Which electrical stimulation probe is right for me?

1st October 202111th October 2021Leave a comment

Do you need an electrical stimulation probe for either the vagina and anus? These are used with pelvic floor electrical stimulation machines and also biofeedback devices. I hope I can help you decide which one would best suit your needs.

This is one of the topics Kegel8 founder, Stephanie Taylor, asked me about in some video Q & A sessions about the Kegel8 Ultra 20 machine. She is passionate about helping their customers get value and success from a purchase.

IN THIS VIDEO:

The different shapes and sizes
Which type to use if you have a nickel allergy.
Electrodes designed for rehab of the anal sphincter

Watch here (or read the adapted transcript below). In this video we are discussing the vaginal and anal electrodes available to use with a machine called a Kegel8 Ultra 20 V2 Electronic Pelvic Floor Toner. Other models of machine in the Kegel8 range and others available elsewhere are very similar. The electrodes we discuss all have “pigtail” connectors and will be compatible with most machines. The principles are the same for all electrical stimulation machines. Even if you don’t have a Kegel8 you might find this video helpful to understand how your own-brand of machine and electrode works too.

Q: can you tell us a bit about the different probes and electrodes that the Kegel8 uses and how women might find a different probe would be better for them.

Can you see how similar they all are? They are all trying to do the same thing. Their job is to deliver the electrical current as close to the belly of the muscle as possible. This current will stimulate the nerves that make the pelvic floor muscles work. They conduct the electricity to your muscles through the metal bars, side to side. They all look quite similar because the shape of the vagina as you go in goes wider rather than higher and the belly of the muscles is mainly on the sides.

Periform was the first one designed (by a physiotherapist), when there was a move from very big long probes to smaller ones, about 30 years ago.

It’s simple, the bars are on the side. I like that it is easy to tell you have it the right way up. It’s the one you usually get form the hospital as it is the cheapest one. The cables should be coming up the top or from the bottom, not side to side. It has a nice hook to help put it in and out which is nice if your hands struggle to hold things. They left a hole in the top to keep it light. But if you have a prolapse of the anterior or posterior vaginal wall some people find it can pinch a bit when taking it out. There are other very similar probes with a filled in middle available.

You can tell which way up to put it in by feeling the hilt to have a smooth surface up and groove bits to the side. It has a nice hilt so that you can tell if it is in the right distance inside. Something to notice here is that the bars are made of stainless steel. Stainless steel is a great conductor but contains a little nickel. So if you know, from jewellery, that you have a nickel allergy this might not suit you.

The Kegel8 Glide Gold has been designed to tick all the boxes. It has gold plated electrodes, which are less allergic, and would be your choice if you had a nickel allergy. The middle is filled in but is still light weight. It has a flatter structure, so that you could put it more comfortably under a prolapse, and its a bit less bulky than the others.

**Kegel8 Super Slim Vaginal or Anal Probe**

This Kegel8 Super Slim probe is to use for stimulation of the anal sphincter through the back passage. So for someone with faecal incontinence or if you had a 3rd or 4th degree ter. When you know that the anal sphincter needs some rehabilitation as well. It has a hilt that moves so that once you know how far in to put it you have this guide to help you. The bar near the hilt is designed to exercise the anal sphincter, the slightly deeper bar is to stimulate the levator plate (the pelvic floor muscles) further in.

Because it is nice and slim we also sometimes use this if we have someone with a very small vagina, or who has had a lot of pain and feels that the vagina can’t stretch. This is slimmer and friendlier to use for vaginal stimulation. The problem is that it could move about more. You would need to be quite small and keep your knees together. More friendly if you are not sure about the other sizes. It can be used in either vagina or anus whereas you can’t put the Periform or Glide in the back passage as they are the wrong shape.

The Perisize Vaginal Probe has a bar that releases so that you can narrow it to put it in but once it is in then it widens. Very ergonomic, as this is the shape of the vagina – the opening is quite small but then it widens. This probe is good if you don’t feel you are getting enough side to side contact. It is the widest probe.

You will also see that it has more cables. This is because it is acting like two electrodes. Each side is independent of each other. If internally you have one side that is more sensitive or uncomfortable then you might want to have this one on a lower amplitude. With Periszie you can choose the settings for each side separately which you can’t do with the standard probes. It is quite specialist. It might be something your physio guides you towards. Or you have used the basic first and decided you want something wider. It is not needed as a first choice probe.

Q: if someone doesn’t want to use an anal or vaginal probe – what’s the option for them

Stimulation to exercise the muscles

Muscle stimulation to exercise the muscles is best delivered as close as possible to the muscle, where the nerves are. Since the invention of discreet & comfortable vaginal and anal probes, physiotherapists would generally choose this internal method of application as the most effective way to create a contraction of the muscles using stimulation.

