Research on Pelvic Floor Strength Training

Table of Contents

How pelvic floor strength training works

Doctors have recommended pelvic floor muscle training for decades. It is the first thing guidelines tell clinicians to offer a woman who leaks when she coughs, sneezes, laughs, or exercises. So the science behind the training is old and well established.

Here is the newer question researchers asked. If the exercises work, why do so many women do them and still leak?

The answer keeps pointing the same three ways. In study after study, most women contract the wrong muscles when they attempt a blind Kegel. Programs collapse on adherence because there is no feedback telling a woman anything is happening. And a squeeze against thin air gives the muscle no resistance to grow against.

We believe Coreogen works through three principles at once.

First, recruitment from the outside in. Squeezing the knees together fires the hip adductor muscles, which co-activate the pelvic floor. The right muscle group works without the guessing that makes blind Kegels fail.

Second, progressive resistance. The adjustable spring gives the muscle real, measurable load to grow against, the same principle behind every other muscle in your body.

Third, feedback. You feel the resistance on every rep and the built-in counter tracks each one, because in the research, feedback and adherence are where training programs live or die.

The studies below are about pelvic floor muscle training and the training principles in general. They are not studies of the Coreogen device, and they are not claims about it. We list them so you can read the science the way we did.

Studies

  • Pressure-Mediated Biofeedback With Pelvic Floor Muscle Training for Urinary Incontinence: A Randomized Clinical Trial (2024). JAMA Network Open. 452 women did identical exercises; the group that trained with feedback was cured at more than twice the rate of the group training blind.
  • A Randomized Control Trial Comparing Common Errors Made by Women During Three Different Methods of Pelvic Floor Muscle Contraction Training (2025). Medicina. With EMG verification, roughly two thirds of untrained women recruited the wrong muscles on their first attempt.
  • Compliance and Adherence to Pelvic Floor Exercise Therapy in People with Pelvic Floor Disorders: A Systematic Review and Meta-Analysis (2025). Life. Across 7 trials and 2,190 participants, adherence decayed over twelve months until trained groups exercised no more than untrained ones. The most commonly named barrier was forgetting.
  • Effects of pelvic floor muscle training on sexual function of postmenopausal women: A systematic review and meta-analysis (2025). Sexual Medicine. doi:10.1093/sexmed/qfaf067. Training improved satisfaction, orgasm, and arousal scores in 527 postmenopausal women.
  • Urinary incontinence, faecal incontinence and pelvic organ prolapse symptoms 20 to 26 years after childbirth (2024). BJOG. Symptoms were still climbing more than two decades after delivery. Time alone does not resolve them.
  • Inefficient impact absorption and reduced shock attenuation in female runners with stress urinary incontinence (2025). Journal of Biomechanics. The runners who leaked were not weaker than the runners who stayed dry; several were stronger. What differed was how their bodies handled impact.
  • Pelvic floor symptoms in elite young athletes (2025). BMJ Open Sport & Exercise Medicine. At a world championship, nearly half of 325 athletes reported symptoms, and 78% had never told anyone.
  • Urinary Incontinence in Women Athletes: Umbrella Review and Meta-analysis of Sport-Related Factors (2026). Sports Medicine.
  • Understanding Barriers to Care for Urinary Incontinence Among a Contemporary Cohort of Women (2026). Journal of Urology. doi:10.1097/JU.0000000000004752. The top two reasons women delay care are cost and the belief that nothing works.
  • Efficacy of biomechanics-based core muscle training in patients with postpartum stress urinary incontinence (2026). Medicine. doi:10.1097/MD.0000000000047763. Training the pelvic floor inside the core system outperformed training it in isolation.
  • Sleep Patterns and Risk of New-Onset Stress Urinary Incontinence: The UK Biobank Prospective Cohort Study (2025). Neurourology and Urodynamics. doi:10.1002/nau.70134.
  • Hip exercises improve intravaginal squeeze pressure in older women (2020). Physiotherapy Theory and Practice. Training the muscles around the hips, including the inner thighs, improved pelvic floor squeeze pressure.
  • Comparative effects of selected abdominal and lower limb exercises in the recruitment of the pelvic floor muscles (2021). Journal of Bodywork and Movement Therapies.

Review articles

  • Involuntary Urine Loss in Menopause: A Narrative Review (2025). Journal of Clinical Medicine.
  • Obstetric risk factors for levator ani muscle avulsion: A systematic review and meta-analysis (2024). European Journal of Obstetrics & Gynecology and Reproductive Biology.
  • Joint hypermobility syndrome for the urogynaecologist: A narrative review (2026). European Journal of Obstetrics & Gynecology and Reproductive Biology.

Expert commentary and guidelines

  • American Urological Association / SUFU / AUGS, Genitourinary Syndrome of Menopause Guideline (2025). Journal of Urology. The major urology societies formally named the cluster of menopause bladder symptoms and direct clinicians toward conservative, first-line care.
  • CY2026 Medicare Physician Fee Schedule, remote therapeutic monitoring provisions (2025). CMS. Medicare and major insurers have begun paying for home pelvic health training and remote monitoring, a signal of where clinical practice is heading.
  • Telehealth-delivered pelvic floor physical therapy (2024-2025). Maturitas; Neurogastroenterology & Motility. Remote programs matched in-clinic care in trials, supporting structured training done at home.

Myths and misinformation

"Half of women do Kegels wrong." That famous statistic comes from a 1991 study. The modern replacement is worse and more specific: in the 2025 EMG trial above, 56% to 69% of women recruited their glutes, 44% to 63% their inner thighs, and up to a third held their breath or strained. The problem was never effort. It was that nobody can reliably train a muscle they cannot feel.

"Leaking means your pelvic floor is weak." Not always. In the 2025 runners study, the women who leaked matched or beat the continent runners on strength. Multiple imaging studies found leaking women's pelvic floors working harder, not less, but firing at the wrong moment. That is why feedback and coordination matter as much as raw strength.

"It is just aging. Nothing works." In the 2026 Journal of Urology barriers study, nearly half of the women who delayed care believed the problem was untreatable. Meanwhile, pelvic floor muscle training remains the first-line recommendation in clinical guidelines. Common is not the same as normal, and neither is the same as permanent.

"If Kegels did not work for you, nothing will." In the 2024 JAMA Network Open trial, the same exercises with feedback cured women at more than twice the rate of the same exercises done blind. The usual failure point is the method, not the woman.

Coreogen is an exercise device for muscle strengthening and toning. It is not intended to diagnose, treat, cure, or prevent any disease. The findings above belong to the cited studies, not to the Coreogen device. If your symptoms are severe, painful, or persistent, see your doctor.