What can we say now?
We cannot currently conclude that breathing exercises can generally replace targeted pelvic floor muscle training for urinary incontinence or pelvic organ prolapse. Different breathing methods, participant groups and outcomes make the answer more complex than a simple yes or no.
What is the evidence?
The 2023 review covered 18 studies: nine short-term experiments and nine randomised studies. Pelvic floor training generally had better outcomes. Differences between studies prevented meta-analysis.
A 2024 review reported some positive results for hypopressive techniques but considered the evidence preliminary. The 2025 review found different findings across outcomes related to prolapse.
A 2026 review included 14 studies with 797 women. It found no statistically significant difference between alternative exercise interventions as a group and pelvic floor training for stress urinary incontinence. Yoga, Pilates and breathing were among the interventions. This does not establish the benefit of breathing alone.
How certain is the answer?
The evidence for pelvic floor training and for each individual breathing technique must be assessed separately. Small samples, varied exercises and different outcome measures limit comparisons.
No statistically significant difference means that the analysis did not detect a difference by its chosen method; this alone does not establish equivalence. No formal GRADE assessment was made for this editorial review.
The newer reviews were summarised from their published abstracts. Statements on this page are limited to the information available in those sources. The full article is consulted when essential details or clarifications are missing.
Who do the findings apply to?
The 2023 review involved adult women and excluded pregnant and postpartum women. It is not direct evidence for those groups or for girls under 18.
Some studies measured muscle activity during a single exercise among healthy participants; others measured symptoms in women with health conditions. Short-term activation does not itself establish reduced leakage over time.
The 2023 review's authors worked in Norway and Brazil. That does not reveal the countries of all participants. We do not infer participant countries from author affiliations; the newer abstracts do not provide a complete breakdown of participant countries.
What might this mean in practice?
Ask what an exercise study actually measured: muscle activity, strength, leakage, prolapse symptoms or quality of life. These are different outcomes.
NICE recommends supervised pelvic floor muscle training for stress and mixed urinary incontinence and as an option for certain grades of symptomatic prolapse. This is a UK guideline, presented separately from research findings.
This page helps explain evidence, not manage symptoms. For further information on assessment and treatment, see Tidlignok Women's Health.
What do we still need to know?
We need better comparisons of clearly defined techniques and training programmes, longer follow-up and evidence about which groups benefit.
We must check whether reviews share primary studies. More reviews do not necessarily mean more independent findings.
Verifiable evidence
Sources and review
This is a limited editorial literature search, not a new systematic review. Reviews of breathing, hypopressive exercises and pelvic floor training were sought via PubMed and publishers' sites. Relevant work may have been missed.
Recent publications identified up to 29 October 2026 are shown. Reviews may include the same primary studies, so we do not add their participant totals together.
- 1. Systematic review
Can you breathe yourself to a better pelvic floor? A systematic review
Bø K, Driusso P, Jorge CH. Neurourology and Urodynamics. 2023;42:1261–1279. DOI: 10.1002/nau.25218.
Compares breathing exercises and pelvic floor muscle training, and reports short-term measures of muscle activation.
Access during review: Full text reviewed.
Read original source - 2. Systematic review
Effects of hypopressive exercises on pelvic floor and abdominal muscles in adult women: A systematic review of randomized clinical trials
Katz CMS, Barbosa CP. Journal of Bodywork and Movement Therapies. 2024;37:38–45. DOI: 10.1016/j.jbmt.2023.03.003.
Describes preliminary findings for hypopressive exercises combining breathing and postures.
Access during review: Abstract reviewed.
Read original source - 3. Systematic review and meta-analysis
The comparative effectiveness of pelvic floor muscle training and hypopressive breathing techniques for pelvic organ prolapse
Mitchell JR et al. American Journal of Surgery. 2025;242:116111. DOI: 10.1016/j.amjsurg.2024.116111.
Results differ depending on outcomes such as strength and reported symptoms.
Access during review: Abstract reviewed.
Read original source - 4. Systematic review and meta-analysis
Alternative Exercise Regimens for Stress Urinary Incontinence in Women: A Systematic Review and Meta-analysis
Hao J et al. International Urogynecology Journal. 2026;37:849–863. DOI: 10.1007/s00192-025-06445-y.
Combines multiple alternative exercise types; effects cannot be attributed to breathing alone.
Access during review: Abstract reviewed.
Read original source - 5. UK clinical guideline
Urinary incontinence and pelvic organ prolapse in women: management (NG123)
NICE. Recommendations 1.4.4 and 1.7.5.
A UK recommendation for supervised pelvic floor training; not an individual study or Norwegian guideline.
Access during review: Original page reviewed.
Read original source