If you’ve ever been told to “just do your Kegels” for better pelvic health, it’s time for an upgrade.
Yes, Kegels have their place, especially during postpartum recovery or in the early stages of pelvic floor dysfunction, but research shows that they aren’t enough on their own. Most women don’t isolate the correct muscles during a Kegel, and even when they do, it’s a small piece of a much larger system. To truly build pelvic power and resilience, especially in perimenopause, menopause, and beyond, we need to think bigger. Enter full-body, functional strength training.
Part of the Team
The pelvic floor isn’t a solo player. It’s part of a pressure system that includes your diaphragm, transverse abdominis (the band of muscles around your waist), multifidus (deep lower back muscles), and glutes. And this team works best when it moves together. That’s why squats, deadlifts, lunges, loaded carries, and core stabilization drills are far more effective than isolated contractions done while sitting in traffic or at your desk.
In fact, a 2021 study found that multi-joint resistance exercises improved pelvic floor strength and reduced stress urinary incontinence more effectively than Kegels alone. Why? Because these exercises “teach” your pelvic floor to coordinate with your breath, handle real-life loads, and respond dynamically.
Lift to Support, Not Strain
Let’s bust a myth right here: heavy lifting does not cause pelvic organ prolapse when done with proper form and pressure management. In fact, a 2022 study found that women who regularly performed compound lifts at 80 percent of their one-rep max showed no increased prolapse risk, and in many cases, they had stronger pelvic floor support than sedentary women.
Another study found that female powerlifters experienced fewer symptoms of stress (urinary) incontinence than runners or gymnasts, likely due to their focus on controlled breath and correct bracing mechanics.
Exercises That Support Pelvic Health
Here are the top compound movements I use with clients to strengthen the pelvic floor and build total-body confidence.
1. Goblet Squats
A deep, controlled goblet squat engages the glutes, quads, adductors (the muscles on the inside of your thighs), and pelvic floor. Think of your pelvic floor lifting as you rise and lengthening as you lower into your reps. Even better, this is an incredibly functional movement for daily tasks like picking up your child or lifting groceries.
2. Romanian Deadlifts (RDLs)
While conventional deadlifts are great, RDLs target the hamstrings and glutes even further, which coactivate with the pelvic floor. This occurs when the sets of muscles contract at the same time, allowing the muscle groups surrounding the joint (in this case, the hips) to become more stable. Strengthening these posterior muscles gives your pelvic floor a stable base to fire from, further enhancing both your deadlift reps and your pelvic floor health.
"To truly build pelvic power... we need to think bigger."
3. Lunges
We all know that forward and reverse lunges challenge balance and hip stability. And one 2018 study found that lateral lunges were particularly effective at activating both the gluteus medius and pelvic floor, crucial for stability and continence.
4. Farmer’s Carries
Walking with weights challenges postural control, deep core activation, and pelvic floor reflexes. This simulates real-life stressors, like carrying a toddler or groceries, better than any clamshell ever could.
5. Dead Bugs and Bird Dogs
Despite their animal-inspired names, these bodyweight moves are perfect for enhancing human pelvic floors. These anti-extension and anti-rotation core exercises reinforce intra‑abdominal pressure without strain. In fact, a 2022 review showed that core-stabilizing drills paired with breath coordination significantly improved outcomes in women with mild pelvic floor dysfunction.
What About Menopause?
During menopause, estrogen drops, connective tissue weakens, and muscle mass decreases, a combination that directly impacts pelvic floor support. But resistance training can reverse, or at least delay, that trend. Studies show that strength training in middle age improves collagen synthesis, enhances lean mass, and boosts pelvic muscles. Another study found that menopausal women who trained with moderate to high resistance three times per week had improved pelvic floor strength, reduced leaking, and better sexual function compared to those who did bodyweight-only routines.
This isn’t just about muscles. Many of the women I train arrive feeling “broken,” ashamed of leaks, or afraid to move. But when they pick up a kettlebell, hip thrust 100 pounds, or hit their first five-rep goblet squat, something shifts. Confidence returns. Control improves. And most importantly, they realize their bodies are not failing them; they’re just learning a new language of strength. If Kegels are the warm-up, strength training is the main event. Squats, deadlifts, carries, and core stability drills train your pelvic floor to do what it’s designed to do: respond to real-life loads with strength and resilience.
Let’s muscle up this fall, not just for aesthetics but for bladder control, sexual health, confidence, and full-body function. The big takeaway is that your pelvic floor doesn’t need isolation: it needs integration.
Written by Patricia Siegel, Pelvic Health Expert
Photography by Paul Buceta
Hair & Makeup by Monica Kalra
