Quick Answer
Kegel exercises can strengthen the pelvic-floor muscles and may help some urinary symptoms, but they do not shrink an enlarged prostate and are not a primary treatment for the obstruction caused by BPH.
They are most useful when a man has problems such as urinary leakage, post-void dribbling or difficulty controlling urgency. Pelvic-floor exercises are also commonly used to help urinary continence after prostate surgery.
But stronger is not always better. Urination requires the pelvic floor and urinary sphincter to relax. If these muscles are already too tight or poorly coordinated, repeatedly squeezing them can potentially worsen difficulty starting or emptying the bladder. In that situation, pelvic-floor relaxation or physiotherapy may be more appropriate than additional Kegels.
Kegel exercises should therefore be viewed as a possible supportive treatment for selected urinary symptoms, not as a natural way to shrink the prostate or replace appropriate BPH medication, testing, procedures or surgery.
If you have significant weak flow, difficulty emptying the bladder or urinary retention, the underlying obstruction should be assessed rather than assuming pelvic-floor strengthening will correct it.
What Are Kegel Exercises?
Kegel exercises are a form of pelvic-floor muscle training.
The pelvic floor is a group of muscles and connective tissues forming a supportive layer at the bottom of the pelvis. In men, these structures help support and coordinate the:
- bladder;
- urethra;
- rectum;
- and pelvic organs.
These muscles also participate in urinary continence, bowel control and sexual function.
NIDDK notes that pelvic-floor muscle exercises can help both men and women and may help men reduce urinary leakage, particularly dribbling after urination.
Do Kegel Exercises Treat an Enlarged Prostate?
Not directly.
An enlarged prostate or benign prostatic hyperplasia develops because prostate tissue increases with age.
The prostate surrounds part of the urethra. When BPH compresses or distorts the bladder outlet, men may develop:
- weak urinary flow;
- hesitancy;
- straining;
- intermittent flow;
- incomplete bladder emptying;
- frequency;
- urgency;
- and nocturia.
Kegel exercises do not remove this enlarged tissue.
If a man’s principal problem is mechanical bladder-outlet obstruction from BPH, strengthening the pelvic floor cannot be expected to open the obstructed prostatic urethra.
Which BPH-Related Symptoms Might Kegels Help?
Pelvic-floor training may be useful when part of the urinary problem involves control rather than obstruction.
| Symptom | Could Pelvic-Floor Training Help? |
|---|---|
| Post-void dribbling | Potentially. Strengthening and coordinating the pelvic floor may help some men empty residual urine from the urethra and reduce dribbling. |
| Urinary leakage | Yes, particularly when weak pelvic-floor support contributes to continence problems. |
| Sudden urinary urgency | Pelvic-floor contractions may help some men suppress urgency while bladder training addresses the overall pattern. |
| Weak urine stream from BPH obstruction | Kegels do not remove the prostate obstruction and should not be expected to restore flow by themselves. |
| High post-void residual | Needs assessment. Simply strengthening the pelvic floor may not help and could be counterproductive if poor relaxation contributes. |
| Urinary retention | No. Retention requires medical assessment to determine the cause and protect the bladder and kidneys. |
Can Kegels Help Urinary Urgency?
They may help selected men control a sudden urge to urinate.
NIDDK describes an urgency-suppression technique in which quick, strong pelvic-floor contractions may help reduce an urgent sensation long enough to reach the bathroom.
This is different from treating the cause of BPH.
For persistent frequency and urgency, the clinician may need to distinguish between:
- BPH-related obstruction;
- overactive bladder;
- urinary infection;
- incomplete bladder emptying;
- excessive fluid or caffeine intake;
- diabetes;
- and other urinary disorders.
See my guide to BPH symptoms and urinary problems .
Can Kegels Improve a Weak Urinary Stream?
This is where the old article was too optimistic.
A weak stream from BPH usually reflects resistance at the bladder outlet. Strengthening the pelvic-floor muscles does not remove that resistance.
In fact, normal urination requires the pelvic floor and external urinary sphincter to relax while the bladder contracts.
Current EAU male-LUTS guidance notes that failure of pelvic-floor or urinary sphincter relaxation can contribute to voiding dysfunction.
For those patients, pelvic-floor physiotherapy focused on relaxation and coordination may make more sense than repeatedly strengthening already tense muscles.
Can Too Many Kegels Make Urination Worse?
Potentially, yes.
The pelvic floor needs both strength and the ability to relax appropriately.
If a man repeatedly contracts the muscles without fully relaxing them, or if he already has an overactive pelvic floor, excessive strengthening may contribute to:
- pelvic muscle tension;
- difficulty relaxing during urination;
- straining;
- pelvic discomfort;
- or difficulty with bowel movements.
