Many women do not know what the pelvic floor is and the importance it has when they get pregnant and it seems that it did not have much importance in a woman's life before. The reality is that the pelvic floor is essential to have a strong and exercised vagina and thus avoid having urinary incontinence problems. Vaginal discharge has nothing to do with these types of exercises, which are also known as Kegel exercises.

Vaginal exercises to strengthen the pelvic floor

  1. Elevator exercise. The vagina is a muscular tube made up of rings. You must imagine that each ring is an elevator floor and that you must go up and down through them, tensing each part. You will have to start tensing up to the first floor, hold for 1 second and move on to the second and so on until you reach the maximum – which can be the sixth or seventh floor. When you have reached the highest floor of your vagina, you must go down - don't do it suddenly - little by little, enduring every second on each floor. At the end, relax your vagina for a few seconds.
  2. Exercise slowly. You will have to tighten the vaginal muscles by taking them up, as if you were taking them towards the navel. When they are contracted you will have to keep them that way for 5 seconds breathing gently, then they have to relax for another 5 seconds. The ideal is to do this exercise 10 times increasing the time between when you contract and relax. The longer you hold on, the better you'll be doing and the stronger your vaginal muscles will become.
  3. Quick exercises.  To perform these exercises you must contract and relax -as in the previous exercise- but with the difference that you will have to do it quickly for two minutes. You can do 10 quick reps four times a day, but as you get more confident you can do as many reps – try to get over 60 reps – each time you do it – with a maximum of 4 times a day.
It is important that you do these three exercises every day, regardless of whether you are pregnant or not, because they will help you to have a more resistant pelvic floor and prevent you from having urinary incontinence problems at any time in your life. ## How to find, assess and safely train your pelvic floor (practical, clinical guidance) As a gynecologist who regularly treats pelvic floor problems, I emphasize that correct muscle identification and safe progression are the foundation of any successful pelvic floor program. Below are step-by-step, evidence-based clinical cues and practical assessments you can use at home or in clinic. ### How to locate the muscles (three reliable methods) - External cue (best for beginners): Sit comfortably and imagine you are trying to stop yourself from passing gas and at the same time stop the flow of urine mid-stream. The squeeze you feel around the vagina and rectum is the pelvic floor. Important: do NOT use the "stop the urine" test as an exercise routine — it's only a teaching cue. - Digital internal check (if comfortable and appropriate): Wash your hands, insert one gloved, lubricated finger 3–4 cm into the vagina. Ask the patient to squeeze around your finger. A correct contraction is felt as a circumferential squeeze and a gentle upward lift. If you are doing this on yourself, proceed only when you feel calm and comfortable. - Visual/cue-based: Place a hand just above the pubic bone. When the pelvic floor contracts correctly, you should feel a small inward pull under the hand (not a bulge). Combine with diaphragmatic breathing. ### How to tell if you're using the wrong muscles - You feel contraction in the buttocks, inner thighs, or abdomen rather than around the vagina and rectum. - You are bearing down or pushing the belly out (Valsalva) instead of lifting. - You have increased pelvic or vaginal pain when contracting. If any of the above happens repeatedly, stop and seek help from a pelvic floor physiotherapist or gynecologist. ### Baseline clinical self-assessment (simple tests you can do) - Strength test: Lie on your back with knees bent. Try one maximum contraction and hold for as long as you can; time the hold in seconds. A healthy quick benchmark: a 5–10 second hold with a clear squeeze is a starting point; longer holds suggest better endurance. Record baseline to track progress. - Endurance test: Count how many quality squeezes you can perform at 50% effort before fatigue. - Symptom diary: For urinary symptoms, use a two-day bladder diary tracking voids, leaks, and pad use. These baseline measures set realistic targets and help when discussing progress with clinicians. ### Safety considerations (pregnancy and postpartum) - Pregnancy: Kegels are generally safe throughout pregnancy and can reduce urinary stress incontinence. Avoid breath-holding and Valsalva. If you have placenta previa or are on pelvic rest, consult your obstetrician before starting new exercises. - Immediate postpartum: Gentle pelvic floor activations can begin in the first days after childbirth for many women — short, soft lifts at rest with attention to pain thresholds. For third-degree perineal tears or complex repairs, follow your surgeon's timeline; often formal strengthening progresses after 6 weeks but gentle reactivation can start sooner under guidance. - Postpartum prolapse symptoms (bulge, heaviness): Do not ignore — modify activity and seek pelvic health physiotherapy early. ## Training programs, progressions and practical schedules (expert-level plans and real examples) The three exercise types in the original article (elevator, slow holds, quick contractions) form the core of any program. Below I provide structured, progressive programs for different goals and realistic examples from clinical practice. ### Principles