Kegel exercises for men over 50

By Kyrylo Lozovyi · September 18, 2026

Most advice about pelvic floor training reads as if it were written for men in their twenties. The research was not. The trial that produced the numbers this whole subject rests on had a median participant age of 59 and included men up to 78 — which makes "does this work after 50" one of the better-answered questions in the field, and "what is different after 50" the more useful one.

The evidence was gathered in men your age

Dorey and colleagues randomised 55 men with erectile dysfunction, median age 59.2, range 22 to 78. At six months, on blinded assessment, 40% had regained normal erectile function, 35.5% had improved without reaching normal, and 24.5% had not improved. Those numbers are discussed in full on the evidence page; what matters here is who they describe. Not a young cohort. The men in that trial were, on average, in their late fifties.

So the eligibility question is answered. The protocol does not change with age either: three sets of eight to twelve, 3–6 second holds, release at least as long as the hold, lying then sitting then standing. The protocol →

What does change

1. More of the problem is vascular

The Massachusetts Male Aging Study found some degree of erectile difficulty in 52% of men aged 40 to 70, and the share that is vascular in origin rises with age. The arteries that supply the penis are narrower than the coronary arteries, so atherosclerosis shows up there first — erectile dysfunction precedes a coronary event by two to five years on average.

This is the one thing on this page that matters more than the exercises. Pelvic floor training addresses the mechanical side of an erection: the muscles that compress the veins and hold blood in. It does nothing for the arterial side. If erectile difficulty is new and you are over fifty, a blood pressure check and a lipid panel are the first move, and the exercises are the second. What else has evidence →

2. Post-void dribbling arrives

A few drops after you thought you had finished. It is common after fifty, rarely mentioned, and one of the most trainable things in the whole pelvic floor repertoire, because it is mechanically simple: the bulbospongiosus muscle is what squeezes the last urine out of the urethra, and a weak one leaves some behind.

Two things help. A firm pelvic floor contraction after finishing — sometimes called the "squeeze out" — and the quick flicks in the training programme: ten one-second maximal contractions with one-second releases. Those fast-twitch contractions are the ones this job needs.

3. The prostate is in the picture

Benign prostatic enlargement is common from fifty onward, and it produces urinary symptoms — hesitancy, a weak stream, frequency, night waking — that pelvic floor training does not treat. It is not a reason to avoid the training, and the dribbling and urgency that often accompany it may improve. But difficulty starting urination in particular needs a doctor, partly for the prostate and partly because an over-tight pelvic floor produces the same symptom and the two need opposite treatment. How to tell a tight pelvic floor from a prostate problem →

If you have had prostate surgery, the evidence is different and less encouraging than the marketing suggests. That has its own page →

4. Muscle adapts more slowly

Not dramatically, and not enough to change the protocol, but enough to change expectations. Stay in the lying position longer before progressing to sitting and standing. Judge at three months, not six weeks. Favour consistency over intensity — this is a small muscle that fatigues fast at any age, and an over-trained pelvic floor causes its own problems. The realistic timeline →

What does not change

• Technique matters more than anything. Squeezing the buttocks instead of the pelvic floor produces nothing at any age. The mirror and hand checks are the same.
• The release is half the exercise. A muscle held permanently tight causes pain and hesitancy, and those symptoms get misattributed to the prostate in older men more often than in younger ones. Reverse kegels →
• Morning erections are still the useful signal. They thin out with age but do not stop, and their disappearance still points at a physical cause worth investigating. Why they matter →
• Aerobic exercise is still the best-evidenced non-drug intervention — and in men over fifty with vascular risk, it is the one most likely to move the underlying cause rather than the symptom.

A reasonable plan after fifty

1. If the erectile difficulty is new: blood pressure and lipids first. Mention the erection problem to the doctor by name — it is a cardiovascular signal and they will treat it as one.
2. Start the pelvic floor protocol lying down. Add quick flicks from the start if dribbling is part of the picture.
3. Give it three months before judging. Six for the full effect.
4. If urinary symptoms are hesitancy and a weak stream rather than dribbling, get the prostate looked at, and consider whether the pelvic floor is tight rather than weak before adding more squeezing.

Sources

• Dorey G, Speakman MJ, Feneley RCL, Swinkels A, Dunn CDR. Pelvic floor exercises for erectile dysfunction. BJU Int 2005;96(4):595–597.
• Dorey G, Speakman M, Feneley R, Swinkels A, Dunn C, Ewings P. Randomised controlled trial of pelvic floor muscle exercises and manometric biofeedback for erectile dysfunction. Br J Gen Pract 2004;54(508):819–825.
• Feldman HA, Goldstein I, Hatzichristou DG, Krane RJ, McKinlay JB. Impotence and its medical and psychosocial correlates: results of the Massachusetts Male Aging Study. J Urol 1994;151(1):54–61.
• Montorsi F, Briganti A, Salonia A, et al. Erectile dysfunction prevalence, time of onset and association with risk factors in 300 consecutive patients with acute chest pain and angiographically documented coronary artery disease. Eur Urol 2003;44(3):360–364.
• Gerbild H, Larsen CM, Graugaard C, Areskoug Josefsson K. Physical activity to improve erectile function: a systematic review of intervention studies. Sex Med 2018;6(2):75–89.