However, if you cannot use an internal electrode it would be worth trying a surface application to see if you can activate the muscles, but it can be difficult to truly reach the muscles through the body’s layers of tissues. Before these internal probes were invented, stimulation was delivered using surface electrodes (sticky skin pads). You can put them where the nerve starts (in the spine) so they can be positioned around the sacrum, the very low bit of the spine. It doesn’t matter if they are placed higher, the nerves below will still be affected. You can do this with 2 or 4 surface electrodes. The machines come with instructions about where to put the electrodes. The key thing is that there must be a gap between them. You don’t want the electricity to jump from one pad to another – you want the electricity to go through the body and stimulate the nerves on the way. Leave a gap of an electrode size between the electrodes.

Stimulation for neuromodulation (to calm the bladder or nerves)

There is a type of stimulation for overactive bladder syndrome. This type of stimulation does not exercise the muscles, it rather calms the nerves by sending lots of sensory sensations. Therefore this can successfully be done through the vaginal electrode, or through sacral placed electrodes, or by putting it near your tibial nerve, down by your ankle, or a combination. The choice is about comfort, finding out what works for you and whether you feel your getting some benefit from the stimulation in your chosen place.

Have you tried several different probes to find the best one for you? Please do share your experiences or ask questions below.

Medical Disclaimer

Any information or guidance we provide is not a substitute for the consultation, diagnosis, and/or medical treatment of your doctor or healthcare provider.

You must not rely on any information or guidance we provide you with as an alternative to medical advice from your doctor or healthcare provide and we expressly disclaim all responsibility, and shall have no liability, for any damages, loss, injury, or liability whatsoever suffered by you or any third party as a result of your reliance on any information or guidance we provide you with.

If you have any specific questions or concerns about any medical matter, you should consult your doctor or healthcare provider as soon as possible.

If you think you may be suffering from any medical condition, you should seek immediate medical attention from your healthcare provider. Do not delay seeking medical advice, disregard medical advice or discontinue medical treatment because of information or guidance we provide you with.

Nothing in this disclaimer will limit or exclude any liability that may not be limited or excluded by applicable law.

Which is the best electrical stimulation programme for new mums?

31st August 202111th October 2021Leave a comment

Which is the best electrical stimulation programme for new mums wanting to rehab their pelvic floor muscles? This is one of the topics Kegel8 founder, Stephanie Taylor, asked me about in some video Q & A sessions about the Kegel8 Ultra 20 machine. She is passionate about helping their customers get value and success from a purchase.

In this video:

What to do to help your muscles from the very early days before you can use an electrical stimulation machine.
When you can start using a electrical stimulation machine safely after birth
Why it is important to test the sensation in the nerves, have a longer rest time between contractions and how to avoid muscle fatigue.

Watch here (or read the adapted transcript below). In this video we are discussing the electrical stimulation programmes for new mums on a machine called a Kegel8 Ultra 20 V2 Electronic Pelvic Floor Toner. Other models in the Kegel8 range are very similar. The principles are the same for all electrical stimulation machines. Even if you don’t have a Kegel8 you might find this helpful to understand how your own-brand of machine works too.

Q: Stephanie asked me: “We’ve got lots of programmes on the Kegel8. I’m a new mum. Which programme is going to be best for me – if I’m looking to get back in shape – what’s your recommendation?”

The first few weeks: simply connect your brain and pelvic floor naturally

Let’s start by thinking about a very new mum. You’ve had a baby and you are starting out with your exercising. In the first 12 weeks the body is very fragile and very vulnerable. We do want you to start exercising but we don’t encourage the use of electrical equipment in this early phase. Why? Partly because you will still have some bleeding, you might also have some hidden raw wounds but also because it is a fragile vulnerable time.

What you do need to be doing in those early days is using your muscles as best as you can. Using your own brain to to activate them. Even if all you are doing is pulsing your muscles a tiny bit and you think “Is it worth it?”. It IS. Because that pulsing action will bring blood flow close to the area. Blood flow helps healing. And helps to get healthy tissues again. In your head it will feel like little tiny pulses, not very exciting. Everything might feel swollen and engorged. But those tiny exercises are a really important thing to do. Little and often through the day. To keep your brain and your pelvic floor connected together and encourage these muscles to start working again.

From 6-8 weeks: feeling proper contractions

About 4-6 weeks you should be feeling that you have some proper pelvic floor contractions. They should feel useful to you. For example, when you want to cough and sneeze and pick up your baby. It’s all a bit mad that nature delivers through the muscles that you need and then hands you a heavy baby to look after. Not quite how you or I would have designed it. But that is the reality. So we’ve got to get these muscles working.

From 12 weeks: why you might choose to use an electrical stimulation programme?

After 12 weeks there are other options to consider.

If you are not getting enough sense of being able to exercise your muscles yourself
Or you don’t feel that you are getting a pelvic floor muscle contraction.
Or you don’t feel that you are progressing.

