So if you’ve completed pelvic floor physical therapy (PFPT) and are wondering whether you should keep doing the exercises forever, you’re not alone.
The short answer is that your pelvic floor, like any other muscle group, will stay healthier if you continue to train it. But that doesn’t mean you have to do Kegels every day, for life. Understanding how these muscles work, what affects them over time, and how to keep them strong in a way that fits your lifestyle will make it a lot easier to protect your pelvic health without burnout.
Why does your pelvic floor need consistent care, but not constant effort?
Your pelvic floor is a layered group of very important muscles and connective tissues that form a supportive ‘hammock’ at the bottom of your pelvis. These muscles:
- Support your bladder, uterus and intestines
- Help control your bowel and bladder movements
- Play a role in sexual and reproductive function
- Work your diaphragm and deep core muscles to stabilize your hips, back and posture
When your pelvic floor is strong and coordinated, it can support daily movements, bowel and bladder control, and comfort. When it is weak or overactive, it can cause a number of symptoms of pelvic floor dysfunction, including leakage, heaviness or pain.
Pelvic floor muscle training (PFMT) helps restore strength, flexibility, coordination or a combination of these. And research shows that consistent pelvic floor training can improve pelvic floor symptoms, especially afterwards birth or during menopause.
Once you’ve built up strength, you can usually maintain your results by training less often, as you normally would different muscle group:
- People who are younger can maintain their strength with one focused session per week.
- Older adults, such as those going through menopause, may need more consistent work, with two short sessions per week to keep their muscles strong.
And not “pelvic floor exercises”. just now mean Kegels. Activities that emphasize deep core control, breathing and movement can also keep your pelvic floor healthy. So activities like yoga, Pilatesor stabilization exercises can also keep your pelvic floor strong. Even improving posture, hip and leg strength, and the way you use your pelvic floor muscles during daily tasks can reduce tension and support long-term pelvic floor muscle health.
So while your pelvic floor needs consistent care, it doesn’t mean you have to use Kegels all the time.
Why is continuing care important?
For people assigned female at birth, major life changes can affect the functioning of your pelvic floor:
- Surgery (such as a hysterectomy or gender confirmation surgery) can damage the pelvic floor tissue, lead to scar tissue, and change the way the pelvic tissue supports your organs.
- Hormonal shifts (such as can happen during pregnancy, certain cancer treatments, menopause, or during breastfeeding) can affect muscle tone, blood flow, and tissue elasticity.
- Pregnancy and childbirth can stretch and strain your pelvic floor in ways that require rehabilitation afterward.
So revisiting pelvic floor muscle exercise, or sticking to a lighter but consistent routine, during these transitions can really help you maintain the support, circulation, and function of your pelvic floor muscles.
If you are considering or undergoing surgery, you can read more about recovery in our related guides:
Why do people stop using PFMT and how can I make it sustainable?
Research shows that most people stop their pelvic floor routine for three main reasons:
- Life gets in the way
- They don’t get enough education or instruction
- There is disagreement about the longer-term consequences
Understanding these barriers will make it easier for you to create a sustainable plan.
Life gets in the way
Between postpartum recovery, hormonal changes, or returning to work, consistency can be difficult. But PFMT doesn’t have to be all-or-nothing. One study found that women who did pelvic floor exercises once a week were able to maintain similar strength and incontinence improvements 5 years after pelvic floor therapy.
It can help to mentally link your exercises to daily cues, such as brushing your teeth or during a regular workout. Some people find that pelvic health specific mobile apps can help them remember.
They don’t get enough education or instruction
Too many people are told to “just do Kegels” without really understanding how, or if it’s even good for them. In reality, pelvic floor training is highly individualized. For some, the problem is weakness. For others it is shortness of breath or poor coordination.
PFMT may include:
- Targeted contractions and relaxations (traditional Kegels)
- Stabilization exercises for the abdominal muscles and hips
- Lifestyle adjustments, such as changes in diet, bathroom habits, or bowel movements
- Breathing and relaxation training
- Mechanics and postural adjustments to reduce strain during movement
A pelvic floor physical therapist can assess your unique muscle patterns and teach you safe, effective strategies for your body and stage of life.
The discrepancy about the long-term consequences
Once symptoms improve, it’s super tempting to quit. But like any muscle group (including your heart), your pelvic floor’s strength decreases if you ignore it. And because your pelvic floor changes as your body changes, it’s important to continue monitoring your long-term pelvic floor health.
