How to do pelvic floor exercises

What is the pelvic floor?

The pelvic floor is the set of sling-like muscles at the base of your pelvis that supports your uterus, bladder and bowel – effectively keeping them all in place. During pregnancy and labour, these muscles are put under a lot of strain.

Where is the pelvic floor?

If you’re scratching your head, see the diagram below.

What happens to your pelvic floor during pregnancy?

Your pelvic floor goes through a tremendous amount of strain in pregnancy. The muscles can become stretched and weak because of the continual weight. As your baby grows bigger, the amount of pressure put on it gets larger, making it harder for it to do its job of preventing incontinence, treating prolapse and improving sex.

Childbirth compounds these problems and can do some real damage to the pelvic floor. Nearly a third of women develop some level of stress incontinence after giving birth and for some the problems persist long after the days of stretch mark cream and pregnancy tests.

Many women can testify to the effects of this and what happens when your pelvic area is put under stress, such as when you sneeze, laugh, cough, run, or have a few too many wines and clamber onto the kids' trampoline.

I didn't do pelvic floor exercises during pregnancy. Trampolines now fill me with fear and when I sneeze I automatically cross my legs.

"Mine never fully recovered from my first pregnancy/birth. I noticed the leaking mostly when I started running." (Mumsnet user Artigene)

"I had an episiotomy and Forceps delivery for ds1. Pelvic floor definitely took a while to get back to normal - don’t panic." (Mumsnetter Chattycat78)

To give your pelvic floor muscles a fighting chance of being able to do their job after the stresses and strains of pregnancy and labour, it's good to get into the habit of doing some strengthening pelvic floor exercises – sometimes called kegel exercises – whenever you get a chance. There are also a range of pelvic floor trainers available if you need a bit of extra help.

What are pelvic floor exercises (or kegels)?

What are kegels? Put simply, they’re exercises which strengthen your pelvic floor, and they can help during childbirth and when you're recovering afterwards. But they don’t just relate to pregnancy – they can also improve your sex life, help stop incontinence, and treat prolapse. For this reason, both men and women can do pelvic floor exercises.

But how do you do kegel exercises? Well, imagine you're having a wee and are trying to stop mid-flow. The muscles you squeeze to do this are your pelvic floor. If you've done pilates or yoga before, you'll probably be familiar with them already.

When you squeeze these muscles, you're exercising them.

How to do pelvic floor exercises

Here’s how to do kegels, step by step:

A standard pelvic floor technique is to imagine that you're trying to stop the flow of urine when you’re urinating – tightening your muscles from the front of your pelvis and round towards your bottom. Do note the ‘imagine’, though – you can try stopping your urine once for a better idea of how to strengthen your pelvic floor, but doing this more frequently may harm the bladder.
It might also help to imagine that you're drawing something up and into your vagina, pulling the muscles upwards.
Keep the muscles tightened for the count of 10, then let them go and relax. Do this five times.
Make sure that you are breathing normally and avoid tightening your legs, stomach or bottom. Just concentrate on the pelvic floor muscles.
When you are used to this, try tightening and relaxing the muscles in succession, without holding the tension. Do this 10 to 15 times.
A variation is to imagine the pelvic floor muscles as a lift, gradually squeezing them tighter as though they are rising from floor to floor.

"Imagine you desperately need a poo and are trying to keep it in so your squeezing your anus slightly, you will feel your bum hole rise slightly inside you." (Advice from Mumsnet user SaveSomeSpendSome)

"Tighten as if you're trying to stop a wee, hold for 10 seconds, relax. Then the same further back. 10x per day. My GP friend told me that's the only way, but it's so hard to remember and get round to it!" (Words of wisdom from Mumsnetter tobypercy)

How long will it be before pelvic floor exercises work?

If you do kegel exercises regularly, you should begin to notice the results within a few months. Keep going and carry on doing your exercises to strengthen the pelvic floor, even when you notice them starting to work.

"I've found that now I'm in my 40s, having done them for all these years is paying off. Mine seems to be in much better shape than most people's, and I've had five babies." (Mumsnet user PomBearWithAnOFRS)

When should I start doing pelvic floor exercises?

