Why Exercise Kegels After 40

After the age of 40, the importance of choosing to exercise kegels becomes increasingly evident as hormonal changes, muscle loss, and life experiences create unique challenges for pelvic floor health.

Once in their forties, people will lose as much as 5% of their muscle per decade. This decreased strength and muscle mass is related to myriad pelvic floor dysfunctions, including stress urinary incontinence, pelvic organ prolapse, fecal incontinence and sexual dysfunction. While many people are familiar with kegel exercises, understanding why and how to exercise kegels specifically after 40 years old requires a deeper appreciation of the physiological changes that occur during this pivotal life stage.

The decision to exercise kegels after 40 isn't just about preventing problems — it's about maintaining quality of life, preserving intimate health, and supporting overall well-being during a time when your body needs targeted attention.

This comprehensive guide explores the compelling reasons to prioritize kegel exercises, the proper techniques for maximum effectiveness, and the life-changing benefits that make this simple practice essential for healthy aging.

Understanding Why Your Body Needs Kegels More After 40

The Physiological Reality of Aging Pelvic Floor Muscles

As we age, the pelvic floor undergoes significant changes that make the decision to exercise kegels not just beneficial, but necessary. Research shows that aging is associated with a significant increase in levator bowl volume, which is 80% larger among older (≥ 70 years) versus young (< 40 years) nulliparous women. This dramatic change begins in the 40s and accelerates with each passing decade.

Key Age-Related Changes:

• Muscle mass decline: Skeletal muscle atrophy and associated weakness are inevitable as people age, and the pelvic floor muscles are no exception

• Hormonal shifts: Declining estrogen affects tissue strength and blood flow to the pelvic region

• Connective tissue changes: Reduced collagen production leads to decreased support for pelvic organs

• Weight changes: Fat mass can increase as much as 44% during menopause. When a person has a higher Body Mass Index (BMI) of 26 or above, their pelvic floor has a consistently heavier load to support

The Menopause Connection: Why Kegels Become Critical

For women, the transition through perimenopause and menopause makes the need to exercise kegels even more pressing. During menopause, estrogen levels decrease resulting in reduced stimulation of estrogen receptors throughout the pelvic region. As a result there is a decrease in blood flow to the pelvic floor.

Menopause-Related Changes:

• This can result in vaginal dryness, reduced lubrication of tissues, thinning of the perineal and vaginal tissue, weakening of the pelvic floor muscles, and recurrent urinary tract infections

• At least 50% of women who go through menopause will experience some type of pelvic floor issue

• Around 15% of women will have at least one of these symptoms during peri-menopause, and around 50% of women will have some of these symptoms during menopause or post-menopause

The Compelling Benefits of Exercising Kegels After 40

1. Urinary Incontinence Prevention and Treatment

• The primary reason most people choose to exercise kegels is to address urinary incontinence, which becomes increasingly common after 40.

• Millions of women experience urinary incontinence (UI), which can take the form of anything from small leaks when you sneeze or even having accidents because you're unable to reach the restroom in time.

• Your risk for this condition increases with age and after menopause due to lower estrogen levels.

Research-Based Evidence:

• Research shows that improvements in urinary incontinence and quality of life were positively correlated with daily Kegel exercise practice

• One study from 2018 even found that regular pelvic floor exercises helped improve quality of life for those with urinary incontinence

• Kegel exercises strengthen your pelvic floor muscles over time, which can prevent some of the uncomfortable symptoms associated with urinary incontinence

2. Enhanced Sexual Health and Function

• One of the most significant yet often overlooked benefits of choosing to exercise kegels after 40 is improved sexual health.

• Research shows that both Kegel exercise and gel were effectively improved sexual function in menopausal women.

• However, the findings indicated that sexual function was more likely to be improved after using Kegel exercise than using lubricant gel.

Sexual Health Benefits:

• Improved arousal: Kegels improve blood circulation to the pelvic floor and vagina, and this may be helpful for arousal and lubrication

• Enhanced sensation: Strengthening the pelvic floor muscles with kegel exercises can make it a little bit more taut. It might be tighter because women are better able to contract their muscles, and that might improve sensation

• Better orgasms: When the pelvic floor muscles are healthy, orgasms are more intense and last longer. Women who have difficulty achieving orgasm may be experiencing weak pelvic floor muscles

• Partner satisfaction: A strong pelvic floor allows women to grip their partner more tightly during sex, which is often more pleasurable for their partner as well

3. Pelvic Organ Prolapse Prevention

• After 40, the risk of pelvic organ prolapse increases significantly, making it crucial to exercise kegels proactively.

