How to use Kegel weights for bladder control: benefits, instructions, and expert tips

If you leak urine when you cough or sneeze, you probably know all about Kegel exercises. Kegels are pelvic floor exercises that involve squeezing and relaxing the muscles you use to stop the flow of urine or hold in gas. Practicing Kegels can strengthen your pelvic floor muscles, which can help reduce urine leakage. 

Sometimes, Kegels alone may not relieve your symptoms. In these situations, a pelvic floor physical therapist may suggest trying Kegel weights: small, smooth weights that you insert into the vagina to help guide your pelvic floor exercises.

Here, learn more about Kegel weights, which symptoms they can treat, how they can help, and get tips for using them from Hinge Health physical therapists.

What are Kegel weights?

Kegel weights are vaginal inserts used to add resistance during pelvic floor exercises. Kegel weights usually come in a variety of shapes and sizes for your needs and comfort. Most often, they’re small, oval, or egg-shaped and made of materials like medical-grade silicone or plastic for easy cleaning. Some look like marbles or balls (sometimes called "Kegel balls" or "Ben Wa balls"), while others may be shaped more like teardrops, cones, or elongated pellets. 

Practicing Kegel exercises with Kegel weights can help build or maintain strength in your pelvic floor muscles, especially after changes related to age, pregnancy, childbirth, or surgery. These exercises can support pelvic floor health and function at any stage of life.

“Kegel weights are kind of like a weighted tampon,” says Karina Marquez, PT, DPT, a pelvic floor physical therapist with Hinge Health. “When they’re inserted, your vaginal muscles have to activate to prevent the ball or weight from falling out or slipping.” 

How are Kegel weights different from gym weights?

Kegel weights work a bit differently from traditional gym weights. While the weight provides steady resistance, you don’t have to engage your pelvic floor muscles constantly the entire time you’re using them. Instead, your muscles naturally engage to keep the weight in place as you move around, similar to the way your arm maintains some activation when holding a free weight.

“When you use a Kegel weight, your pelvic floor muscles need to work to keep the device from slipping out, but this doesn’t mean constant tension,” explains Dr. Marquez. If you notice the weight starting to shift, a quick squeeze can bring it back into position, she explains. This approach mirrors how your pelvic floor responds in daily life — reacting quickly when needed, such as during a cough or sneeze. Over time, as your coordination and strength improve, you may be able to use heavier weights. Building endurance this way can help with symptoms like urine leakage, reduced sexual sensation, or pelvic discomfort.

When to use Kegel weights

Research shows that Kegel weights can help with stress urinary incontinence, or leaking when coughing, sneezing, or exercising. Studies show that people who use them often do better than those who don’t do any pelvic floor exercises, but they may not be more effective than Kegels alone, or other pelvic floor strengthening techniques. 

“They work well for the right people,” explains Dr. Marquez. This often includes those who have pelvic floor symptoms after childbirth, people who leak urine when they sneeze, cough, or exercise, or those who need to urinate frequently. But it’s important to be evaluated by a pelvic floor physical therapist before trying Kegel weights, says Dr. Marquez. Here are some situations when a physical therapist may suggest using Kegel weights:

• Postpartum recovery. Pregnancy and childbirth can affect your pelvic floor muscles and sometimes lead to symptoms like urine leakage, pelvic heaviness, or a sense of less support in your pelvis. Using Kegel weights can help some people rebuild muscle coordination and strength as part of their recovery after giving birth. As your body heals, these tools can offer additional resistance and feedback, making it easier to retrain and reconnect with your pelvic floor. It’s important to wait at least six weeks after you deliver, and get approval from both your ob-gyn and physical therapist before starting to use Kegel weights.

• Urinary incontinence. Involuntary urine leakage can happen after pregnancy and childbirth, during perimenopause and menopause, with aging, or for no clear reason. Strengthening your pelvic floor muscles with the support of Kegel weights may help improve bladder control and reduce leaking during daily activities.

• Pelvic organ prolapse. Sometimes, pelvic organs like the bladder, uterus, or rectum can shift out of their normal position. This can happen when the pelvic floor muscles and tissues provide less support, which may be influenced by a variety of factors such as childbirth, aging, or hormonal changes. Kegel weights may be recommended by your provider to help rebuild pelvic support and stability for pelvic organ prolapse.

• After pelvic surgery. Surgeries like a hysterectomy (removal of the uterus) or a myomectomy (removal of fibroids) can contribute to pelvic floor muscle issues. Surgery can change the support structures in the pelvis, disrupt muscle or nerve pathways, or lead to a period of reduced physical activity during recovery. Targeted strengthening, possibly including Kegel weights, can aid in recovery and help restore function and support. It’s important to allow your body adequate time to heal after surgery and to get clearance from both your surgeon and your physical therapist before beginning Kegel weight exercises.

