How To Do Kegel Exercises Correctly After 50—‘It’s Never Too Late To Start’

If you’ve ever wondered whether you’re doing Kegel exercises correctly—or if they’re even working—you’re not alone. Social media is full of advice about strengthening your pelvic floor to prevent bladder leaks, manage pelvic organ prolapse and improve intimacy. But the truth is, many women have never properly been shown how to do Kegel exercises. So we spoke with a board-certified gynecologist, ob-gyn and doctors of physical therapy who shared simple, actionable steps to help you master this powerful exercise and feel more confident and in control. Here’s everything you need to know to get it right.

What are Kegel exercises?

“Kegels are exercises that strengthen the pelvic floor muscles, the group of muscles that form a supportive ‘sling’ at the base of the pelvis,” explains Maral Malekzadeh, DO, board-certified gynecologist and co-owner of The Well Westlake. “These muscles help support the bladder, uterus and bowel, and they play an important role in urinary control, pelvic stability and sexual function. The exercise itself involves intentionally contracting and lifting these muscles, similar to the feeling of stopping the flow of urine or preventing passing gas.”

Dr. Malekzadeh says the pelvic floor may weaken with age, hormonal shifts, childbirth and changes in connective tissue, but doing Kegels regularly and correctly can help keep these muscles strong.

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“From a clinical standpoint, Kegels are one of the simplest ways to support pelvic health because they directly target the muscles responsible for continence and pelvic organ support,” adds Dr. Malekzadeh. 

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How to do Kegel exercises correctly

If you’re ready to start incorporating Kegels into your health routine but feel like you only know how to do them in theory rather than practice, Dr. Malekzadeh shares a step-by-step guide: 

• Find your pelvic floor muscles: “Think of an internal ‘lift’ around the vaginal opening and urethra, as if you are gently drawing those structures upward inside the pelvis,” says Dr. Malekzadeh. “You should feel a subtle lift, not a strain or a push downward.”

• Get comfortable: “Lying down with your knees bent is often the simplest place to start,” explains Dr. Malekzadeh. “As you get more comfortable with the technique, you can also practice sitting or standing.”

• Focus on a gentle lift: “Gently contract and lift—not brace—the pelvic floor muscles,” says Dr. Malekzadeh. “The contraction should stay focused internally, without visibly clenching the glutes, inner thighs or abdomen.”

• Breathe through the contraction: “Hold [the contraction] for about three to five seconds, continuing to breathe,” says Dr. Malekzadeh. “Avoid holding your breath, which can increase abdominal pressure and interfere with proper engagement.”

• Relax your pelvic floor: Next, “release completely,” says Dr. Malekzadeh. “Relax the pelvic floor fully for the same amount of time [you contracted it].”

• Repeat the process: “Repeat consistently and build gradually,” explains Dr. Malekzadeh. “A typical starting routine is 10 repetitions once or twice per day. Over time, the hold can gradually increase to about eight to 10 seconds as strength improves.”

Are you doing Kegels right? Ask yourself these questions 

If you’ve followed the “how-to” guide above but still aren’t sure you’re doing Kegels correctly, can ask yourself these three questions to confirm you’re on the right track:

Are my glutes, abs or thighs doing most of the work? 

Over-tightening nearby muscles can interfere with proper pelvic floor engagement, says Lisa Kelly, PT, DPT, at WAVE Physical Therapy & Pilates. And finding the right muscles to use is crucial. 

“The core muscles and bigger hip stabilizing muscles will want to take over [and] make it easier, [but] don’t let them,” adds Jaclyn Skirkanich, PT, DPT, OCS, CMTPT, global rehabilitation leader Gaylord Specialty Healthcare. “Focus on the internal musculature.”

Can I relax in between Kegel reps? 

“Relaxation is just as important as the contraction for muscle health,” adds Karen Toubi, MD, board-certified ob-gyn, vulvovaginal specialist and medical ambassador for VSL Probiotics. “Constant tension can lead to pelvic floor dysfunction rather than improvement.”

Am I gently lifting? 

“The correct action is a subtle inward lift, not a forceful squeeze,” explains Kelly. She adds it’s a red flag you’re not doing your Kegel exercises correctly if you don’t feel an internal sensation or feel a straining sensation rather than lifting. 

Kelly adds that if you’re pushing down with your muscles instead of lifting and squeezing, you’re actually increasing pelvic pressure, which can worsen bladder leaks or pelvic organ prolapse. You shouldn’t feel pressure or heaving when performing Kegel exercises. 

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Why Kegel exercises are so important for women over 50

“Pelvic floor health becomes both more important and more complex” as we age, explains Samantha Pulliam, MD, FACOG, urogynecologist and CEO & Chief Medical Officer at Axena Health. “Menopause brings a significant drop in estrogen, and that directly affects the tissues of the pelvic floor and bladder. Those tissues become thinner and less elastic, which can make bladder leakage, urgency and pelvic discomfort more common during and after menopause.”

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Dr. Pulliam adds that strengthening the pelvic floor with exercises like Kegels can help support the body during this transition. That said, she recommends speaking with a doctor about other options that may help as well, such as pelvic floor physical therapy.

“It is never too late to start,” adds Dr. Pulliam. “I’ve seen women of all ages make real, meaningful improvements in their pelvic floor strength and quality of life. Your body is capable of change at any age—it just needs the right support.”

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