Pelvic Floor Exercises for Men: A Safe Starting Guide

01Anatomy

What the male pelvic floor does

Gloucestershire Hospitals explains that the pelvic floor muscles lie between the legs, stretching from the pubic bone at the front to the tailbone (coccyx) at the back. In men they support the bladder and bowel and help control the urethra, the tube that carries urine out of the body, and the anus.

Mayo Clinic notes that these muscles also affect sexual function. With practice, the exercises can be done almost anytime and anywhere.

02Symptoms

Weakness, tension and overlapping symptoms

A weak pelvic floor can cause urinary incontinence, leakage of stool or difficulty controlling wind, according to Gloucestershire Hospitals. Factors that can weaken the muscles, listed by the two sources, include:

• pelvic surgery, such as removal of the prostate or bowel surgery
• straining to open the bowels and constipation
• being overweight
• a chronic cough
• overactive bladder, aging and lack of exercise of these muscles

Not every pelvic symptom comes from weakness. Muscles can also be too tense, which may need relaxation rather than more strengthening; our guide on tight versus weak pelvic floor explains the difference. That is one reason to have symptoms assessed.

03Who benefits

Who may benefit, and getting assessed first

Mayo Clinic says you might benefit from Kegel exercises if you dribble urine after urinating, leak urine, leak urine after a strong, sudden urge, or leak stool. It advises talking with a health care professional before starting, to check that Kegels are right for you.

Gloucestershire Hospitals adds that men who have had surgery and still have a catheter should wait until it has been removed by a nurse or doctor before trying the exercises.

04Finding the muscles

Finding a gentle contraction

Gloucestershire Hospitals suggests sitting or lying comfortably with your thighs, buttocks and stomach relaxed, then tightening the muscles around the back passage as if trying to hold in wind, and relaxing again. You can also imagine stopping the flow of urine midstream; you should feel your testicles lift slightly upward. When standing, you may feel the base of the penis draw slightly inward.

Both sources warn against using urination as practice. Mayo Clinic says not to do Kegels while urinating, because stopping the bladder from emptying could raise the risk of infection. Gloucestershire Hospitals says testing it for real should be done no more than once a fortnight. If you are unsure whether you are using the right muscles, a professional can check, rather than self-examination at home.

05Relaxation

Breathing and complete relaxation

Both sources stress the same points of technique:

• breathe freely; do not hold your breath
• do not tighten your stomach, buttocks or thighs
• squeeze and lift up, never push down or push urine out
• let go fully after each squeeze: Gloucestershire Hospitals describes a definite feeling of letting go at the end of each hold

Gloucestershire Hospitals notes that the muscles tire easily and that the exercises take a lot of concentration at first. Resting between contractions is part of the exercise, not a pause in it.

06Routine

Individualizing holds and repetitions

The two sources describe different starting routines, which shows there is no single program for everyone:

• Mayo Clinic: squeeze for 3 seconds and relax for 3 seconds, building up to 10 to 15 repetitions per set, at least three sets a day.
• Gloucestershire Hospitals: long holds for as long as you can manage, up to 10 seconds, with 10 seconds’ rest, around 8 times; then 8 short, quick lifts; three sets of each a day. If you can only hold for 3 seconds, start there and build up to 4, then 5.

Start with what you can do with good technique and full relaxation, and build up gradually. Mayo Clinic says a health care professional can make a plan tailored to you. Write down the hold time, rest time and number of repetitions agreed, and review them together.

07Daily life

Fitting exercises into daily tasks

Once confident, both sources suggest doing the exercises in different positions: lying, sitting, standing and squatting or walking. Mayo Clinic suggests linking a set to routine tasks such as brushing your teeth, and doing one after urinating to clear the last drops.

Both recommend tightening the pelvic floor just before and during activities that make you leak or put pressure on the abdomen, such as coughing, sneezing, laughing, lifting or rising from a chair. Gloucestershire Hospitals also advises drinking enough fluid, cutting down on caffeinated drinks, avoiding constipation and keeping a healthy weight.

08Precautions

Pain, catheters and surgery

Do not start the exercises while a urinary catheter is in place, and after surgery follow your surgical team’s advice on when to begin. If the exercises cause pain or new symptoms, stop and get advice: pain or a feeling of excess tension may need a different approach, such as learning to relax the muscles.

Mayo Clinic says that if you have trouble, a health care professional or a physical therapist experienced in pelvic floor exercises can show you how to use the correct muscles. Biofeedback, with a small pressure sensor, or electrical stimulation may sometimes be suggested alongside the exercises. See also our guide on pelvic floor stretches.

09Sources

Where the sources differ

Routine. Mayo Clinic suggests 3-second holds with 10 to 15 repetitions; Gloucestershire Hospitals suggests holds of up to 10 seconds, 8 long and 8 short lifts. Neither is the only correct program, and they should not be added together.

Timeline. Mayo Clinic says results can come within a few weeks to a few months. Gloucestershire Hospitals says improvement may take several weeks, with the best results after 3 to 6 months, and advises seeing a specialist physiotherapist if there is little change after 3 months.

Sexual function. Mayo Clinic says Kegels may improve sexual function; Gloucestershire Hospitals links the pelvic floor to erection and ejaculation control. Neither guarantees a result.

10Summary

In summary

Pelvic floor exercises strengthen the muscles that support the bladder and bowel and help control leaks. The technique is to squeeze and lift the muscles around the back passage and base of the penis, hold briefly, then relax completely, while breathing normally and keeping the stomach, buttocks and thighs relaxed.

Start gently, build up gradually and practice daily; results take weeks to months. Do not practice by stopping urine, wait for any catheter to be removed, and seek professional help if exercises are painful, you are unsure of your technique, or there is little change after about 3 months.