Pelvic Floor Gadgets Review
Note: The views in this post are mine, not sponsored by any company and are free from advertising. This is not an advice on which gadgets might be right for you. Consult the user manual and speak to your healthcare team for personalised advice.
Back in my 20s, I tried out weights (also known as Geisha balls) and was disheartened when as soon as I stood up they fell out. Only a decade later, I discovered that, like most women, I did not know how to use them properly.
Fast forward ten years, during the pelvic floor rehab after my second birth in France, I met three different specialists that used a variety of approaches and so my deep dive experience of pelvic health and gadgets started: intra-vaginal electrostimulation, abdominal electrostimulation, biofeedback, vaginal cones, Epi-no, Elvie.
It was eye-opening and ironic to truly meet my body for the first time after having given birth twice. I remember sensing that a long-term tension that I carried probably since my first birth got unblocked, freeing up a stream of energy. Sitting outside the physio clinic, I started to dot down ideas that will become Modern Postnatal Recovery Coaching.
That's when I realised how much our health after pregnancy and childbirth affects every other area of our life. When health is off balance (whether we consciously notice it or not), our parenting has less patience, our sex life has less passion, our work has less of our attention, our headspace and life energy is limited. It's all connected.
Health is an integral part of all my coaching practice.
Myth #1 Gadget is the quickest / most certain way to a strong pelvic muscle
Research shows that pelvic floor exercises done properly are more efficient than gadgets in strengthening pelvic muscles. But gadgets can make it easier to get into the habit of exercising, boost motivation and maximise results.
Myth #2 Gadgets teach you how to exercise your pelvic muscles
Gadgets will have written or video clues on how to do your pelvic exercises. However, it's hard to assess whether you actually do them correctly when you can't see the muscle. Some have biofeedback function, but all gadgets can be tricked. All women should see a specialist women's health physiotherapist for a vaginal examination and a personalised advice, whether you had vaginal or caesarean birth.
Myth #3 Gadget that my friend is raving about will be right for me
Some gadgets might not be right for you. If you are pregnant, have a pelvic organ prolapse, vaginal scar, heart condition, vaginal infection, herpes, etc. Check the user manual, talk to your antenatal team and women's health physio if you intend to use a gadget.
Read Do Pelvic Floor Gadgets Work? article for more information.
The most common types of gadgets aimed at strengthening differ by their purpose and your main concern:
Apps & reminders, to help you get into the habit of exercising.
Biofeedback, to help you visualise the work of your pelvic muscles.
Electrostimulation, to help you awaken and connect with your pelvic muscles.
Vaginal cones / weights, to help you build muscle endurance. Some have a 'biofeedback wand' function.
APPS & REMINDERS
Pros: Cheap or free. The only aid you might need once you know how to do your exercises correctly. Some have bladder diary.
Cons: Apps cannot assess if you engage and relax muscles properly.
Squeezy App. £2.99.
Developed by UK’s leading women’s health physios, it's a very informative, easy to use and visually pleasing app which is approved by the NHS. Squeezy is used by many NHS and private pelvic health physios to track your individualised physiotherapy programme progress.
It has five options:
1. Squeeze now – takes you straight to the exercises and has a visual reminder when to squeeze and when to relax and a countdown of 10 short and 10 long squeezes. To some, short squeezes might feel too rapid for some and not give you enough time to properly relax muscles between squeezes.
2. Exercise plan – this is where you can change the settings to reflect your personal exercise programme and schedule.
3. Exercise record – this tells you (and your physiotherapist, if you show them) how many exercises you have managed to do.
4. Bladder diary – this helps you keep a diary that is a pre-requirement to incontinence treatment with a specialist physiotherapist.
5. Information – on how to perform the exercises, how to find a specialist physio and further information that is kept up-to-date.
Squeezy App website is a reliable source of information you can access for free without buying the app.
My Pelvic Floor Fitness app (My PFF). Free.
Similar in concept, this app features daily reminders and tips about pelvic floor exercises.
It has a twist on the classic exercises: the short squeeze option has a quick squeeze and a gradual relaxation, while the long squeeze option encourages you to hold for as long as you can. If your physio recommends the classic NHS style exercises, this app will be confusing.
Also, the long squeeze programme lacks a reminder to relax and does not count down 10 long squeezes. So after each long squeeze, you need to go back to the home screen and restart the long squeeze.