Then you might like to use a machine to help you.

What is special about the electrical stimulation programmes for new mums?

Some programmes on the Kegel8 V2 Ultra 20 are designed specially for postnatal mums. For example programmes 14 & 15. What makes them different?

A sensory phase

The first phase of these programmes is actually a circulation phase, a very low frequency current, to create just a tingling sensation for about 10-15 mins. This allows you to test whether you can actually feel anything. A problem that can affect new mums is finding that the nerves aren’t working properly at all and you can’t feel things properly. It wouldn’t be safe to use a machine if you couldn’t feel properly as you would have no way of knowing how high to turn it up which could be sore. So the first phase allows you to test for what you can feel. This phase is also really good for circulation. It brings blood flow to the area and oxygen to the tissues.

A muscle strengthening phase

Later in the programme it moves to a muscle strengthening phase. It actually makes the muscles tighten and release. But different to the one that is listed for stress incontinence, this phase has a longer rest time between the contractions. When we make muscles contract they do need to be able to relax completely between contractions before we ask them to contract again.

A longer rest time

When your muscles are very weak it is important to have almost twice as long resting to working. As you get stronger you can choose a programme where there are shorter rest times but when you are very new post delivery it is really important to have a rest phase.

An overall shorter programme

The overall working in this programme is 15-20 mins maximum, because your muscles will fatigue easily. Tired muscles can’t do anything. Yet you’ve got to look after the baby! So it’s really important that the machine doesn’t made you so tired that you can’t look after your baby and hold your body up!

So that is the idea behind this programme being called a postnatal programme

Q: How often would you recommend using an electrical stimulation programme for new mums?

The manufacturers say that you can use these devices up to twice a day every day. I think a lot of women feel that is an unrealistic goal. We tend to start women out in clinic using their device once every other day. As a starting place. You don’t want to put yourself off. These are plastic gadgets in in very delicate places! If you do too much too quick you end up not wanting to do anything.

So I tend to aim to underachieve at first. Use it for 20 minutes every other day. Then if that is going well, and you are liking it and you feel it is beneficial, you could go to every day. And if you were blessed with time to do twice a day that would be a bonus. I am not sure that is very many mums?! We find people get good results on every other day or once every day.

Feeling more confident how to choose an electrical stimulation programme as a new mum?

I hope this post has given you more confidence to get started with a Kegel8 Ultra 20 stimulation machine or something similar? We have made several other videos about using stimulation machines. For other conditions, for example for a prolapse, for an overactive bladder or for stress incontinence. We also do a Q&A to show the different types of probes available.

Another series is all about the pelvic floor and how to do exercises without a machine too!

Please don’t hesitate to email if you have questions and I will do my best to help. Please do comment below or on YouTube if you found these helpful.

Medical Disclaimer

Any information or guidance we provide is not a substitute for the consultation, diagnosis, and/or medical treatment of your doctor or healthcare provider.

If you have any specific questions or concerns about any medical matter, you should consult your doctor or healthcare provider as soon as possible.

Nothing in this disclaimer will limit or exclude any liability that may not be limited or excluded by applicable law.

Get started with a Kegel8 Ultra 20 Stimulation Machine

31st August 202111th October 2021Leave a comment

How to get started with an electronic pelvic floor toner

Are you trying to get started with a Kegel8 Ultra 20 stimulation machine? Let’s be honest. The instructions that come with pelvic floor toner machines are not great. They are generally from the era of men in labs writing high-tech specs in teeny tiny writing. However, Kegel8 are a company working hard to make it easier for women to use a pelvic floor stimulation machine by themselves, or with their physiotherapist. I was delighted that they asked me to film a Q&A session with company owner Stephanie Taylor, to try to iron out some of the bits that frequently confuse.

In this video

What’s in the box?
Which cable goes where?
The purpose of gel and how to insert your internal electrode
Which buttons to press
A good first programme to try for muscle strengthening
Step by step what you will feel (8:47)
Turning up with confidence!
How many times a day when you are starting out?

Watch here (or read the adapted transcript below). In this video we are demonstrating how to get started with a stimulation machine called a Kegel8 Ultra 20 V2 Electronic Pelvic Floor Toner. Other models in the Kegel8 range are very similar. The principles are the same for all electrical stimulation machines. Even if you don’t have a Kegel8 you might find this helpful to understand how your own-brand of machine works too.

Using a stimulation machine to get a pelvic floor muscle contraction

These machines can be used for several different reasons. Today, let’s assume that you want to get a muscle contraction. First so that you can start learning exactly where your pelvic floor is. Second to know what it feels like when it is working correctly. And to help you towards the goal of learning how to do pelvic floor exercises yourself, without a machine. As recommended by physiotherapists (!). Pelvic floor exercises help problems with bladder or bowel leakage, to support a pelvic organ prolapse and for full recovery after childbirth.

What’s in the box?