Now! Every woman, pregnant or not, can benefit from exercising these muscles and you can do these exercises anywhere, from lying in bed with your best pregnancy pillow to brushing your teeth. The benefits of kegels aren’t just limited to your body post-pregnancy – keeping the pelvic floor fit and healthy can help you enjoy a satisfying sex life through increased sensitivity during sex and, as a result, stronger orgasms.

Starting kegel exercises before pregnancy can also help ward off problems that can be exacerbated by pregnancy and childbirth, weight gain, or ageing.

Having strong pelvic floor muscles also helps when giving birth, as they’re useful during the second stage of labour when you need to push your baby out. If you experience a perineal tear during birth, they can also help you to heal faster.

Stopping peeing midflow can be a useful way of checking your pelvic floor muscles are getting stronger, but this shouldn't be used as muscle training as you can give yourself a urine infection.

How often should I exercise my pelvic floor?

As pelvic floor exercises can be done while you're going about your business without anyone noticing, try to do them as often as you can. Don't overdo it, and make sure you know how to relax the muscles as well as tighten them – this can help during the second stage of labour, where relaxing the muscles around your vagina may help you to avoid damaging your perineum.

Everyone should aim to make these exercises a regular activity to maintain a healthy and fully functioning set of pelvic floor muscles. Try to associate them with something else you do every day, such as during your regular commute, checking Twitter, or watching your favourite show. This way, you're more likely to remember to do them.

"I started trying to remember to do them when I was on the tube or train, and it became associative." (Advice from Mumsnet user PollyIndia)

"Stick a note on your fridge if you have to." (Recommendation from Mumsnetter AnnTeak)

What will happen if I don't exercise my pelvic floor muscles?

Pelvic floor exercises help to avoid the functional problems you may encounter during and after pregnancy and childbirth. And, as the NCT states, it “can also prevent prolapse, which is where the pelvic organs drop down into the vagina.”

The Royal College of Obstetricians and Gynaecologists cites the symptoms of pelvic prolapse as follows:

Feeling a dragging or heaviness in your pelvic area
Discomfort and a lack of sensation during sex
A bulge in the front or back wall of your vagina. This bulging may extend outside the vagina.
Trouble with continence – bladder or bowel

Your pelvic floor also has a big role to play during sex – a weakened pelvic floor can affect your ability to have an orgasm, which seems a pretty good reason to pay it some attention.

Pelvic floor exercises make a noticeable difference to the enjoyability of sex, which frankly I consider a good payoff for remembering to do them.

Do pelvic floor exercises really work?

Do kegels work – really? The short answer is that yes: generally, they should do. However, everyone’s body is different, and if you’re finding them ineffective it might be time to turn back to your doctor.

Electrical stimulation

In recent years there's been some talk of the benefits of electrical stimulation for pelvic floor issues – especially if you're unable to contract the muscles on your own.

This is where a small probe is inserted into the vagina, through which an electrical current runs – with the aim of strengthening your pelvic floor muscles as you exercise them. Some women find this uncomfortable, but it is seen to help if you're having issues doing pelvic floor muscle contractions yourself.

Electrical stimulation is prescribed in some cases on the NHS. You can also buy your own device to use at home – they retail at around £50, but do talk to your doctor first. (And read our buyers' guide to the best pelvic floor trainer here)

There have also been calls to make this treatment more routinely available (as it is in other countries, such as France).

"It's a small electronic device with a part you insert in to the vagina and it gives the muscles a workout. There were many different programmes - I haven't actually used it for years as my symptoms improved so much that I no longer felt the need." (Tried and tested by Mumsnet user SallyWD)

"I had originally bought one a couple of years ago after my 3rd child and used it for about 2/3 months which I found made a notable difference. I stopped using it but have actually just gone back to it this week. IMO they are good but like anything you need to commit to using them fairly regularly to see a difference." (Advice from Mumsnetter JonSnowedUnder)

"I've been using [mine] really consistently for the last 2-3 weeks and am really starting to notice a marked difference. I really noticed last night that I felt I was starting to be able to activate a proper 'clench' again." (Recommendation from Mumsnet user MrsGhastlyCrumb)