When not to use Kegel weights

It’s important to be evaluated by a healthcare provider or pelvic floor physical therapist before trying Kegel weights, says Dr. Marquez. While Kegel weights may be helpful for some people, there are certain situations when they should be avoided. Dr. Marquez cautions against using Kegel weights if you:

• Have an active infection, such as a yeast infection, sexually transmitted disease (STD), or urinary tract infection. Inserting a weight in these circumstances may cause additional irritation and can increase the risk of spreading bacteria or worsening symptoms.

• Are on pelvic rest, a period recommended by your healthcare provider when all internal vaginal activities should be paused to support healing. Pelvic rest is often advised after surgery, childbirth, or if you have symptoms like vaginal bleeding, open wounds, or unexplained pelvic pain.

• Are pregnant. Kegel weights are not recommended unless you have been specifically cleared by your healthcare provider. This is especially important for those with high-risk pregnancies, vaginal bleeding, or signs of pelvic infection.

• Have pelvic pain, tension, or tightness that has not been evaluated by a healthcare provider. In some cases, Kegel weights can worsen these symptoms rather than provide relief. “If someone has very tight pelvic floor muscles, using weights could actually make things worse and contribute to additional pelvic floor problems,” says Dr. Marquez.

If you’re unsure whether it’s safe to use Kegel weights, talk to your healthcare provider before trying them.

How to use Kegel weights

If you haven’t used Kegel weights before, it might seem unfamiliar. Following this step-by-step approach can make the experience more comfortable and effective, says Dr. Marquez. Here is a guide to help you get started. 

• Prepare. Empty your bladder (aka, urinate) and wash your hands thoroughly with antibacterial soap and warm water. Clean the Kegel weights using mild soap and water before each use. This helps reduce the risk of introducing bacteria and prevents infection.

• Choose the lightest weight. “Kegel weights usually come in kits or packs with several options, so start with the lightest one,” says Dr. Marquez. Starting too heavy can strain your pelvic floor muscles, which can lead to other pelvic symptoms. As your pelvic floor muscles get stronger and you feel more confident, you can gradually progress to heavier weights. 

• Apply water-based lubricant. Using a small amount of water-based lubricant can make it easier and more comfortable to insert the Kegel weight. Avoid silicone-based lubricants if your Kegel weights are made of silicone, as this can damage the surface of the device over time. 

• Insert the weight in a comfortable position. Gently insert the weight as you would a tampon. Many people prefer standing with one leg elevated on a surface or lying down with knees bent and feet hip-width apart. If insertion causes pain or is difficult, stop and consult your physical therapist.

• Engage your pelvic floor muscles to keep the weight in place. To keep the weight from slipping out, gently contract your pelvic floor muscles — the same ones you’d use to stop the flow of urine. You don’t need to maintain a strong squeeze the entire time; instead, try doing a mix of gentle holds (for 5–10 seconds) followed by relaxation, repeated in sets. If you notice the weight starting to shift, a quick squeeze can help bring it back into position. 

• Begin with brief sessions. Start with just a few minutes per session, advises Dr. Marquez, and use the weight as you go about your daily activities. Gradually increase your time to around 15–20 minutes, if comfortable. “Avoid keeping the weight in for too long, as overuse can lead to excessive muscle tightness and discomfort,” she notes.

• Think about positions. You don’t have to start using Kegel weights only while standing. It’s often recommended to begin using them while lying down, then progress to sitting, and finally to standing. As you become more comfortable, you can try using the weights during gentle movement or simple daily activities to further challenge and strengthen your pelvic floor muscles.

• Progress to a heavier weight. Once you can do this comfortably, you may consider progressing to a heavier weight if recommended by your healthcare provider or pelvic floor physical therapist.

• Clean weights after each use. Wash the weights with mild soap and water before and after each use.

Kegel weights can be a helpful addition to your pelvic floor routine, but they are most effective when used as part of a comprehensive treatment plan. This might include pelvic floor physical therapy, other pelvic floor exercises, bladder retraining strategies, and lifestyle changes. Using these approaches together often leads to better results than relying on Kegel weights alone.

“Using Kegel weights in combination with other treatments can help you get the best results for your symptoms,” says Dr. Marquez. 

Are Kegel weights better than doing regular Kegels?

Not necessarily. Standard Kegel exercises can be very effective for many people and are often enough to reduce certain pelvic symptoms. Using Kegel weights to add intensity doesn’t automatically lead to better results — in fact, for some, it can be unnecessary or even lead to new pelvic floor issues if the muscles are overworked.

But for some people, Kegel weights can provide an added challenge that’s helpful for improving muscle strength and reducing symptoms, especially if traditional Kegel exercises aren’t providing the desired results. Work with a pelvic floor physical therapist who can help you determine whether Kegel weights are right for you. 

Pelvic floor physical therapy for urinary incontinence

Pelvic floor physical therapy is a key treatment for urinary incontinence, focusing on safe movement, targeted exercises, and stretches to help relieve symptoms and support your pelvic floor muscles. The goal is to strengthen and coordinate the muscles that help control bladder function, so you can experience fewer leaks and better bladder control.