NIDDK specifically warns against overdoing Kegel exercises and notes that too much pelvic-floor exercise can contribute to straining when urinating or having a bowel movement.
If urinary flow becomes more difficult, pelvic pain develops, or you feel you cannot relax the muscles properly, stop increasing the exercise volume and ask a clinician or pelvic-floor physiotherapist to assess your technique.
How Do You Find the Male Pelvic-Floor Muscles?
One of the easiest ways is to imagine that you are trying to:
- prevent yourself from passing gas;
- or stop urine from escaping.
You should feel the muscles around the anus and base of the penis draw inward or upward.
NIDDK also explains that temporarily stopping the urine stream can help identify the correct muscles.
Should You Stop Your Urine Stream to Practice Kegels?
No—not as a regular exercise.
The old version of this page told men to identify the muscles by stopping urine while urinating. That can occasionally help a man recognize the correct muscle group, but it should not become the exercise routine.
NIDDK advises against routinely performing Kegels while urinating because repeated interruption can prevent complete bladder emptying and may increase the risk of urinary problems.
How to Do Male Kegel Exercises
If strengthening exercises are appropriate for you, a simple starting technique is:
-
Empty your bladder normally.
Do the exercise separately from urination rather than repeatedly stopping your urine stream. -
Find the pelvic-floor muscles.
Imagine preventing yourself from passing gas or stopping urine leakage. -
Gently squeeze the pelvic floor.
Try not to strongly tighten your abdominal, thigh or buttock muscles. -
Hold for about 3 seconds initially.
NIDDK suggests beginning with a short contraction rather than forcing a long hold. -
Relax completely.
The relaxation phase matters just as much as the contraction. -
Repeat gradually.
Work toward approximately 10 to 15 repetitions per session if comfortable and if advised by your healthcare professional.
NIDDK suggests performing pelvic-floor exercises in different positions such as lying down, sitting and standing as strength improves.
How Often Should Men Do Kegels?
There is no single perfect prescription for every man.
NIDDK provides a general program of pelvic-floor exercise several times a day, while also emphasizing that clinicians may individualize:
- how long each contraction is held;
- how many repetitions are performed;
- how many sessions are done;
- and whether strengthening is actually appropriate.
I would therefore avoid promising that every man with BPH should perform 10–15 repetitions four times daily.
How Long Before Kegels Start Working?
Muscles need time to develop strength and coordination.
NIDDK notes that some people may not notice better bladder control until after approximately 3 to 6 weeks.
However, improvement depends on the symptom being treated.
A man with leakage from weak pelvic-floor muscles may improve, while someone whose main problem is severe obstruction from a large prostate may notice little change because Kegels do not address the obstruction.
Should You Tighten the Abdomen and Buttocks?
No.
Try to isolate the pelvic-floor muscles while breathing normally.
NIDDK advises against strongly tightening the:
- stomach;
- thighs;
- or other surrounding muscles.
Contracting the wrong muscles can increase pressure on the bladder and make the exercise less effective.
Should You Hold Your Breath?
No.
Breathe normally throughout the exercise.
Holding the breath and bearing down increases abdominal pressure and is the opposite of the controlled pelvic-floor contraction being practiced.
What If I Cannot Tell Whether I Am Doing Kegels Correctly?
This is common.
A pelvic-floor physiotherapist can determine whether you are:
- using the right muscles;
- squeezing too strongly;
- failing to relax afterward;
- or actually suffering from excessive pelvic-floor tension rather than weakness.
NIDDK notes that clinicians or physical therapists may also use biofeedback or other techniques to help patients learn the correct contraction.
Who Should Be Especially Careful With Kegels?
I would seek individualized advice rather than beginning an aggressive strengthening program if you have:
- significant difficulty starting urination;
- severe weak flow;
- high post-void residual urine;
- urinary retention;
- pelvic or perineal pain;
- painful ejaculation;
- chronic prostatitis/chronic pelvic pain syndrome;
- difficulty relaxing during urination or bowel movements;
- or previous pelvic surgery with ongoing symptoms.
These symptoms may require assessment of both strength and relaxation.
Kegels and Chronic Prostatitis or Pelvic Pain
Men with chronic prostatitis or chronic pelvic pain should be particularly careful about assuming that strengthening is the answer.
Some men with chronic pelvic pain have pelvic-floor muscle tenderness, overactivity or poor relaxation.
For them, treatment may involve:
- pelvic-floor relaxation;
- myofascial physiotherapy;
- breathing and relaxation work;
- movement;
- and other multimodal pain strategies.
Repeated forceful Kegels may not be appropriate for an already tight pelvic floor.
Can Kegels Improve Sexual Function?
Possibly in some men, but the evidence should not be exaggerated.