of training the pelvic floor - Overload: Gradually increase the intensity (longer holds, more reps, added resistance via vaginal weights) as strength improves. - Specificity: Train both fast-twitch (quick contractions for cough/sneeze) and slow-twitch (endurance for daily activities). - Frequency: Daily practice is ideal; short sessions spread throughout the day are better tolerated and more effective than a single long session. - Integration: Pair pelvic floor contractions with functional movements (e.g., before lifting, coughing, sneezing) to build automatic support. ### Beginner program (no symptoms, learning phase) Goal: Learn contractions, build base endurance. - Weeks 1–2: - Elevator: 5 sets of 3 slow “elevator” rises (each ring hold ~1 second), once per day. - Slow holds: 5 × 5-second holds with 5-second rest (2 sessions per day). - Quick contractions: 2 minutes of quick squeezes, gentle pace (once per day). - Weeks 3–6: - Elevator: 5 sets of 5 rises, progress to reaching 5–6 “floors”. - Slow holds: 8–10 × 6–8-second holds with equal rest (3 sessions per day). - Quick contractions: 4 sets of 10 quick reps, 3 times daily (aim for total 40–60/day). Practical tip: Do sessions during times you already have (brushing teeth, waiting for kettle to boil). Real example: "Anna, 28, first-time exerciser" — after 6 weeks following the beginner program reported firmer sensation and no leakage during high-impact fitness classes. ### Intermediate program (mild stress incontinence or postpartum 6–12 weeks) Goal: Increase strength and function; introduce resistance and functional training. - Weeks 1–6: - Slow holds: 3 sets of 10 × 10-second holds with 10-second rest (3 times a day). - Quick contractions: 6 × 10 quick reps before activity (e.g., before lifting child). - Vaginal weight training: Start with light cone (15–30 g) for 10 minutes while walking; progress weight/time weekly as tolerated. - Functional pairing: Practice a pelvic floor contraction immediately before coughing, sneezing, lifting. Real example: "Maria, 36, postpartum with leakage when running" — after 8 weeks using intermediate program and vaginal cones she progressed to 25–30 g cones and was able to run without leakage. ### Advanced program (athletes, persistent symptoms needing targeted training) Goal: High-load and endurance capacity; combine with core and hip strength. - Daily: - Slow holds: 3 sets of 8 × 15-second holds with 10–15-second rest. - Quick contractions: 5 sets of 12 fast squeezes, twice daily. - Vaginal weights: 20–60 g for 15–30 minutes during low-impact activity (walking, light step). - Integrate into resisted work: teach co-contraction during squats, deadlifts; practice pelvic floor contraction on exhale while engaging transverse abdominis. - Add biofeedback sessions: once weekly for 6–8 weeks if available. Real example: "Sofia, 42, CrossFit competitor" — used targeted co-contraction drills with her coach and pelvic physiotherapist; improved lift mechanics and reduced stress leakage during heavy lifts. ### How to progress safely - Increase hold time by 2–3 seconds every 1–2 weeks. - Once you can do 10–12 × 10–15 second holds with good form, introduce resistance (weights) or functional loads. - For quick contractions, increase number per set and reduce rest, aiming for 50–100 quality quick squeezes/day interspersed. ### Sample 8-week program (practical schedule) Week 1–2: Learning — see Beginner program. Week 3–4: Build endurance — add sets and increase holds to 8 seconds. Week 5–6: Increase intensity — 10-second holds, add vaginal cone 3x/week. Week 7–8: Functionalization — pair contractions with daily lifts, introduce co-contraction during core exercises. ### Devices and adjuncts (how to use them) - Vaginal cones/weights: Start with the smallest weight you can hold for 10–15 minutes. Insert while standing or walking. Remove if there is discomfort, bleeding, or slippage. [shop](/shop) carries a selection of medical-grade cones. - Biofeedback apps/sensors: Provide objective feedback; helpful if you cannot feel contractions. Use under guidance to ensure correct placement and avoid reliance on the device alone. - Electrical stimulation: May be used in clinic for women unable to voluntarily contract; typically provided by physiotherapists. ### Measuring progress (objective and subjective) - Subjective: Symptom diary, reduction in leakage episodes, improved confidence while exercising. - Objective: Repeat baseline strength/endurance tests every 4–6 weeks. Many women notice symptom reduction in 4–8 weeks with consistent practice; significant improvement typically by 3 months. ## Common mistakes, troubleshooting and when to seek professional help Correct technique and appropriate progression are critical. Below are frequent errors and clear troubleshooting steps. ### Common mistakes and fixes - Mistake: Bearing down during squeezing (Valsalva). Fix: Exhale gently, visualize lifting upward; stop if you feel pressure downwards. - Mistake: Using only glutes or inner thighs. Fix: Place a hand on inner thigh/buttock to feel absence of squeeze, retrain with internal or visual cues. - Mistake: Overtraining (daily maximal holds causing pain). Fix: Scale back; quality over quantity. Rest 1–2 days if pain persists. - Mistake: Expecting immediate results. Fix: Track progress; set 4–12 week timelines. ### When pelvic floor physiotherapy or medical referral is indicated - Ongoing leakage despite 8–12 weeks of correct training. - Pelvic pain, pain with penetration, or pain during Kegels. - Sensation of bulge or organ prolapse, or fecal incontinence. - Inability to voluntarily contract pelvic floor. - Recent pelvic surgery or complex