It’s the question almost every woman asks me at some point in her first appointment: “How long do I actually have to do these exercises before I’ll know if they’re working?” For years, the honest answer was “give it 3 months and we’ll see.” Now we have something much better to offer — a clear, evidence-based timeline of what most women can expect, week by week.
Why this question matters
Pelvic floor muscle training is the recommended first-line treatment for stress and mixed urinary incontinence — the kind of leakage that happens with coughing, sneezing, lifting, jumping, or running. It works for the majority of women who try it. But the standard advice has always been to commit to a 12-week programme and see how things look at the end.
The trouble with that advice is that 12 weeks is a long time to keep doing exercises every day with no clear sense of whether you’re heading in the right direction. Knowing what’s normal — and when to expect noticeable change — is one of the biggest things that helps women stay motivated and consistent.
What the new research found
A 2025 study published in the International Urogynecology Journal looked at 328 women aged 60 and older who completed 12 weeks of supervised pelvic floor muscle training. Instead of just measuring improvement at the end, the researchers tracked progress every single week. This gave us, for the first time, a really clear picture of when change actually starts to show up.
Here’s what they found:
| THE TIMELINE OF IMPROVEMENT BY WEEK 3 ~50% of women had already cut their leakage in half BY WEEK 4–6 7 in 10 had a major improvement — leakage halved or more BY WEEK 12 ~9 in 10 had meaningful improvement by the end of 3 months |
The really striking finding was that for women who responded to treatment, the improvement often happened a lot sooner than the 12-week endpoint. Roughly two-thirds of the women who would eventually respond reached a 50% reduction within just 4 weeks. Four-fifths got there within 7.
| THE BOTTOM LINE You should start to see real change by week 4, and a noticeable improvement by week 6 to 8. Improvements often keep building gradually all the way to 12 weeks — so if you’re heading in the right direction, keep going. |
What if it’s taking a bit longer for you?
Not everyone responds at the same speed, and the research showed some women genuinely need a bit more time before they see results. The factors that tended to slow things down were:
- Longer-standing symptoms — if you’ve had leakage for many years, it can take a few extra weeks for your body to respond
- More severe leakage to begin with — bigger problems take longer to shift
- Older age — interestingly, age didn’t slow down the initial 50% improvement, but it did affect how long it took to reach really significant gains
None of these mean pelvic floor training won’t work for you — they just mean the timeline may be a little longer. Several of the women in the study who were slower starters still ended up with excellent results.
One thing that did make a difference: how the training was supervised
The study compared women doing one-on-one physiotherapy sessions versus group classes. By week 12, both groups had achieved equally good results — but the women doing one-on-one sessions reached their improvement faster. If quicker results matter to you, individual physiotherapy is worth considering.
An important caveat: pelvic floor training isn’t a fix for everyone
The honest truth is that around 1 in 5 women won’t get a major reduction in leakage from pelvic floor exercises alone. This isn’t a personal failure — it’s a sign that something else is contributing to the leakage that exercises alone can’t address. Sometimes there’s a structural issue with the supportive tissues (the fascia) that needs a different kind of intervention, or there are other factors at play that need to be assessed.
The point isn’t to feel discouraged — it’s to know that not improving is information. If you’ve been doing your exercises consistently and properly for 6 to 8 weeks and you’re not seeing change, that’s a signal to come back for reassessment, not a sign to give up.
What this means for you
If you’re starting (or already in the middle of) a pelvic floor exercise programme, here’s the most useful thing to take from all of this:
- You don’t have to wait 3 months wondering if it’s working. Most of the answer arrives much sooner.
- Aim for noticeable change by week 4, and a real improvement by week 6 to 8.
- If you’re improving — even slowly — keep going. Gains often continue building through the full 12 weeks.
- If you’re not improving by week 6 to 8, book a reassessment. There may be something we can adjust, or another approach worth considering.
- Doing the exercises with the right technique matters far more than doing more of them. If you’re not sure your technique is right, that’s the single most valuable thing to get checked.
Not sure if your pelvic floor exercises are working?
At Precision Health Twickenham, our pelvic health physiotherapists can assess whether your technique is correct, identify anything that might be slowing your progress, and put together an individualised plan to get you the results you’re looking for — faster.
Book a pelvic health assessment today.
59 King Street Parade, Twickenham TW1 3SG · 020 8607 9255 · info@precisionhealthtwickenham.co.uk
Source: Cacciari LP, Morin M, Mayrand MH, Dumoulin C. Incontinence in Older Women: When to Expect Meaningful Leakage Reduction from Pelvic Floor Muscle Training. International Urogynecology Journal. 2025. doi: 10.1007/s00192-025-06486-3.
This article is for general information and does not replace individualised medical advice. If you’re concerned about urinary incontinence or pelvic floor symptoms, please consult a qualified pelvic health physiotherapist or your GP.