• Kegel exercises also help to prevent pelvic organ prolapse, which can be caused by the natural aging process.

• Even if you do experience pelvic prolapse, these exercises may reduce the chance of mild conditions worsening while reducing symptom intensity and frequency.

4. Core Stability and Back Pain Reduction

• An often-underappreciated benefit of choosing to exercise kegels is improved core stability and reduced back pain.

• The pelvic floor muscles are a component of the inner core, the muscles that support the trunk and hips.

• These muscles work in coordination with the deep layers of the abdominals to support the spine.

  
  

Core Benefits:

• It is estimated that 38% of women with urinary leakage also experience low back pain, and Kegels address both of these conditions

• Enhanced postural support during daily activities

• Improved stability during exercise and movement

• Better coordination between deep core muscles

5. Mental Health and Quality of Life Benefits

• The psychological benefits of choosing to exercise kegels after 40 cannot be overstated.

• Many women with urinary incontinence deal with a reduced quality of life.

• A lot of those with UI change a lot about their lives due to the condition, like avoiding going places due to fear of leakage.

• Many also feel embarrassed and isolated socially because of the condition.

When you exercise kegels consistently, you regain confidence and freedom to participate fully in life activities without fear or embarrassment.

The Complete Guide to Proper Kegel Technique

Step 1: Finding Your Pelvic Floor Muscles

Before you can effectively exercise kegels, you must identify the correct muscles. About 40% of people don't perform a Kegel correctly the first time.

Identification Methods:

• Stop urination mid-stream: Stop urination in midstream. You shouldn't do this often, at most once per month, as it could create a habit of contracting while urinating

• Prevent gas passage: Squeeze the muscles you use to stop passing gas

• Internal check: Place your finger into your vagina and squeeze as if trying to hold in urine. A feeling of tightness around your finger means you're squeezing the pelvic floor muscles

Step 2: Perfecting Your Technique

When you exercise kegels, proper form is essential for effectiveness and safety.

The Three-Step Method:

1. Tighten the anus: The first step involves tightening the anus as if stopping gas from passing. The anus tightens and buttocks should stay relaxed

2. Squeeze the vaginal entrance: Tighten and squeeze the entrance to the vagina as if you're closing it shut and at the same time try to lift your vagina inwards

3. Tighten the urethral opening: Tighten the opening where the urine comes out. You may feel the anus and vagina tightening, if you do this is correct

Key Technique Points:

• Perfect your technique. Tighten your pelvic floor muscles for three or four seconds and then relax for an entire breath. It's important to get the full contraction and lengthening of each exercise

• To do Kegels, imagine you're sitting on a marble. Tighten your pelvic muscles as if you're lifting the marble upward, toward your head

• Focus on tightening only your pelvic floor muscles. Try not to flex the muscles in your stomach area, thighs or buttocks

Step 3: Optimal Positioning and Breathing

When you exercise kegels, position and breathing matter significantly.

Best Positions for Beginners:

• When you're starting out, the best position for doing your Kegels is the one that you can really feel your exercises including:

  • Kneeling on all fours

  • Lying prone on your stomach

  • Lying on your back

  • Sitting

Breathing Guidelines:

• Don't hold your breath. Instead, breathe freely during the exercises

• Breathe normally during your kegels and never hold your breath

Common Kegel Mistakes to Avoid After 40 Years Old

Mistake 1: Using the Wrong Muscles

One of the most common mistakes users make when performing Kegel exercises includes targeting and squeezing the wrong muscles. When you exercise kegels incorrectly, you won't get the intended benefits.

Signs You're Using Wrong Muscles:

• If you put your hand on your abdomen and you feel your belly muscles clenching, you're not squeezing the right place.

• If you feel your butt cheeks tightening and coming up off the chair, then you are not squeezing the right place

Mistake 2: Forgetting to Relax

Forgetting to relax is another common error that users make and that frequently leads to Kegel mistakes. Kegel exercises are more than just contractions and entail letting go and reducing tension externally and internally.