In the video we can see everything that comes in the box. But we are not going to need the surface electrodes or the second wire at the moment. To get started with your stimulation machine all you need is the machine (with the battery in ) and one lead wire.

Step one – insert your vaginal probe

So the first thing I would get you to do is to put the probe in. In the video we are only going to pretend!

First put a nice big blob of gel on a tissue. Then put some gel on each bar, a really good coating. Twizzle it over and get the gel around the back. Then a bit on the end to help it go in.

When you put the probe in, I would suggest lying down. At home it could be on the sofa. So underwear off, lie flat and put the vaginal probe in with the bars going side to side. It’s not dissimilar to a tampon but you are not putting it in so far. You want to feel 1 cm of cable inside. You don’t want it sticking out on a stalk and shouldn’t be able to feel the plastic. And then you can put your underwear back on, which feels more natural. Have the cables down one knicker leg or out the top. Or your PJs or tracksuit bottoms. So that if anyone came into the room they wouldn’t know what you were doing!

Then connect your vaginal probe to the lead wire

There are two tails from the vaginal probe to connect to the lead wire. It will be a bit tight – you need to push them in until you can’t see the metal. It doesn’t matter which end to which. Some stimulation machines come with black and red coloured ends, which is a little bit disconcerting, as it does look like jump leads, but again it doesn’t matter which to which as long as a nice firm connection.

Note: When you put them in and take them out always use the tough plastic bit. Try not to pull on the wires as they are quite delicate.

Connect the lead wire to the stimulation machine

Now,the single connector at the other end will connect to the top of the hand-held machine. Plug the top of the lead wire into one of the ports on the top. It doesn’t matter which port you use. But whichever side you plug in at the top is the side buttons you should use. So all on the left or all on the right. We are going to plug into the top left. So we will be using the left hand buttons when we want to turn the machine up.

Turning on your machine

To get started with your stimulation machine press the classic “on” button symbol. Up on the screen will pop lots of information and symbols.

Choosing a first programme to try

First we are looking for which programme we are going to use. Today, for demonstrating a programme for muscle strengthening, we are going to choose Programme 10. I am going to press the programme button over and over until I have gone all the way to P10. It’s on a loop – so if you do what I did in the video and go too fast (!) you have to go all the way around again until you get back to your programme.

Now we can see the number of the programme and it’s name. Don’t get too bogged down by the names. They were pre-programmed a while ago and they don’t always exactly match with the symptoms women have. Kegel8 are making an updated list to help you choose (available soon). Programme 10 is called “stress incontinence” which you might or might not have. However, this is a muscle strengthening programme. Something many women know they need to do. P10 is a useful one to get started with a stimulation machine.

In the top Right corner you can see what we call the parameters – the frequency and the pulse width. Like when you tune your radio and choose your channel. The programme choice decides what style of electricity is going to come to you. Programme 10 has two phases, indicated by the two chevrons.

Starting with Programme 10 Phase 1

When you switch this programme on, the first phase of the programme is a sensitivity test, also for circulation. It’s not at first going to make your muscles work. The first phase is just stimulating your sensory nerves and letting you feel whether you can feel this machine. It’s really important that we know that you can feel. Because if you have damaged nerves for any reason you could feel sore before it was of benefit to you.

Look for the bottom number, Zero, in line under your connected cable. This is like the volume on your radio. It is zero which means you are getting no electricity at all. Go ahead and press the + button, + + +. I suggest you go up to 10 straight off because very few people feel much before this level. In the video, Stephanie has the probe in her hand. In her hand Stephanie it’s going to feel it very quickly and strongly because our hands are very sensitive! However, if the probe is inside the vagina you probably wouldn’t feel it at all at 10. However, the current is running – You can tell this because you can see the number go up (the mA). Each 10-15 seconds turn it up a bit more. Edging it up until you can feel it.

What to expect with the first feelings as you turn up

You will feel a light – tingly – maybe a bit scratchy sensation. Some people say it just feels warm. There isn’t a right or wrong feeling, but it’s something that wouldn’t be there otherwise. This is the first place we try to get to. Stimulating your sensory fibres and letting your brain go “Oh yes, that’s where my pelvic floor is!” Though mostly people will go “Oh, that’s not where I thought my pelvic floor was!”. Perhaps a bit deeper inside you than you were expecting? We often think it is all at the vagina opening but actually the pelvic floor muscle belly is deeper inside.

If you haven’t had much going on with your pelvic floor for a while, then this is all going to be new! This is learning. Just spending your first session FEELING and getting used to it could be all you need to do initially.

Why it might quickly change to a lighter feeling

It is normal that after after a few minutes you might notice “I can’t feel it anymore”. Why’s that? Your body is getting used to it – accommodating. Your body is going “Oh, this is alright”! Not as scary as you thought it would be! Your brain has relaxed and blanked it out a bit now. When it fades you need to turn yourself up a bit more, using the + + + until the feeling comes back again. In your first couple of sessions you will probably have to keep turning yourself up a bit, little and often. Until you have become a bit braver, got used to the feeling and know which settings work for you best.