Even short periods of regular exercise or awareness exercises can keep you from deteriorating and reduce the risk of leakage or recurrence of the prolapse.
So… Do you really have to do pelvic floor exercises forever?
Not exactly. You probably won’t have to do Kegels every day forever. But your pelvic floor does need eternal attention.
A more realistic pelvic floor plan usually consists of three phases:
- Reconstruction (early recovery): Initially, you will likely need daily guided exercises with a PFPT to regain coordination and control. Some of these exercises may include Kegels.
- Menopause (after initial recovery): Once you begin to improve and master the function of your pelvic floor muscles, you can usually reduce the amount of training (to perhaps 1-3 times per week), focusing on maintaining strength and movement quality.
- Maintenance (long term): In the long term, you can integrate pelvic awareness into your daily activities (such as while lifting, exercising or during every visit to the toilet) and schedule check-ups with your doctor when you need them.
And if your progress stalls or your symptoms return, a short refresher course with a pelvic floor therapist can help.
The goal is lifelong awareness and adaptability, because your pelvic floor changes as your body changes.
For help creating a pelvic floor plan that actually fits your life, plan a visit with a pelvic floor physiotherapist at Origin. They give you the personal support you need to help you want to to do your pelvic floor exercises forever!
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References:
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Cho, S.T., and K.H. Kim. “Pelvic floor muscle exercise and training for dealing with urinary incontinence.” Journal of Exercise Rehabilitation, vol. 17, no. 6, December 27, 2021, pp. 379–387. PubMed Central, doi:10.12965/jer.2142666.333.
Dimli, B.O., E.K. Mutlu, D.S. Altac and H. Taskiran. “Comparison of the Effects of Pelvic Floor Muscle Training and Modified Pilates Exercises in Older Women with Stress Urinary Incontinence: A Randomized Clinical Trial.” European Journal of Obstetrics & Gynecology and Reproductive Biology, vol. 300, September 2024, pp. 327–336. doi:10.1016/j.ejogrb.2024.07.033.
Harper, R. C., S. Sheppard, C. Stewart, and C. J. Clark. “Research on adherence to pelvic floor muscle training in women using mobile apps: Scoping Review.” JMIR mHealth and uHealth, vol. 11, 2023, e45947. doi:10.2196/45947. PubMed Central.
Kannan, P., W. H. Hsu, W. T. Suen, L. M. Chan, A. Assor, and C. M. Ho. “Yoga and Pilates Compared with Pelvic Floor Muscle Training for Urinary Incontinence in Older Women: A Randomized Controlled Pilot Study.” Complementary Therapies in Clinical Practice, vol. 46, Feb 2022, 101502. doi:10.1016/j.ctcp.2021.101502.
Marcellou, E.G., S. Stasi, V. Giannopapas, K. Bø, D. Bakalidou, M. Konstadoulakis and G. Papathanasiou. “Effect of pelvic floor muscle training on symptoms of urinary incontinence in postmenopausal women: a systematic review and meta-analysis.” European Journal of Obstetrics & Gynecology and Reproductive Biology, vol. 304, January 2025, pp. 134–140. doi:10.1016/j.ejogrb.2024.11.040.
Spiering, B.A., I. Mujika, M.A. Sharp, and S.A. Foulis. “Maintaining Physical Performance: The Minimum Dose of Exercise Needed to Maintain Endurance and Strength Over Time.” Journal of Strength and Conditioning Research, vol. 35, no. 5, May 2021, pp. 1449–1458. doi:10.1519/JSC.0000000000003964.
Tsartsapakis, I., I. Bagioka, F. Fountoukidou and E. Kellis. “A Comparison between Core Stability Exercises and Muscle Thickness Using Two Different Activation Maneuvers.” Journal of Functional Morphology and Kinesiology, vol. 9, no. 2, April 11, 2024, p. 70. doi:10.3390/jfmk9020070. PubMed Central.
Wang, Y., Y. Zhuo, H. Yan, et al. “How important is the timing and duration of pelvic floor muscle training for preventing postpartum urinary incontinence? A meta-analysis.” International Urology and Nephrology, 2025. doi:10.1007/s11255-025-04640-w.
Yount-Tavener, SM and RA Fay. “Maintaining a Long-Term Practice of Daily Pelvic Floor Muscle Exercises: What Do Fertile Women Think?” Journal of Midwifery & Women’s Health, vol. 69, no. 4, July-August 2024, pp. 567-576. doi:10.1111/jmwh.13626.
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