Everyone Says Do Kegels. Sometimes Your Pelvic Floor Needs the Opposite.

Written by: VibeSequence Editorial Team · Research-based sexual wellness education
Sources reviewed: peer-reviewed research and recognized health organizations · Last reviewed: September 2026

“Do your Kegels” is advice almost every woman hears at some point: after childbirth, at a checkup, from an app. For many people it’s good advice. But the pelvic floor isn’t only built to squeeze. It also has to let go. For some people, especially those whose main problem is pain rather than leaking, more squeezing may be the wrong direction.

Here’s what Kegel exercises can and can’t do, how to do them properly, and how to tell when it’s time to stop training on your own.

The short answer

• Strongest evidence: Kegels (pelvic floor muscle training) have the strongest evidence for stress urinary incontinence, meaning leaking when you cough, sneeze, laugh or exercise. Clinical guidelines also recommend them for stress and mixed urinary incontinence.
• Not automatically right for everyone: Clinicians caution against too much, or inappropriate, strengthening when the pelvic floor muscles are already overactive and don’t relax well.
• If your main symptom is pain: Learning to relax the pelvic floor, with proper assessment, may matter more than doing more reps.

What Kegel exercises actually are

Kegel exercises, also called pelvic floor exercises, involve tightening and then releasing the muscles of your pelvic floor. These muscles support the bladder, bowel and vagina and help with peeing, pooping and sex.

A Mayo Clinic review notes that Kegels were originally developed to treat urinary incontinence. The same review points out that peeing, bowel movements and sex all require the pelvic floor muscles to relax and coordinate, not just contract. That second job is the part most Kegel advice leaves out.

What the evidence actually supports

What the research shows

• Stress urinary incontinence: A Cochrane review included 31 trials and 1,817 women overall. For the cure result, the evidence came from a smaller subset of 4 trials and 165 women with stress incontinence: those who did pelvic floor muscle training were about eight times more likely to report being cured than those who had no treatment (56% vs 6%). The review rated this as high-quality evidence.
• Any type of urinary incontinence: In the same review, a subset of 3 trials and 290 women with any type of incontinence found that training made women about five times more likely to report cure (35% vs 6%). This was rated moderate-quality evidence. Across the review, adverse events were rare and minor.
• Clinical guidelines: The UK’s NICE guideline recommends a supervised pelvic floor muscle training programme of at least 3 months as first-line treatment for women with stress or mixed urinary incontinence.
• Pregnancy, as prevention: In pregnant women who did not have leakage at the start, doing pelvic floor training during pregnancy probably lowered the risk of reporting leakage in late pregnancy by 62% (moderate-quality evidence). This finding is about prevention only. The same review found no evidence that training during pregnancy treats leakage that already exists, and no evidence of a difference 6 to 12 months after birth for women with ongoing postnatal leakage.
• Pelvic organ prolapse: A Cochrane review found that three trials all showed greater improvement in prolapse symptoms with pelvic floor training than without it. The trials were small, and some had a high risk of bias.

What this likely means

If your main problem is leaking when you cough, sneeze or exercise, Kegels are a well-supported first step. For other goals, including sexual function, the evidence is weaker or less clear.

How to do a Kegel correctly

These steps follow MedlinePlus, the U.S. National Library of Medicine’s health site, and Cleveland Clinic.

1. Find the muscles. Imagine you’re trying to stop yourself from passing gas, or holding in pee. MedlinePlus also describes stopping your urine midstream to identify the muscles, but warns not to practise Kegels while urinating more than twice a month. Treat that as a one-time check at most, never as your workout.
2. Get comfortable. Empty your bladder, then sit or lie down. If your muscles are weak, lying down may be easier at first.
3. Squeeze and lift. Tighten the muscles and hold for 3 to 5 seconds.
4. Fully let go. Relax for 3 to 5 seconds before the next squeeze.
5. Keep everything else quiet. Breathe normally and keep your stomach, thigh and buttock muscles relaxed.

Kegels shouldn’t hurt. If your stomach, lower back or head hurts afterward, Cleveland Clinic says you’re probably holding your breath or clenching the wrong muscles.

Our interpretation: Relaxation isn’t just dead time between contractions. Healthy pelvic-floor function depends on being able to contract and relax in a coordinated way.