Once you’ve got a bit more used to using this you will know where to head for straight away. But initially it’s best to go really cautiously. Don’t scare yourself, take your time, and get used to having sensations coming up to the brain from the vagina.

Moving to the second phase of programme 10

With this particularly programme we have chosen to use today, the sensory part of the programme takes 10 minutes. When this 10 minutes has gone by it will move to another phase. You will see the little numbers at the top change to 35Hz frequency and 250µs pulse width. This is the setting that could make your muscles work for you. From a muscle strengthening goal, this is where we want to get to. Past the sensory phase, onto the next phase.

Now I am going to encourage you to turn up the current (mA) of the machine more until you start to feel something actually happening inside the vagina area, where the pelvic floor muscles are.

It is a bit weird when it happens. People will say it feels “like a pressure”. Or it feels like “just like a contraction” or “like something tenses”. Or they feel something move – what they are feeling move is the probe. In the second phase the current will be coming on and off rather than be continuous like in phase 1. The contraction/electricity will be coming on for 5 seconds and then it will go to zero for 5 seconds. You will see the number at the bottom, the mA, coming on (say to your setting of 25) and then off again.

When you get started with a stimulation machine, it is really important that you have the rests. It is not wrong that it goes to zero. If you count, you will feel it coming on for 5 and off for 5. Another clue, is the little top right arrow moving to the highest position “work” and dropping down to “rest”.

Making sure you are getting a pelvic floor muscle contraction

At this point we want a pelvic floor muscle contraction. Now it’s a little bit of playing with the amplitude (the up and down buttons). You want to get it as strong as is comfortable. Because it’s only when it is a bit stronger that the muscle will actually contract. One of the problems we see with the machines used at home is that women have been plugged in, and they are running a moderate current through, but it’s not quite enough to actually make the muscle DO something. So they are not stimulating the muscle as much as they could. If you can’t get it to that place its fine. It is still of benefit to the muscle. But the best place is where you have felt it do something and then it relaxes.

Can you feel it doing something and relaxing? If you are not sure, another way to tell is to reach down and hold the cable. This is what I would do if you were in clinic to check you have the current high enough. When the machine comes on you will feel that there is a slight pulling inside. When the machine goes off you want to feel a letting go. Sometimes you are not sure if it has actually pulled in – but you feel it let go. That’s your clue!

How high to turn up the machine?!

Once you have got a muscle contraction, you can edge it up a bit higher. But never ever make this uncomfortable.

It’s wrong if you feel. thecurrent coming and you are feeling yourself backing off from it. That’s too high. That’s not helpful or therapeutic. You want the opposite. You want the feeling that when it comes you want to embrace it.

How to work with the stimulation machine

It is great to feel that you want to do your squeezes at the same time as the electricity is stimulating your muscles. If that happens, then the machine is telling some of the fibres to work and your brain is telling your fibres to work. So those are the best squeezes of all!

However, you probably wouldn’t be able to keep that up for the whole programme. So one of my tips would be to join in for a minute and then let the machine run for a minute. Then join in again and then let the machine run. Or you might count joining in for 5 of them, and then chilling out for 5 of them, letting the machine do it’s own thing. And then try to do your squeezes at the same time for 5 then relax for 5.

How long to work with the programme when you are starting out

The second phase is set to last for 15-20 minutes. If you are quite new to this, that could feel like too much initially. You might use it for 10 minutes with a sense that you’ve done way more pelvic floor squeezes in the last 10 minutes than I’ve done all year! In which case turn it off. Stop. Come back to it the next day or day after and do another short session.

You will know you are getting used to it when you don’t feel you need to turn it off. You find you are quite happy to run the whole cycle.

When you get started with a Kegel8 Ultra 20 stimulation machine there are no strict rules about what will work or not work. The most important thing is that it is comfortable and it is doing something useful for you. Perhaps something that you couldn’t do by yourself. Or that you can exercise better with it than you could do by yourself. Or you might be using it to remind yourself, every now and then, what a squeeze is supposed to feel like – so that when you are doing your 3 x a day squeezes to build your muscles up – you have a better picture in your head of what it should feel like and that you are in the right place.

What to do if it feels like too much or not enough stimulation

You might find, even part way through, that you want to take the stimulation current down a bit – almost like it is becoming a bit overwhelming. Feel free to use the – button to edge back. Or that you have got used to it and want it a bit stronger.

The stimulation current may not feel the same or be the same number of mA each time

It probably won’t be the same exact strength next time you use it. Firstly because you might put it in a slightly different place. Or you might have a bit more or a bit less gel. Or your body might just be in a different sensory place. You might not need it so high to get the same response – or you might need it a bit higher.