A pelvic floor physical therapist (PT) can assess your movement patterns and pelvic floor muscle activity to create a personalized strengthening and stretching program. They can also suggest ways to modify your daily activities to minimize leaking and empower you with practical tools and tips to manage symptoms confidently. Recommendations may include exercises like Kegels to build muscle strength, the ‘Knack’ (quickly engaging your pelvic floor before coughing or sneezing), and deep breathing techniques to support pelvic floor relaxation and coordination.

You can see a physical therapist in person or use a program like Hinge Health to access a PT via telehealth or video visit. 

1. Kegels

Exercises to strengthen your pelvic floor, including Kegel exercises, can help hold urine inside the bladder, preventing leakage.

Note that Kegels are not a cure-all for every urinary problem: If your pelvic floor is too tight instead of weak, strengthening exercises can make some urinary problems worse.

2. The ‘Knack’

Engaging your pelvic floor right before you cough or sneeze helps close your urethra (the outlet for urine) so you avoid leaks. Pelvic floor physical therapists call this technique the ‘Knack.’ Performing the Knack before moderate coughing, for example, has been shown to prevent up to 98% of leaks after just a few weeks of practice. You can use this technique for any situation (sneezing, laughing, blowing your nose, straining during exercise, etc.) that increases abdominal pressure. 

Here's how to Knack:

• Do a Kegel to contract the muscles in and around your urethra, vagina, and anus. 

• Maintain the contraction and perform a cough, then relax your pelvic floor muscles.

• Contract your muscles again and cough with more force, or perform repeated coughs.

• Vary the length of the contractions with a mix of quick (two seconds) and long (five to 10 seconds) holds to train your pelvic muscles for endurance and rapid response.

• Avoid holding your breath, pulling your stomach in, straining, or contracting other nearby muscles.

3. Deep breathing

Practicing diaphragmatic breathing, or deep belly breathing, helps coordinate the muscles of your diaphragm and pelvic floor. When these muscle groups work together effectively, it can help support the bladder and improve control over urine flow. Deep breathing increases awareness and activation of your pelvic floor muscles, helping you engage and relax them as needed. Over time, strengthening this mind-muscle connection can reduce the risk of accidental leaks, especially during activities like coughing, sneezing, laughing, or exercising. Diaphragmatic breathing also helps reduce tension in the abdomen and pelvic region, which can further improve bladder function and control.

Kegel weights and pelvic trainers: What’s the difference?

Kegel weights and pelvic trainers are devices used to support pelvic floor muscle strengthening, but they work in different ways. Kegel weights are small, weighted devices that you insert into your vagina to provide resistance for your muscles to work against as you hold them in place. 

Pelvic trainers, on the other hand, are vaginal devices that may use sensors, biofeedback, or even connect to a smartphone app to guide your exercises and track your progress. Your physical therapist may recommend combining strengthening exercises with a pelvic trainer. When inserted into your vagina, pelvic trainers have sensors that provide real-time biofeedback to monitor your pelvic floor contractions, helping you better understand and improve your technique.

While Kegel weights rely solely on physical resistance, pelvic trainers offer additional feedback and support to help you perform Kegel exercises more effectively. A pelvic floor physical therapist (like those accessible in the Hinge Health women’s pelvic health program) can evaluate your symptoms and discuss if a pelvic trainer can help.

FAQs about Kegels and Kegel weights

1. Are Kegel exercises effective? Yes, research consistently shows that Kegel exercises can help reduce urine leakage and improve overall quality of life. 

2. How long before Kegel exercises work? If your symptoms are related to pelvic floor weakness, you might start to see improvement with regular practice in about six weeks, says Dr. Marquez.

3. How long should I use Kegel weights each day? Aim to use Kegel weights for 15–20 minutes per day, says Dr. Marquez. This gives your pelvic floor muscles the right amount of targeted work without overdoing it.

4. Are Kegel weights safe during pregnancy? Kegel weights are not recommended during pregnancy. “Your pelvic floor muscles are under increased stress from added weight and an expanding uterus,” explains Dr. Marquez. Adding extra strain with Kegel weights can place more pressure on these muscles, potentially leading to discomfort or new pelvic floor symptoms.

5. How do I know if I’m using the right weight? “It’s okay to experiment a little to find what works best for you,” says Dr. Marquez. Start with the lightest weight. If you can easily keep it in place for 15–20 minutes, try the next heaviest weight the following day. If you find yourself straining or needing to squeeze your pelvic muscles continuously to keep it from slipping out, it’s likely too heavy, she explains. In that case, switch back to a lighter weight that feels more comfortable to use.

PT tip: Don’t overdo it 

“More isn’t always better,” says Dr. Marquez. When doing pelvic floor exercises with Kegel weights, start slowly and give your muscles time to adjust. Doing too much can lead to increased tightness and discomfort, rather than improvement. “Building pelvic floor strength and coordination takes time, and gentle, regular practice is often more effective than trying to progress too quickly,” says Dr. Marquez.

How Hinge Health can help you

If you have pelvic pain, bladder, bowel, or other pelvic symptoms that are affecting your quality of life, you can get the relief you've been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app, when and where it works for you. Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

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