Eight signals that it's time to see a specialist — not instead of practice, but as the next step on the ladder.
No improvement after 8–12 weeks of regular practice
Consistent effort, no change. The exercises may be correct — but something else needs assessing.
Symptoms are getting worse, not better
Progression in the wrong direction is always a signal to get eyes on it.
Pain during the exercises — any kind
Stop and get assessed. Pain during pelvic floor exercises is not normal and not a sign you're "working hard."
A "something falling out" sensation that's getting stronger or more frequent
Increasing heaviness or pressure — especially by the end of the day — warrants an in-person check.
Leakage becoming more frequent or larger in volume
The pattern is moving in the wrong direction despite consistent practice.
Gas or fecal incontinence
When gas or stool comes out without an urge, at an inappropriate moment, with no way to hold it — this is loss of control over the anal sphincter, not "loud passing wind in an awkward situation." Even rare episodes warrant assessment. Start with a pelvic floor physiotherapist who has experience with the anal sphincter (a sub-specialty within pelvic floor) or a colorectal specialist — ideally both in contact. This is treatable, and for these specialists it's a standard conversation.
Pain during sex persists or has appeared since starting exercises
New or continuing pain during sex is not a side effect of correct pelvic floor work.