It is just like the volume on a radio. Find a level that you feel comfortable with but still a good contraction and sensation.

How to stop the machine at the end of the programme or sooner

When the programme is finished, the machine automatically turns itself off. Or you can just press stop (off) whenever you’ve had enough.

How to clean the probe after your stimulation session

First disconnect the 2 ends from the probe – use the plastic bits to pull not the delicate wires! Put the machine and lead wire to one side so that you won’t drop it all on the floor. Then, in your own time, take out probe inside. Wash it in warm soapy water. Or use the anti-bacterial spray that is provided to spray it and leave it to air dry. It’s what we call clean technique. The vagina isn’t a sterile place. The probe doesn’t need to be sterile but you do want your hands and the probe to be clean to avoid any infection.

Feeling more confident to get started with your stimulation machine?

I hope this post has given you more confidence to get started with a Kegel8 Ultra 20 stimulation machine or something similar? We have made several other videos about using stimulation machines. For different conditions, for example for a new mum, for a prolapse, for an overactive bladder or for stress incontinence. We also do a Q&A to show the different types of probes available. Another series is all about the pelvic floor and how to do exercises without a machine too!

Please don’t hesitate to email if you have questions and I will do my best to help. Please do comment below or on YouTube if you found these helpful.

Medical Disclaimer

Any information or guidance we provide is not a substitute for the consultation, diagnosis, and/or medical treatment of your doctor or healthcare provider.

If you have any specific questions or concerns about any medical matter, you should consult your doctor or healthcare provider as soon as possible.

Nothing in this disclaimer will limit or exclude any liability that may not be limited or excluded by applicable law.

water lily to illustrate bladder support devices

Bladder support pessaries: how do they work?

11th June 202111th October 2021Leave a comment

Bladder support pessaries: extra support from the inside

updated 2021 (original 2019)

Strengthening your pelvic floor is still first prize for bladder leakage problems. But what if you cannot create enough strength and support for the bladder with your pelvic floor muscles alone? You may benefit from one of the modern bladder support pessaries that give some reinforcement to the bladder neck and bladder tube.

These are devices that you can buy on the internet and then insert and remove yourself. They are designed to be worn all day but not all the time. These can be a surprisingly inexpensive & eco-friendly option, compared to disposable pads. Ideal if you know when you will leak and need to use the device only for intermittent pre-planned activities.

Available in the UK at the moment are , Contam, Contiform, Efemia and Uresta. They vary in price chiefly relative to how many times they can be re-used. Contiform and Efemia are available on prescription.

Would they suit you ?

Have you done your pelvic floor exercises, improved your core, modified high impact and improved your fluid management? Still not quite resolved your bladder leakage? Then one of the bladder support pessaries may offer an alternative to surgery (NICE Guideline NG123 2019). They have a similar mechanism of action (mechanical support of the urethra) to the TVT and colposuspension surgical procedures but no side effects or surgical risk.

In my clinical experience, these support pessaries work particularly well in certain situations. For example when the bladder has dropped only a little bit and the uterus is still well supported. Or, if exercises have created a good layer of muscles but you still need more bladder support to be active.

How do internal bladder support pessaries reduce urinary leakage?

These devices work by providing more support for the bladder neck. When you move fast (eg jogging, playing tennis) or there is an increase in abdominal pressure (coughing, sneezing, jumping), the pelvic floor muscle is supposed to support the bladder neck so that there is no leakage. However, if the muscles are weakened and/or untoned that support can be lost.

hose lying on grass and path — Would it be easier to stop the water by standing on the hose on the grass or on the path?

Are a visual person? Imagine a running hose pipe, lying on soft grass. When you lay your foot on the pipe you may slow the flow of water. But you may not be able to stop it completely. However, if you lay your hosepipe on a firmer surface, like a garden path, when you press down on the hosepipe the water flow stops. A toned pelvic floor should act like that firm path. But if yours isn’t up to scratch a pessary could do that job instead.

What type of urinary leakage will they help?

Bladder support pessaries are best for small leaks associated with movement. Or leaks when the bladder is under pressure from coughing, sneezing or laughing (stress urinary incontinence).

They create a mechanical uplift to support the bladder neck the way the pelvic floor is supposed to do.

These would suit women who don’t generally experience day to day stress incontinence but know when they are going to leak. For example if you know you will have incontinence if you do a run, or when you go to Zumba. Or if you feel anxious about an event, like going to a wedding, or travelling. You might only use a product like this once or twice a week. With one of these in you might not need any other protection, or would feel confident with simply a liner or a pair washable knickers “just in case”.

They can’t help with urgency or irritable bladder

What these devices can’t do is change symptoms like urgency. If your bladder is irritated by caffeine, being too full, or you have an overactive bladder, you won’t see any improvement using one of these. Pelvic floor exercises DO help these symptoms because the pelvic floor contracting activates neurological messages which calm the bladder down. Unfortunately these devices can’t do that.

