56 versus 6
56% of women who trained reported cure. 6% without training. This one comparison is why I built a class around a 5-minute habit.
If you remember 1 number from my letters, make it this one.
56%.
In a Cochrane review, 56% of women with stress leaks who did pelvic floor muscle training reported cure. In the groups without training, 6% did.[1]
A Cochrane review pools the best trials on one question. This number comes from 4 trials and 165 women, after 3 to 6 months of training.[1]
Cure is the high bar. Improvement is wider.
Count the women who were cured or improved, and it was 74% with training against 11% without (3 trials, 242 women).[1]
Women who trained also had about 1 fewer leak every 24 hours (7 trials, 432 women).[1]
Why every guideline puts it first
- NICE, UK: at least 3 months of supervised pelvic floor training, first, for stress or mixed leaks.[2]
- ACOG, US: pelvic floor training is effective first-line care for stress, urgency and mixed leaks.[3]
- AUA, US: the American Urological Association lists pelvic floor exercises as a non-surgical option.[4]
First-line means: start here, before pills or procedures.
Get the next letter on Sunday.
1 idea, 1 exercise and 1 reader question from Dr. Dana. Free, in a 3-minute read.
Does an app work?
A Swedish trial gave 123 women with stress leaks either a training app or nothing for 3 months.[5] 55.7% of app users rated themselves much improved. In the other group, 5% did.
Here is the catch. At 3 months, 41% of app users still trained every day.[5]
The method works. The habit is the hard part.
That is the problem my class solves: 1 short session a day, a reminder at the time you choose, and a cat that cheers when you finish.
The fine print
- These cure numbers are for stress leaks: laughing, sneezing, lifting. Urgency leaks have their own plan.
- The trials ran 3 to 6 months. Six weeks is the start.
- Technique decides the result. Check yours here.
56 versus 6. Which group will you be in by spring?
Quick answers
Do Kegels really work for bladder leaks?
For stress leaks, yes. In a Cochrane review, 56% of women who did pelvic floor muscle training reported cure, versus 6% without training, after 3 to 6 months. Counting cure or improvement, it was 74% versus 11%.
Do Kegels work for urge incontinence?
US guidelines (ACOG) call pelvic floor training effective first-line care for stress, urgency and mixed leaks. The strongest cure numbers come from women with stress leaks.
Can an app help with pelvic floor exercises?
In a Swedish trial of 123 women with stress leaks, 55.7% of app users rated themselves much improved after 3 months, versus 5% of women without the app.
Written by Dr. Dana Kivlin, DO, board-certified urologist. Updated . Every number links to its source below. This letter teaches; your own doctor diagnoses. How we write
Sources
- Dumoulin C, Cacciari LP, Hay-Smith EJC. Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women. Cochrane Database of Systematic Reviews, 2018. cochranelibrary.com
- NICE guideline NG123. Urinary incontinence and pelvic organ prolapse in women: management, 2019. nice.org.uk
- ACOG Practice Bulletin No. 155. Urinary incontinence in women, 2015 (reaffirmed). acog.org
- American Urological Association and SUFU. Stress urinary incontinence guideline, 2017, amended 2023. auanet.org
- Asklund I, et al. Mobile app for treatment of stress urinary incontinence: a randomized controlled trial. Neurourology and Urodynamics, 2017. pubmed.ncbi.nlm.nih.gov
Liked this? Get the next one Sunday.
Short, sourced and kind. Each Sunday, Dr. Dana sends the one thing she wants every woman to know about her pelvic floor.
- 1 ideaWhat the research says, in plain words, with its source.
- 1 exerciseA 2-minute move to try the same day.
- 1 questionA reader asks. Dr. Dana answers.
Turn the letter into a habit.
Pelvic Health Class: for Women: Dr. Dana’s class on your phone. 6-week programs, 1 short lesson a week, 1 guided exercise a day.
- 5 minutes a dayA guided session with a breathing ring and a timer. The cat lifts with you.
- 1 lesson a weekWritten by a urologist, in plain words, with every source.
- Your log stays on your phoneYour answers, notes and photos: only you see them.