The MyPFF App is supported by TENA, who are in business of selling incontinence pads and some of their messages come across as normalising incontinence. While it is very common to experience incontinence around childbirth and after menopause, it is not normal to live with it.
For the reasons above, I would not recommend this app.
Trigger associations & phone reminders. Free.
Find a standard time, an association which will remind you to do your pelvic floor exercises. For example, first thing in the morning while still in bed, after brushing your teeth, set a reminder on your phone.
Pros: Biofeedback devices measure the strength of voluntary contractions of your pelvic floor muscles and give you a real-time feedback on a screen or a dial. It’s hard to exercise a muscle you can’t see. Biofeedback gadgets help you visualise and connect what you feel to what your muscles are doing. Also some of them make exercising a game, making working out your pelvic muscles entertaining and motivational.
Cons: You can trick a biofeedback machine. For example if you use glutes and abdominal muscles instead of pelvic muscles, the machine might show you a good squeeze. Good for a dopamine boost, but you are not exercising the pelvic muscles. Some biofeedback machines are reported to be harder to trick than others.
Elvie Trainer & App. £169.
You insert a small pebble-shaped silicon probe inside your vagina, the probe connects to an app on your phone via Bluetooth. A marker appears on your phone’s screen – a little pink gem because all girls love diamonds. As you squeeze, the gem lifts, allowing you to visualise your muscle performance in real-time.
There are four different levels: training, beginner, intermediate, advanced. As you build up your pelvic floor strength, you will move to higher, more challenging levels, and keep track of your progress with a personalised LV score.
Elvie tells you if it senses that you are not doing the exercises correctly. Some physios say that Elvie is easier to trick (for example if you use your glute and abdominal muscles) than Epi-no (see below). I used both and you can trick both, so it is important to learn your basic pelvic exercise.
Elvie worked well for me because it was a home-use version of the supervised biofeedback rehab programme with a specialist physio I had in France. For someone who has not seen a physio, the gaming part might distract you from noticing what your muscles are actually doing. Epi-no, on the other hand, gives a simple pressure dial that helps you concentrate on the work of your muscle. Also, Elvie needs charging and if you it's not charged when you need it, you are more likely to skip the exercise.
Elvie is now available on the NHS prescription, subject to budgetary and clinical reasons.
Other makers (e.g. Perifit) produce a similar, but more affordable version of a biofeedback trainer with an app, not personally tested.
Kegel8 Biofeedback Pelvic Trainer. £95.
Instead of an App, an intra-vaginal probe is connected directly to a feedback display. You insert a probe inside your vagina, you squeeze and the device measures. On-screen display shows you how strong your pelvic floor squeeze really is and guides you through timed fast and slow pelvic exercises.
Simpler design in comparison to an Elvie-style sleek Bluetooth-connected probe and visually pleasing app, but does the job. However, not personally tested and there is a range of reviews.
Other makers (e.g. Peritone) make similar machines. See Periform+ vaginal probe in 'Electrostimulation' below.
EPI-NO Delphine Plus. £99.99.
EPI-NO is a dual-purpose device for pregnancy and post-birth:
In pregnancy, it is used to stretch the perineum from 37 weeks of pregnancy to prepare you for birth and avoid or minimise tears.
After birth, it is used as biofeedback for pelvic floor muscle exercises.
For pelvic floor exercises, the technology is very simple. An inflatable silicone balloon is connected by a flexible plastic tube to a hand-operated pump with a pressure display, similar to a blood pressure pump. You insert the balloon inside your vagina, inflate the balloon to barely feel it and then squeeze. The strength of your squeeze is shown on the pressure display.
According to some physios, Epi-no is harder to trick than other biofeedback devices like Elvie (see above). I found Epi-no very effective and it's simple design helpful in focusing on the work of the muscle.
For birth preparation, you insert the silicone balloon and inflate it to feel a gentle stretch, similar to an antenatal perineal massage. After stretching, you let the balloon slide out to feel a gentle simulation of the baby's head crowning.
The effect and safety of Epi-no for perineal stretch during pregnancy is debated. Many women swear by the device, while others aren’t convinced it’s worth the spend. Some research suggests that there is no evidence of Epi-no's preventive effect against tear. I used Epi-no during my second pregnancy and gave birth without a scratch. However, many other things went differently during my second birth, so I cannot say how much Epi-no had to do with the positive outcome.