The pelvic-floor muscles participate in erection, ejaculation and orgasm, and NIDDK notes that studies suggest pelvic-floor muscle training may improve sexual function.
However, it is too strong to promise that Kegels will reliably:
- restore erectile function;
- cure premature ejaculation;
- or correct sexual dysfunction caused by BPH.
Erectile and ejaculatory problems can have vascular, neurological, hormonal, medication-related and psychological causes and should be assessed accordingly.
Are Kegels Useful After Prostate Surgery?
Yes, this is one of the better-established uses of pelvic-floor muscle training in men.
The EAU recommends pelvic-floor muscle training, alone or with selected biofeedback or electrical stimulation approaches, to help speed recovery of urinary continence after radical prostatectomy.
That evidence should not be confused with evidence for treating BPH obstruction before surgery.
Kegel Exercises vs BPH Medication
The two approaches do very different things.
| Treatment | Main Role |
|---|---|
| Kegel exercises | Improve pelvic-floor strength or control when muscle function contributes to urinary symptoms. |
| Alpha blockers | Relax smooth muscle in the prostate and bladder neck to improve urinary symptoms and flow. |
| Finasteride / dutasteride | Can gradually reduce prostate volume and reduce progression risk in appropriately selected men with prostate enlargement. |
| Tadalafil | Can improve lower urinary tract symptoms and may also improve erectile function; it does not substantially shrink the prostate. |
| Procedures or surgery | Remove, displace or ablate obstructing prostate tissue when indicated. |
See the full comparison in my BPH treatment guide .
Can Kegels Replace BPH Medication?
Not when medication is needed to treat clinically important BPH.
A man whose symptoms come mainly from pelvic-floor weakness may benefit from physiotherapy, but a man with:
- significant obstruction;
- large post-void residual;
- recurrent urinary retention;
- recurrent urinary infections;
- bladder stones;
- or BPH-related kidney or bladder complications
needs appropriate urological assessment.
Pelvic-floor exercise should not delay necessary BPH medication or other treatment.
Can Kegels Shrink the Prostate Naturally?
No.
There is no good evidence that repeatedly contracting the pelvic-floor muscles reduces prostate volume.
If the prostate itself needs to be reduced, the established options include 5-alpha-reductase inhibitors in appropriate men and procedures that remove or ablate prostate tissue when clinically indicated.
You can read more about evidence-based conservative options in: natural and lifestyle approaches for enlarged prostate .
Which Lifestyle Changes Can Be Combined With Pelvic-Floor Training?
For men with uncomplicated BPH symptoms, conservative management may also include:
- avoiding excessive fluid intake at one time;
- reducing evening fluids when nocturia is troublesome;
- reducing caffeine or alcohol if they aggravate urgency or frequency;
- remaining physically active;
- preventing constipation;
- reviewing medicines that can worsen urinary symptoms;
- and using bladder-training techniques when appropriate.
These measures can support symptom management but do not guarantee that medication or a procedure will never be needed.
What Is Bladder Training?
Bladder training is different from Kegel strengthening.
It may involve gradually extending the interval between urination, scheduled voiding and techniques to control urgency.
NIDDK describes bladder training and pelvic-floor contractions as strategies that can help some people manage urinary urgency and leakage.
For a man with significant BPH obstruction, however, bladder training should not be used to force prolonged holding when the bladder is already emptying poorly.
How Do You Know Whether BPH Is Causing Obstruction?
Symptoms provide clues, but objective testing may be needed.
A clinician may consider:
- symptom scoring;
- physical examination;
- urinalysis;
- PSA when appropriate;
- uroflowmetry;
- post-void residual measurement;
- prostate size assessment;
- and selected additional tests when the diagnosis remains uncertain.
See: tests for enlarged prostate and urinary symptoms .
Dr. Albana’s Perspective
I would not tell every man with an enlarged prostate to simply start doing more Kegel exercises.
The first question is: What urinary problem are we trying to improve?
If a patient has leakage or post-void dribbling and the pelvic floor is weak, strengthening may be useful.
If the patient has urgency, pelvic-floor contractions may sometimes help with urgency suppression as part of bladder training.
But if the main problem is severe hesitancy, weak flow, incomplete emptying or urinary retention, I would first determine whether BPH is obstructing the bladder outlet. Kegels do not remove that obstruction.
I would also be cautious in a man with pelvic pain or difficulty relaxing the muscles. Normal urination requires pelvic-floor relaxation, so some men need relaxation and coordination training rather than additional strengthening.
The goal is therefore not to create the strongest possible pelvic floor. The goal is a pelvic floor that can contract when continence is needed and relax when urination is needed.
— Dr. Albana Greca, MD, MMedSc