Do Kegel exercises help with urinary incontinence?
Yes, when done correctly. Kegel exercises strengthen the pelvic floor muscles that support your bladder and urethra. They help most with mild to moderate stress incontinence. Technique matters, because many women do Kegels incorrectly when they learn from written or verbal instructions alone.
How Kegels help
The pelvic floor muscles wrap around the urethra and vagina like a sling. When these muscles are strong and well-coordinated, they help keep the urethra sealed during coughing, sneezing, and physical activity. Kegel exercises train these muscles to contract more effectively and with better timing.
Getting the technique right
The most common mistakes:
- Bearing down instead of lifting. You should feel a lift and squeeze, not a pushing sensation.
- Using the wrong muscles, like squeezing your buttocks, thighs, or abdomen instead of the pelvic floor.
- Holding your breath. You should breathe normally throughout the exercise.
- Only doing quick squeezes. You need both quick contractions and sustained holds.
A pelvic floor physical therapist can use biofeedback to show you which muscles to use and to track your progress objectively.
When Kegels aren’t enough
Kegel exercises work best for mild to moderate stress incontinence. They may be less effective for:
- Severe stress incontinence, where significant structural support has been lost
- Urge incontinence, which involves involuntary bladder muscle contractions (though pelvic floor therapy can still help as part of a broader treatment plan)
- Pelvic floor muscle tension. Some women have overactive pelvic floor muscles that need to learn to relax before strengthening.
Dr. Stewart’s perspective
“Dr. Kegel didn’t just get famous because he invented an exercise; he also invented a device to let women know if they were doing it correctly. That’s why I recommend working with a pelvic floor physical therapist. They can confirm you’re using the right muscles, and just as importantly, Kegel exercises are only part of the picture. A good PT will also work on core, breathing, bracing, and improving function of the surrounding structures like your hips, buttocks, and thighs. All of that is critical.”
“If you’ve been doing Kegels faithfully for three months and aren’t seeing improvement, don’t get discouraged. It doesn’t mean nothing will work — it means we need to explore other options.”
References
- Nygaard IE, Heit M. Stress Urinary Incontinence. Obstetrics & Gynecology. 2004. doi:10.1097/01.AOG.0000137874.84862.94
- Wu JM. Stress Incontinence in Women. New England Journal of Medicine. 2021. doi:10.1056/NEJMcp1914037
- Lukacz ES, Santiago-Lastra Y, Albo ME, et al. Urinary Incontinence in Women: A Review. JAMA. 2017. doi:10.1001/jama.2017.12137
- ACOG Committee on Practice Bulletins—Gynecology, American Urogynecologic Society, Kenton KS, et al. Urinary Incontinence in Women (ACOG Practice Bulletin No. 155). Obstetrics & Gynecology. 2015. doi:10.1097/AOG.0000000000001148
- Ashton-Miller JA, Howard D, DeLancey JOL. The Functional Anatomy of the Female Pelvic Floor and Stress Continence Control System. Scandinavian Journal of Urology and Nephrology Supplementum. 2001.
- DeLancey JOL. The pathophysiology of stress urinary incontinence in women and its implications for surgical treatment. World Journal of Urology. 1997.
- Harm-Ernandes I, Boyle V, Hartmann D, et al. Assessment of the Pelvic Floor and Associated Musculoskeletal System: Guide for Medical Practitioners. Female Pelvic Medicine & Reconstructive Surgery. 2021. doi:10.1097/SPV.0000000000001121
- Moody CC, Fashokun TB. Painful Bladder Syndrome/Interstitial Cystitis and High Tone Pelvic Floor Dysfunction. Obstetrics and Gynecology Clinics of North America. 2021. doi:10.1016/j.ogc.2021.05.010
- Bo K, Frawley HC, Haylen BT, et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for the conservative and nonpharmacological management of female pelvic floor dysfunction. International Urogynecology Journal. 2017. doi:10.1007/s00192-016-3123-4
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