If urgency or frequency symptoms are your bother – then you need to practice “endurance/holding” pelvic floor exercises (see more in the Pelvic Floor School) and have also read of the article “How much should you drink in day and when should you have a wee?” for more impact on these problems.

a glass how much should you drink in a day

Can I leave it in to wee? What about during my period?

Yes, they are all designed to be left in when you have a wee or bowel movement. The pressure of the bladder squeezing is enough to push the urine past the supported area when you need to.

You could still use the Contiform or Efemia pessary when you had a period (as the menstrual fluid can flow through it) but you couldn’t use a tampon at the same time. The other designs (Contam, Uresta) act as a block but are not absorbant like a tampon, so shouldn’t be used during your period.

Note: The term pessary can be confusing

Because these devices to reduce bladder leakage sit inside the vagina they are termed a “pessary” but they should not be confused with a traditonal pessary used for supporting Pelvic Organ Prolapse (POP). For more information about pessaries for prolapse read here

Field Guide: bladder support pessaries to reduce stress urinary incontinence

Each company markets their own product and may use more than one distributor so prices can vary. Here is my personal “quick guide” to what’s out there at the moment, apologies if it has already changed again by the time you read this! Please do let me know if I have missed something out, or you find a new supplier or product before me! Please do comment to support other readers & share your experiences:

Contrelle Activgard

single use only

currently unavailable in UK but understood to be returning soon.

Contam Pessary

single use only

£26.99 for a starter set (range of 3 sizes “normal” or “large”). From £12.95 each bought singly, or just under £10 each if bought in groups of 3 thereafter from www.stressnomore.co.uk

* use promotion code SUPPORTEDMUMS at checkout for a 15% discount

These are quite new on the market. There are no clinical trials listed.

Contam is a brand offering a variety of shapes and sizes of single-use vaginal pessaries. It is the tampon shaped ones that are suitable for supporting the bladder neck. The cube shaped ones are for going much further back in the vagina to support a more severe uterus prolapse. Unlike tampons they do not absorb moisture from the vagina. You soak them in water before use to make them pliable and elastic to insert and to prevent drying out of the vaginal wall.

It is suggested that you position them differently according to the problem: For incontinence: “insert the pessary deep into your vagina, then pull it back slightly so that it’s within reach of your fingers”

Note: see a size chart under “product description” on the website.

Contiform

available on NHS prescription

re-use up to 30 times

£97 starter pack of 3, £46 per unit thereafter* from contiform.co.uk

*further 20% reduction if you complete a VAT exemption form

Also available on NHS prescription from your GP [starter pack: NHS order code SKU184 , PIP code 375-5808 ]

The principle of the Contiform is to create uplift and support for the neck of the bladder. These are guaranteed to be re-usable up to 30 insertions. So if you felt you needed support daily rather than ad hoc this is likely a more economical option in the longer term.

The Contiform Pessary looks like a plastic hollow tampon. The smaller circle supports the bladder tube (the urethra). The larger surface lies against the floor of the vagina, giving support to the bowel wall. They are made of a firm but flexible non-latex plastic. Each can be reused, with the guarantee up to 30 times. There is a “slit” that develops with wear to show you when the device needs changing. Use for longer if not worn all day. There is an optional ribbon to help with removal.

You can buy Contiform online or they are available on NHS prescription. You would need to tell your GP about your symptoms, and ask him to prescribe a starter pack for you. While you are there ask for a referral to specialist physiotherapy too if you haven’t already got your own pelvic floor coach(!). Especially if using a Contiform works for you – it suggests that a stronger pelvic floor could do this job naturally for you too!

Fiona Rogers, physio, clearly explains how to use the contiform. See 2:18 to understand how the “split” works. 3:08 about removal with or without the ribbon.

Efemia Bladder Support

available on NHS prescription

re-use for 3 months

The Starter Kit contains all three sizes (S- 30mm, M- 35mm and L- 40mm) to find your best fit. £59. Thereafter £49 for each single replacement.

www.aghealth.co.uk

The newest member of this ‘family’ of bladder support pessaries. Efemia feels more petite, lighter and softer than the Contiform & Uresta. It is made of transparent flexible medical grade silicone. It is designed to sit lower in the vagina, tucking just behind the pubic bone. Similar to the space where a TVT procedure is positioned. Positioning correctly is straight forward. You leave the handle part on the outside of the body, but this could be irritating to the labia or vulva tissues for some women (efemia recommend using water based lubricant if this occurs). The external loop makes it easy to remove. It needs just a rinse between uses. You can leave it in place during menstruation but you could not use a tampon at the same time.

The Efemia website has a good video to show you the position it takes up and how this helps to support the bladder tube (the urethra) as you cough or move.

