than numbers — a few correct squeezes beat 100 rushed ones.

Do kegels actually work?

For stress leaking, yes: they're the most studied first step. A Cochrane review of randomized trials found women with stress leaking who did pelvic floor training were eight times more likely to report their leaking had stopped than women who did no training. Technique matters, and NICE advises at least 3 months before judging results.

How long do kegels take to work?

It varies. Some women notice fewer leaks within a few weeks, but muscles take time to change. NICE recommends at least 3 months of training before judging whether it's working, so give it a fair trial.

How do I know if I'm doing kegels right?

You should feel a squeeze and a lift inside, around the vagina and anus, without your belly, glutes or thighs tightening and without holding your breath. After each squeeze, you should feel a clear release. If you can't tell, a pelvic health physical therapist can check with an exam or biofeedback.

Can I do kegels while peeing?

Stopping your stream once can help you find the muscles, but don't use it as a regular exercise. Repeatedly stopping and starting while you pee can interfere with normal bladder emptying. Do your kegels with an empty bladder at other times.

Are kegels good for everyone?

Not as a first step for everyone. If you have pelvic pain, pain with sex, trouble emptying, or kegels made things worse, your pelvic floor may be too tight. In that case, learning to relax comes first — see reverse kegels — and strength work comes later.

Sources

1. Urinary incontinence and pelvic organ prolapse in women: management (NG123) — NICE
2. Pelvic floor dysfunction: prevention and non-surgical management (NG210) — NICE, 2021
3. Kegel exercises — NIDDK
4. Assessment of Kegel pelvic muscle exercise performance after brief verbal instruction — American Journal of Obstetrics & Gynecology (Bump et al.), 1991
5. Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women — Cochrane (Dumoulin et al.), 2018
6. Pelvic floor exercises — South Tees Hospitals NHS Foundation Trust

This page is general education about exercise, not a diagnosis or treatment plan. Talk to a clinician about symptoms that are new, severe or getting worse.