Patient education

Pelvic floor exercises

For bladder leakage, prolapse, menopause, and before or after surgery

Bladder leakage, needing to rush to the toilet and a feeling of heaviness in the vagina are common, but they aren't something you have to live with. Pelvic floor exercises are usually the first step, and they work well for many women. This page explains how to do them, what else helps, and when to get extra support.

Pelvic pain? Read this first. Not every pelvic floor needs strengthening. If you have pelvic pain, pain with sex or when inserting a tampon, vaginismus or vulvodynia, your pelvic floor may be too tight rather than weak, and strengthening exercises can make this worse. See a pelvic health physiotherapist, who can teach you to relax these muscles, before starting the routine below. Read more about pelvic pain.

Your pelvic floor

Your pelvic floor is a sling of muscles at the base of your pelvis. It supports your bladder, uterus (womb) and bowel, helps you control wee, wind and poo, and plays a part in sex.

These muscles can weaken with:

  • pregnancy and birth, even many years later
  • menopause and getting older
  • a long-term cough
  • constipation and straining on the toilet
  • heavy lifting
  • carrying extra weight

Signs your pelvic floor may need attention include leaking when you cough, sneeze, laugh or exercise; rushing to the toilet or going often; a feeling of heaviness, dragging or a bulge in your vagina; and trouble controlling wind.

Finding the right muscles

  • Sit or lie comfortably with your thighs, buttocks and tummy relaxed.
  • Imagine you are stopping yourself passing wind and holding in a wee at the same time. Squeeze and lift inside.
  • You should feel a squeeze and lift around your back passage and vagina. Your buttocks should not clench, and you should keep breathing normally.
  • Don't practise by stopping your wee mid-flow. It can stop your bladder emptying properly.
  • If you can't feel the muscles working, see a pelvic health physiotherapist. Many women need help to get the technique right, and that's normal.

Continence Health Australia has a short 3D animation showing which muscles to squeeze (opens in new tab).

Your daily routine

  1. Squeeze and lift, then hold for 6 seconds while breathing normally.
  2. Relax completely for 6 seconds.
  3. Repeat 6 times. That is one set.
  4. Do 3 sets a day, at least 5 days a week.
  5. Over the following weeks, build up to 8-second holds, 12 times per set.

Squeeze before you strain. Tighten your pelvic floor before you cough, sneeze, laugh or lift.

Give it time. Most women notice a difference after 6 to 8 weeks. Keep going for at least 3 months, or at least 4 months for prolapse, then keep the exercises up for life. Training with a pelvic health physiotherapist works better than training on your own.

Make it a habit. Link your sets to things you already do each day, like brushing your teeth or waiting for the kettle. If you like reminders, the optional Squeezy app (opens in new tab), a paid app, can prompt you. It was designed by UK NHS physiotherapists, costs about $6 one-off for iPhone and Android, and you can adjust its settings to match this routine.

This routine follows the Royal Women's Hospital program. You can download their sheet in English and 13 other languages (opens in new tab).

What else helps

Leaking when you cough, sneeze, laugh or exercise

This is called stress incontinence. Pelvic floor exercises are the first treatment to try, ideally guided by a pelvic health physiotherapist for at least 3 months. If leakage continues after that, we can talk about other options.

Rushing to the toilet or going often

This is called urgency, or an overactive bladder. Bladder training (slowly stretching the time between toilet visits), together with pelvic floor exercises, helps many women. A physio or continence nurse can guide you through a program over about 3 months, often starting with a bladder diary. Read more about bladder training (opens in new tab).

Prolapse: heaviness, dragging or a bulge

A supervised pelvic floor program of at least 4 months can ease prolapse symptoms. Avoid straining on the toilet: sit with your feet on a small stool and your knees above your hips, and treat constipation. Exercises may not make a bulge go away completely, so we can also talk about other options, including a pessary (a soft silicone device worn in the vagina) or surgery. Read more about pelvic organ prolapse (opens in new tab).

Around menopause

Lower oestrogen levels affect the tissues of the vagina and bladder and can bring on urgency, leakage or bladder infections. Keep up your pelvic floor exercises, and ask me whether vaginal oestrogen could help. Read more about menopause and incontinence (opens in new tab).

Before and after surgery

Seeing a physiotherapist before prolapse or incontinence surgery helps you learn the right technique for your recovery. After surgery, follow the instructions you're given about lifting and when to restart your exercises.

Pelvic pain

If you have pelvic pain, pain with sex or when inserting a tampon, vaginismus or vulvodynia, your pelvic floor muscles may be holding too much tension. Strengthening exercises can make this worse. A pelvic health physiotherapist can teach you to relax and release these muscles, usually alongside other treatment. Jean Hailes explains this in Bladder health and pelvic floor muscles (opens in new tab) and Persistent pelvic pain (opens in new tab).

When to see a pelvic health physiotherapist

See a pelvic health physiotherapist if:

  • you're not sure you're doing the exercises correctly
  • you have no improvement after 3 months
  • your symptoms are affecting your work, exercise, sleep or sex life
  • you have pelvic pain or pain with sex
  • you're preparing for prolapse or incontinence surgery

Finding a physio: search the Continence Health Australia physiotherapist directory (opens in new tab) by suburb. Every physio listed has postgraduate training in continence and pelvic floor care.

What happens at the appointment: the physio will ask about your symptoms and check how your pelvic floor is working. This may include an internal examination or an ultrasound on your tummy, but only with your consent. You'll leave with a program that suits you.

Cost: you don't need a referral, and most private health extras policies cover physiotherapy. If you have a long-term condition, ask your GP whether you're eligible for Medicare-subsidised physiotherapy sessions.

When to see your doctor

Check in with your GP or me if you have:

  • blood in your urine
  • pain or burning when passing urine, or frequent bladder infections
  • trouble emptying your bladder or bowel
  • a bulge that is sore, bleeds or won't go back in

Go to an emergency department or call 000 if you suddenly lose control of your bladder or bowel and have numbness around your bottom or genitals, or new weakness in your legs.

Trusted resources

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Common questions

How long until I notice a difference?

Most women notice a change after 6 to 8 weeks. Give it at least 3 months, or at least 4 months for prolapse, before deciding whether it's working.

Can I do too many?

More isn't always better. Muscles that are tired don't squeeze well, so stop a set when you can no longer do a good-quality squeeze. If the exercises cause pain, stop and see a physiotherapist.

Will exercises fix my prolapse?

They can ease symptoms such as heaviness and dragging, but may not make a bulge go away completely. If symptoms still bother you, we can talk about a pessary or surgery.

Can I practise by stopping my wee mid-flow?

No. It can stop your bladder emptying properly. Use the "stop wind and hold in a wee" squeeze instead.

Do I need a referral to see a pelvic health physio?

No. You can book directly. Most private health extras policies cover physiotherapy.

I've already had surgery. Should I still do the exercises?

Yes, once you've been told it's safe to restart. They're part of looking after your pelvic floor for life.

This page is general information and does not replace advice about your own health. Last reviewed October 2026.

Sources: Royal Women's Hospital, Pelvic floor exercises (2025); Continence Health Australia (2026); Jean Hailes for Women's Health (2026); NICE guideline NG123, urinary incontinence and pelvic organ prolapse in women (2019); POPPY trial of pelvic floor training for prolapse (Hagen et al., Lancet 2014).