Some antenatal practitioners say that using a device might cause tear while doing the perineal stretching. I have not seen evidence of that. To avoid damaging the perineum, some practitioners advise to slightly deflate the balloon before expulsion, because the fully inflated balloon is pear-shaped with the larger part sitting deeper than the already stretched perineum. Do you own research and ask your antenatal team for advice.
Pros: Awakens and pinpoints the right muscles.
Cons: Over-relied upon by women and professionals alike. Research and personal experience show that electrical stimulation alone does not sufficiently strengthen pelvic muscles. Electrical impulses stimulate involuntary contractions that feel like a lot of work is happening, while not motivating you to learn to use the muscles in a controlled way.
Electrostimulation is not suitable if you are pregnant, during your period, if you have a prolapse or a vaginal infection, if you have a pacemaker, if you have cancer. Check the user manual and consult with your healthcare team.
Kegel8 Electronic Pelvic Toner. £90 - £140.
They have a range of models.
A vaginal probe is connected to the controller. Electrical impulses from the vaginal probe stimulate a contraction within the muscles of your pelvic floor. You control the level of intensity that is comfortable for you. Trying it for the first time at home on your own might feel surprisingly strong. Follow the user manual and start on a lower setting.
Neen Pericalm Pelvic Floor Stimulation. £88.
Neen Periform+ Intra-Vaginal Probe. £15.
The stimulation device is very similar to the Kegel8 one. However, the vaginal probe (sold separately) is different.
In addition to the electrical stimulation function, this vaginal probe has a wand connected to it that can be used as a visual aid when performing pelvic floor exercises (see 'Vaginal cones/Weights' below). When the pelvic floor exercises are completed correctly the indicator will move downwards, an upward movement indicates the pelvic exercises are being completed incorrectly.
The vaginal probe can be used with the electrostimulator Pericalm. It can also be used with the biofeedback device Peritone and is compatible with other makers.
Vaginal cones/weights (Geisha balls)
Pros: Made to build up endurance, they are a good way to progress your pelvic floor training and they are relatively cheap (£25-50). Some have a 'biofeedback tail/wand' to show if you are doing the exercises correctly.
Cons: Women introduce them too early or start with a too heavy weight and get disheartened by the experience. Not advisable if you have a pelvic organ prolapse.
A couple of things to keep in mind:
Cones and weights are a progression from the basic pelvic floor exercise. You need to have a good basic technique and strength to progress to cones and weights. Otherwise they are just going to fall straight out the minute you stand up – most disheartening.
So start using weights when you already know the skill of doing pelvic floor exercises and have a good control of your muscles. If you do not manage to hold them up, get your technique checked with a pelvic health physio.
Start with the lightest weight for beginners.
Some specialists advise against using weights if you have a pelvic organ prolapse, there is a risk of putting too much pressure on already weakened tissue.
Neen Aquaflex Pelvic Floor Exercise System, £30.
The set includes two plastic shells of different width and four weights. You put little weights inside a plastic shell and add more weights as you progress.
Good choice of weights - 5gr, 10gr and 2 x 20gr. You can combine the weights in various combinations from 5gr to 55gr in 5gr increments. Great for beginners.
Discreet, you can put your underwear on and do things around the house while you exercise, if you are at that level.
Kegel8 Vaginal Cones, £29.99.
The set includes 3 cones of progressive sizes and lighter to heavier weight (24gr, 37gr, 48gr). Comes with a 12 week programme of 12-min daily exercise. You start with the largest & lightest cone and progress to the smallest & heaviest cone.
The indicator tail will wave downwards showing you when you are exercising the muscles correctly. A marker on the tail helps you accurately locate your pelvic floor muscles without inserting too high.
The tail does not let you put your knickers on, so only suitable for purposeful pelvic floor exercise at home.
The cones are available on the NHS prescription, as well as to purchase online.
LELO Luna Beads classic, £39.
A modern take on the classic Geisha balls. The set includes 4 weighted balls (2 x 28gr and 2 x 37gr) and a silicone holder if you want to use two weights together. Each ball has a smaller inner ball sealed inside that rolls around when you move thus creating vibration and signalling your muscles to hold on tighter.
Pelvic floor heavy-lifting.
Not for beginners.