Like Contiform and Uresta it’s effectiveness is supported by small clinical trials. It is available on NHS prescription in England. You would need to tell your GP about your symptoms, and ask him to prescribe a starter pack for you. While you are there ask for a referral to specialist physiotherapy too. Especially if using an Efemia Bladder Support works for you. That suggests that a stronger pelvic floor could do this job naturally for you too!

Uresta

resuable for a year

£179 (ex-VAT ) + £8 P&P for a starter kit containing 3 sizes from iMEDicare on 01923 237795 or via uresta.uk

Uresta, designed and manufactured in Canada, joins this family of internal support devices with the unique selling point that it is fully reuseable for one year.

So if you have had good success with one of the devices above this would be a natural progression to a potentially more environmentally friendly and overall less expensive option.

A clinical trial of 32 women found that of those still using it at 2 weeks (21 women out of the original 32), 76% of them (16) were still using it at their 12 month visit.*

* Farrell SA, Baydock S, Amir B, et al. Effectiveness of a new self-positioning pessary for the management of urinary incontinence in women. Am J Obst Gynaecol 2007:196:474e.1-474.e8

There is a helpful video from their website below. If you are worried about the high initial cost Uresta offer a full money back guarantee. There is also give good advice about how to find the right size for you.

this video is from uresta.co.uk

Beware misleading marketing

Some of the marketing blurbs list “strengthen your pelvic floor” as a benefit of using their pessary device. This is only true in the loosest meaning. While they are in place, by artificially re-inforcing the vagina wall, I suppose you could claim that is “strengthening” the pelvic floor action – but they are in no way making any change to the muscle. Only exercise can change the composition and activity of the muscles or surgery the non-muscular elements. When you take the device out the structural situation remains the same. However, these devices definitely offer an alternative to surgery. Or a Buy Some Time option if you need to complete your family or are undecided about a bigger procedure.

Living life to the full

To conclude – I would suggest that these devices are part of your package of things you are doing/using to change the way that bladder leakage limits your lifestyle. Make it your goal to cure your leakage problem rather than simply manage it.

However, if you are not worrying about leaking, you will fee more confident to exercise. This is a Good Thing for your overall health, wellbeing and mood.

Do contact your local specialist physiotherapist to help support you. She will guide you towards the right products, exercises and sports for your needs

Have you tried one of these internal bladder support pessaries? What did you think? Any tips for other mums?

Medical Disclaimer

Any information or guidance we provide is not a substitute for the consultation, diagnosis, and/or medical treatment of your doctor or healthcare provider.

If you have any specific questions or concerns about any medical matter, you should consult your doctor or healthcare provider as soon as possible.

Nothing in this disclaimer will limit or exclude any liability that may not be limited or excluded by applicable law.

Field Guide: incontinence pads and pants

7th June 202111th October 2021Leave a comment

Trying to stay dry with bladder leakage? Not sure what will work best for you – incontinence pads or pants? Overwhelmed by the choices in the shops and online? This detailed post & video discusses all the options and explains the difference between them. Don’t waste money buying the wrong thing. Tips and tricks to feel safe and dry without irritating your skin.

This is a practial, unbiased, useful overview of incontinence protection products, to help you decide what might suit you best.

Even a few drips or spurts when you cough or sneeze (stress incontinence) can quickly make your knickers feel wet and uncomfortable. It’s natural to worry that it has gone through onto your clothes and be anxious that everyone can see what has happened. Irritable bladders can catch you short before you make it to the toilet, or even unexpectedly empty without much warning (urge incontinence). Those leaks can be very big.

Fear makes you avoid doing things. Feeling anxious takes the edge off life and motherhood. Let’s start by making you feel safe. #No More Miserable Mums.

full disclosure: this article contains some affiliate links marked*. As an amazon associate I earn from qualifying purchases. If you make a purchase by clicking through from an affiliate link I receive a small commission at no further cost to you. Thank you, this helps to support this blog.

#1. Disposable incontinence pads

Sanitary pads and incontinence pads are not made of the same thing. It is important to use a pad designed for bladder leakage not menstruation.

The products designed to be used for menstruation are great for that purpose. However, they do not to cope well with liquid. This is because they are predominantly cottonwool based. So if they get wet, they just go soggy and misshapen. If you are moving about they can get scrunched up, rub, and leave your skin in contact with urine causing chafing and soreness.

The right pads for the task are worth the little bit of extra cost. With the advent of new technology you will be amazed how slim a proper bladder leakage pad can be to hold a large amount of liquid, keep damp away from your skin and control smell.

WHAT TO LOOK FOR IN THE SHOPS (or online )

Products for incontinence are usually in the same ‘feminine hygiene’ aisle (or website section of an online store) separated into one column of shelves for products for periods and one for bladder leakage.

Most brands will send you free samples from their websites. Collect them up and see which suit you best!

disposable incontinence pads — Some of the main UK brands are Tena, