Pelvic floor (Kegel) exercises: how to do them correctly

The pelvic floor is a sling of muscles at the base of the pelvis. It supports the bladder, womb and bowel, helps keep you dry, and tightens automatically when you cough or lift. Pregnancy, childbirth, menopause, long-term constipation, chronic cough and heavy lifting can all weaken it.

When these muscles are weak, you may leak urine when you cough, laugh, sneeze or exercise, feel heaviness in the vagina, or find it hard to hold wind. These problems are common, but they are not a normal part of ageing or motherhood that you have to accept.

Sit or lie comfortably with your thighs, bottom and tummy relaxed. Imagine you are trying to stop yourself passing wind, and at the same time stop the flow of urine. The feeling is a squeeze and a lift inside, upwards and forwards. Your bottom and thighs should stay still.

You can check once by trying to slow the flow of urine on the toilet, but do not do this regularly as an exercise, because it can upset normal bladder emptying.

If you are not sure whether you are doing it right, that is very common. A physiotherapist can guide you with simple self-checks.

Slow squeezes: tighten and lift the pelvic floor, hold for as long as you can up to 10 seconds, then relax fully for the same length of time. Repeat up to 10 times. Start with whatever you can manage, even if it is 3 seconds and 4 repetitions, and build up.

Quick squeezes: tighten and lift quickly, then let go straight away. Repeat up to 10 times. These help the muscles react fast when you cough or sneeze.

Do both sets three times a day. UK clinical guidelines recommend at least eight squeezes, three times a day, for at least three months before judging whether pelvic floor training has worked.

Start lying down or sitting, then progress to standing, and finally to squeezing during everyday activities.

Pushing down instead of lifting up. This is surprisingly common and can make symptoms worse. The movement should feel like a lift, never a bearing down.

Holding your breath, or squeezing your bottom, thighs or tummy hard instead. Breathe normally throughout.

Not relaxing fully between squeezes. Relaxing matters as much as squeezing.

Doing too many too soon, so the muscles tire and the exercises feel like they are not working. Quality matters more than quantity.

Stopping after a few weeks. Muscles take time to strengthen, and most women need around three months of regular practice to see the full benefit.

Once you can contract the pelvic floor well, practise tightening it just before you cough, sneeze, laugh or lift something. Over time this becomes automatic, and for many women it quickly reduces leakage during these moments.

Some women have pelvic floor muscles that are too tight rather than too weak. This can cause pelvic pain, pain during intercourse, difficulty emptying the bladder or constipation. Strengthening exercises can make these problems worse. If you have pelvic pain, see a physiotherapist before starting Kegels.

See a doctor first for blood in your urine, burning, being unable to pass urine, bleeding after menopause, or a lump you can see or feel at the vaginal opening.