How often, and when to expect results

Reputable sources give similar but not identical advice:

• MedlinePlus: 10 repetitions, 3 times a day. You should have fewer symptoms after 4 to 6 weeks, though incontinence can take several months to improve. MedlinePlus also advises not to keep increasing the number, because overdoing it can lead to straining when you pee or have a bowel movement.
• Cleveland Clinic: Start with 10 squeezes of 3 seconds, twice a day, and build up gradually. Expect results after 6 to 8 weeks.
• NICE (for treating incontinence): At least 8 contractions, 3 times a day, as part of a supervised programme lasting at least 3 months, and continued if it helps.

Our interpretation: steady, moderate practice over weeks to months matters more than intensity. More isn’t better.

Five common mistakes

1. Practising while you pee. Doing the exercises while urinating can weaken the pelvic floor over time or damage the bladder and kidneys, according to MedlinePlus.
2. Pushing down instead of lifting. In one small 1991 study of 47 women, only 49% did an ideal Kegel after brief verbal instruction, and 25% used a technique that could potentially promote incontinence. The study is small and old, so it can’t tell us how common this is today. But its authors concluded that simple verbal or written instruction alone wasn’t adequate preparation.
3. Holding your breath or clenching other muscles. Squeezing your buttocks, stomach or thighs, or squeezing so hard you hold your breath, means the exercise isn’t being done correctly.
4. Overdoing it. MedlinePlus notes that in women, doing Kegels incorrectly or with too much force may cause the vaginal muscles to tighten too much, which can cause pain during sex.
5. Skipping the release. Rushing from one squeeze to the next leaves out the relaxation that the pelvic floor also needs for normal function.

Kegels and sex: possible, but uncertain

What the research shows

A 2024 systematic review looked at 21 randomized trials of pelvic floor muscle training for female sexual dysfunction. A meta-analysis of four of those trials found improvements in arousal, orgasm, satisfaction and pain scores. However, the reviewers rated the certainty of that evidence as very low, because the studies differed a lot from one another.

What this likely means

Better sexual function is a possible benefit, not a promise. Kegels aren’t a proven way to get stronger orgasms, to make the vagina “tighter,” or to improve sexual performance. As mistake #4 above shows, squeezing too hard can even contribute to pain during sex.

Weak vs. too-tight: two different problems

What the research shows

Some pelvic floor problems come from muscles that don’t relax well. A Mayo Clinic review calls this nonrelaxing pelvic floor dysfunction. Its symptoms can include pain and problems with bowel movements, urination and sex. Cleveland Clinic describes a similar picture, a hypertonic pelvic floor, in which the pelvic muscles are continuously contracting.

These patterns can overlap, and symptoms alone can’t tell you whether your pelvic floor is weak, overactive, or both.

Possible patterns, not a diagnosis:

Leaking isn’t only a “weak” symptom. A pelvic health physical therapist quoted by Nebraska Medicine lists leaking when sneezing, coughing, laughing or running among possible symptoms of a hypertonic pelvic floor, too.

When Kegels can be the wrong approach

What clinicians and health organizations say

• MedlinePlus warns that overdoing Kegels can lead to straining, and that too much force may tighten the vaginal muscles too much.
• A pelvic health physical therapist quoted by Nebraska Medicine says that doing too many Kegels, or doing them incorrectly, may increase muscle tension and pain, or worsen symptoms.
• The Mayo Clinic review says instruction on relaxation and overall pelvic floor function is equally important, and recommends early referral to physical therapy for nonrelaxing pelvic floor dysfunction.
• For a hypertonic pelvic floor, Cleveland Clinic describes physical therapy that teaches you to both contract and relax the muscles as the primary treatment, using biofeedback, relaxation techniques and stretching.

What we don’t know

No randomized trials have directly tested whether Kegels make an overactive pelvic floor worse. This caution comes from clinical guidance and professional experience, not from trial evidence.

There is trial evidence that pelvic floor physical therapy can help some pelvic pain conditions. In a trial of 212 women with provoked vestibulodynia (pain at the vaginal opening), a program of education, pelvic floor exercises with biofeedback, manual therapy and dilation was more effective than a numbing cream for reducing pain during sex. That study shows the value of expert-guided therapy. It doesn’t test Kegels on their own.