Why Relaxation Matters:

• Not releasing your contractions fully may overwork or over-tighten these muscles. This can cause damage to the pelvic floor

• Remember a strong pelvic floor is NOT a tight pelvic floor. It needs to be able to both contract and lengthen to work correctly

Mistake 3: Doing Too Many Kegels

When you exercise kegels, more isn't always better. Doing too many kegels a day can make your pelvic floor tired and your symptoms worse.

Mistake 4: Holding Your Breath

• Holding your breath can cause you not to get the most out of your Kegel exercises, and this creates an increase in intra-abdominal pressure.

• This heaviness will mislead you by making your muscles feel tight and give you a sense that the Kegel exercises are working.

• However, they are not in fact working as designed.

The Optimal Kegel Exercise Program for Adults Over 40

Beginner's Program (Weeks 1 - 4)

When you first exercise kegels, start conservatively to build proper technique.

Starting Protocol:

• When you're starting out you might not be able to do that 8 to 12 repetitions so you might start and you might be able to do 2 or 3

• Two exercises in a row and holding each exercise for 3 seconds. Try to repeat this routine three times a day

• Focus on technique over quantity

• Practice in quiet environment to concentrate

Intermediate Program (Weeks 5 - 12)

As your technique improves, gradually progress when you exercise kegels.

Progression Protocol:

• Tighten your pelvic floor muscles. Hold tight and count 3 to 5 seconds.

• Relax the muscles and count 3 to 5 seconds.

• Repeat 10 times, 3 times a day (morning, afternoon, and night)

Advanced Maintenance Program (Months 3+)

For long-term benefits when you exercise kegels, establish a sustainable routine.

Maintenance Protocol:

• Aim to be performing about 12 Kegels, two different types, some for around 10 seconds in length and others on and off as fast as you can, three times a day

• When you get better probably about after 6 months or when your muscles are getting stronger after about 6 months of training then you can look at doing your exercises 2 to 3 times a week maybe alternate days to keep your pelvic floor muscles strong

Research-Based Guidelines

Research-based guidelines for how many Kegel exercises you should do every day:

• For stronger pelvic floor muscles:

  • Use the correct Kegels technique

  • Doing up to 8-12 consecutive Kegels

  • Holding every exercise for 3-10 seconds

  • Practice 3 sets of Kegels daily

Age-Specific Benefits: Why 40+ Makes Kegels Essential

Menopause Support and Hormone Health

• When you exercise kegels during and after menopause, you're providing crucial support during hormonal transitions.

• During menopause fluctuating levels of estrogen can lead to less blood flow in the pelvic floor muscles and overall decrease in muscle tone.

• Imagine the pelvic floor as a soapy sponge that you're squeezing under clean running water – you squeeze out soap, and then allow the sponge to fill with fresh water as you loosen your grip on it.

• This is what Kegels are doing for your tissues – squeezing out the old blood and pulling in fresh blood to help with the restorative and strengthening process.

Career and Lifestyle Protection

After 40, many people are at the peak of their careers and social activities. When you exercise kegels, you protect your ability to participate fully in professional and personal activities without the limitations that incontinence can impose.

Long-term Health Investment

It's never too late to start working your pelvic floor muscles, and doing so could actually prevent future problems. When you exercise kegels after 40 years old, you're making an investment in your future health and quality of life.

Integrating Kegels with Other Health Strategies

Combining with Core Strengthening

When you exercise kegels, combining them with other core exercises enhances overall effectiveness. The pelvic floor muscles are a component of the inner core, the muscles that support the trunk and hips.

Complementary Exercises:

• Bridge pose

• Bird dog

• Modified planks

• Deep breathing exercises

Lifestyle Factors That Support Kegel Success

• Hydration: Proper hydration supports tissue health and function

• Weight Management: Maintaining healthy weight reduces pressure on pelvic floor

• Posture Awareness: Good posture supports proper pelvic floor function

• Stress Management: Chronic stress can affect muscle function and recovery

When to Seek Professional Help

Signs You Need Expert Guidance

While most people can safely exercise kegels independently, certain situations warrant professional intervention:

• Persistent symptoms despite consistent practice

• Pain during kegel exercises

• Inability to identify correct muscles

• Complex pelvic floor dysfunction

Benefits of Pelvic Floor Physical Therapy

• A physical therapist will perform an evaluation and determine if Kegel exercises are appropriate to perform given your dysfunction.

• A physical therapist can ensure you are performing the exercises correctly without compensation strategies and utilizing the full range of motion.