perineal repair — ask your surgeon or physiotherapist for a tailored timeline. Pelvic health physiotherapists provide internal assessment, manual therapy (if needed), biofeedback, and individualized progressive plans. If you live in an area with limited access, ask your gynecologist for a referral. ## Practical integration into daily life (low-friction strategies) - Habit stacking: Link a set to daily tasks — e.g., 10 slow holds while brushing teeth morning and night. - Activity triggers: Squeeze before sneezing, lifting the stroller, or coughing — this builds automatic protective responses. - Posture cues: Sit tall, ribcage stacked over pelvis; poor posture reduces ability to recruit pelvic floor effectively. - Combine with core work: During squats or lunges, perform a gentle pelvic floor lift on the exhale before initiating the movement; do not brace the breath. For more lifestyle and exercise articles that complement pelvic floor training see [related topic](/blog). ## Real cases — what I commonly see in clinic and practical adaptations Case 1 — New mom, 6 weeks postpartum - Presentation: Light stress leakage when coughing, tired of bladder urgency. - Program: Start with gentle elevator and 5-second holds, increase to 10s by week 4. Avoid heavy lifting first 6–8 weeks. Add functional "pre-contraction" before lifting breastfed baby. - Outcome: At 12 weeks she had no leakage during coughing and reported improved pelvic support. Case 2 — Recreational runner with stress urinary incontinence - Presentation: Leak during runs and sprinting. - Program: Emphasis on quick contractions (fast-twitch) and co-contraction before impact; progressive vaginal cone training during walking; incorporate plyometric-safe technique coaching. - Outcome: Fewer leakage episodes within 8 weeks; able to run 5K symptom-free at 12 weeks. Case 3 — Woman with pelvic pain and inability to contract - Presentation: Tight, painful pelvic floor; attempted Kegels increased pain. - Program: Referral to pelvic physiotherapy for down-training, myofascial release, and graded re-education. Kegels withheld until therapist establishes ability to relax and then restore balanced control. - Outcome: Pain reduced and voluntary control restored over several months. These examples show that programs must be individualized — there is no one-size-fits-all, and sometimes the correct course is relaxation rather than strengthening. ## FAQ ### Can I do Kegels during pregnancy and immediately after birth? Yes — for most women Kegels are safe throughout pregnancy and can help reduce urinary incontinence. During pregnancy, avoid breath-holding and heavy Valsalva. Immediately after vaginal birth, gentle pelvic floor activations (short, soft lifts) are often appropriate in the first days, but if you had significant perineal tears (3rd/4th degree), complex repairs, or cesarean-related complications, follow your surgeon's instructions. Formal strengthening programs typically progress after your 6-week postpartum check or earlier under physiotherapy guidance. If you feel unusual pain, bleeding, or a bulge, stop and consult your clinician. ### How many times per day should I do pelvic floor exercises, and how long until I see results? Start with short sessions 2–3 times per day, then progress to 3–4 sessions daily as tolerated. A common effective routine is: - Slow holds: 8–10 reps of 6–10 second holds - Quick squeezes: 3–4 sets of 10 fast contractions Most women notice some improvement in symptoms within 4–8 weeks of consistent practice. Meaningful strength gains and sustained symptom relief often require 3 months or longer, especially for chronic issues. ### What if I feel pain when I try to do these exercises? Pain means stop and reassess. Painful contractions can indicate an overactive or hypertonic pelvic floor, untreated infection, scar tissue, or incorrect technique. Do not force through pain. Seek evaluation from a pelvic floor physiotherapist or gynecologist, who can assess for causes and provide down-training techniques, manual therapy, and a modified exercise plan. ### Can I overtrain my pelvic floor? Is there such a thing as too many Kegels? Yes, overtraining can occur. Excessive, frequent maximal contractions without adequate rest may lead to muscle fatigue, increased pelvic pain, and paradoxical tightening. Quality matters more than quantity. If you experience increased pelvic tension, pain, or constipation after starting an intensive program, reduce frequency and consult a physiotherapist to rebalance strength and relaxation. ### When should I use tools like vaginal cones, biofeedback or electrostimulation? - Vaginal cones: Helpful when you can’t hold a contraction against gravity; they provide progressive resistance. Start with the lightest cone you can hold for 10–15 minutes and progress slowly. - Biofeedback sensors/apps: Useful if you can’t feel your contractions or need objective feedback. Use under guidance or after an initial instruction session. - Electrical stimulation: Typically used in clinic for women who are unable to contract voluntarily. It can assist muscle activation but should be delivered by a trained clinician. If considering devices, choose medical-grade products and, when possible, consult a pelvic health professional. You can find recommended devices in our [shop](/shop). --- Category: Exercises If you have persistent symptoms, complicated postpartum recovery, or pelvic pain, book an assessment with a pelvic floor physiotherapist or your gynecologist. Correct diagnosis and individualized treatment significantly improve outcomes — and targeted, well-progressed training gives you long-term pelvic health and confidence.