Our interpretation:

• If Kegels themselves increase your pain, stop doing them on your own and get assessed.
• If pain is your main symptom (rather than leaking), get assessed before starting, increasing or intensifying Kegel training.

Pain alone doesn’t mean your pelvic floor is overactive. It can have many causes, which is exactly why an assessment matters.

When to stop and see a pelvic floor physical therapist

Consider stopping self-training and talking to a clinician or pelvic floor physical therapist if:

• Kegels hurt or make your symptoms worse. They shouldn’t cause pain.
• Nothing changes after several weeks of consistent practice. A pelvic health physical therapist recommends specialist help if your symptoms don’t change with practice.
• You’re not sure you’re doing them right. Your provider can check your technique and may refer you to a specialist physical therapist.
• You have pain with sex, tampons or pelvic exams. A pelvic health physical therapist lists pain with any type of penetration among the signs worth specialist help.
• You strain to pee or have a bowel movement. Difficulty with urination and bowel movements can be part of nonrelaxing pelvic floor dysfunction, and MedlinePlus notes that overdoing Kegels can itself lead to straining.
• You feel heaviness or a bulge in your vagina, which can be a sign of pelvic organ prolapse.
• Leaking is affecting your life. Guidelines recommend a supervised programme rather than going it alone.

This article is for general education and isn’t a substitute for personal medical advice.

The bottom line

Kegels are one of the best-supported first steps for stress urinary incontinence. But a healthy pelvic floor needs to relax as well as contract. If Kegels hurt, if your main symptom is pain, or if nothing changes, the answer may not be more squeezing. It may be learning to let go, with the right guidance.

Related reading

• Can a Vibrator Cause a UTI, BV or a Yeast Infection?
• Can a Vibrator Cause Desensitization or Nerve Damage?
• The Quiet Truth About Female Pleasure: Why Permission Matters

Sources

• Dumoulin, C., Cacciari, L. P., & Hay-Smith, E. J. C. (2018). Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women. Cochrane Database of Systematic Reviews, CD005654. PMC
• National Institute for Health and Care Excellence (2019). Urinary incontinence and pelvic organ prolapse in women: management (NG123), recommendations
• Woodley, S. J., Lawrenson, P., Boyle, R., Cody, J. D., Mørkved, S., Kernohan, A., & Hay-Smith, E. J. C. (2020). Pelvic floor muscle training for preventing and treating urinary and faecal incontinence in antenatal and postnatal women. Cochrane Database of Systematic Reviews, CD007471. PubMed
• Hagen, S., & Stark, D. (2011). Conservative prevention and management of pelvic organ prolapse in women. Cochrane Database of Systematic Reviews, CD003882. PubMed
• Bump, R. C., Hurt, W. G., Fantl, J. A., & Wyman, J. F. (1991). Assessment of Kegel pelvic muscle exercise performance after brief verbal instruction. American Journal of Obstetrics and Gynecology, 165(2), 322–327. PubMed
• Faubion, S. S., Shuster, L. T., & Bharucha, A. E. (2012). Recognition and management of nonrelaxing pelvic floor dysfunction. Mayo Clinic Proceedings, 87(2), 187–193. PMC
• Jorge, C. H., Bø, K., Chiazuto Catai, C., Oliveira Brito, L. G., Driusso, P., & Kolberg Tennfjord, M. (2024). Pelvic floor muscle training as treatment for female sexual dysfunction: A systematic review and meta-analysis. American Journal of Obstetrics and Gynecology, 231(1), 51–66.e1. PubMed
• Morin, M., Dumoulin, C., Bergeron, S., et al. (2021). Multimodal physical therapy versus topical lidocaine for provoked vestibulodynia: A multicenter, randomized trial. American Journal of Obstetrics and Gynecology, 224(2), 189.e1–189.e12. PubMed
• MedlinePlus, U.S. National Library of Medicine. Kegel exercises: self-care
• Cleveland Clinic. Kegel Exercises
• Cleveland Clinic. Hypertonic Pelvic Floor
• Nebraska Medicine (2025). Can you do too many Kegels? What to know about hypertonic pelvic floor