  
  

Advanced Techniques and Tools

Biofeedback Training

During biofeedback, a healthcare provider inserts a probe into your vagina. Your provider asks you to perform a Kegel. A monitor shows if you're squeezing the correct muscles.

Kegel Exercise Tools

Kegels balls are special devices you wear inside your vagina. Sometimes called Kegel exercisers, these mostly round or circular devices help tone your pelvic floor muscles.

Tool Benefits:

• Provide resistance training

• Give tactile feedback

• Help maintain proper positioning

• Can progress difficulty levels

Long-term Success Strategies

Creating Sustainable Habits

When you exercise kegels successfully long-term, consistency matters more than intensity.

Habit Formation Tips:

• Link kegels to existing daily activities

• Set phone reminders initially

• Track progress in a journal

• Celebrate small victories

Monitoring Progress

Positive Changes to Watch For:

• Many women notice an increase in bladder control within 3 - 6 weeks of regularly doing Kegels, but it may take up to six months to fully strengthen your pelvic floor

• Improved sexual satisfaction

• Better core stability

• Increased confidence in daily activities

Adjusting Your Program Over Time

Adaptation Strategies:

• Progress difficulty as strength improves

• Modify techniques based on comfort

• Incorporate functional movements

• Maintain variety to prevent boredom

Special Considerations for Different Life Circumstances

Post-Surgical Recovery

If you've had pelvic or abdominal surgery after 40, when you exercise kegels may be particularly important for recovery, but timing and technique should be guided by your healthcare provider.

Chronic Health Conditions

Certain conditions common after 40 may affect how you exercise kegels:

• Diabetes can affect nerve function

• Arthritis may limit positioning options

• Heart conditions may affect exercise tolerance

Medication Considerations

Some medications can affect pelvic floor function, making it even more important to exercise kegels consistently while working with healthcare providers to optimize treatment.

The Future of Your Pelvic Floor Health

Maintaining Benefits Long-term

Once you start doing them, you may need to do them for the rest of your life. When you exercise kegels as a lifelong practice, you're investing in sustained health and quality of life.

Preventing Regression

Incontinence will return if you stop doing these exercises. This reality makes consistency crucial when you exercise kegels.

Conclusion: Your Path to Optimal Pelvic Floor Health After 40

The decision to exercise kegels after 40 isn't just about addressing current concerns — it's about taking proactive control of your health and quality of life for decades to come. Whether you're 21 or 60 years old, pelvic floor exercises have a variety of benefits that can help you both now and in the future. There's no reason not to give them a try.

The evidence overwhelmingly supports the benefits of choosing to exercise kegels after 40. From preventing urinary incontinence and supporting sexual health to reducing back pain and enhancing overall quality of life, these simple exercises offer profound benefits that become increasingly valuable with age.

The CU Urogynecology team recommends that all women do Kegels, even if they have no urinary incontinence symptoms, in order to prevent incontinence later in life. This preventive approach is particularly crucial after 40 when the risk factors for pelvic floor dysfunction increase dramatically.

Remember, when you exercise kegels correctly and consistently, you're not just performing a simple exercise — you're investing in your independence, confidence, and overall well-being.

The time to start is now, regardless of your current pelvic floor health status. With proper technique, realistic expectations, and consistent practice, kegel exercises can transform your experience of aging, helping you maintain strength, function, and confidence well into your later years.

Key Takeaways

1. Age-related changes make kegels essential after 40 - Muscle loss, hormonal changes, and increased dysfunction risk create compelling reasons to start

2. Proper technique is crucial for effectiveness - Learning correct form prevents injuries and ensures maximum benefits

3. Benefits extend beyond incontinence prevention - Sexual health, core stability, and quality of life all improve with consistent practice

4. Consistency trumps intensity - Regular, moderate practice provides better long-term results than sporadic intensive sessions

5. Professional guidance enhances success - Physical therapists can optimize technique and address specific concerns

6. Lifestyle integration is key - Successful long-term practice requires building kegels into daily routines

7. Prevention is more effective than treatment - Starting before problems occur provides the best outcomes

Your pelvic floor health after 40 is not predetermined by age — it's influenced by the choices you make today. When you exercise kegels with intention, proper technique, and consistency, you're taking control of your health in a way that will benefit you for decades to come. Start today, be patient with the process, and trust in the profound benefits that await those who commit to this simple yet powerful practice.

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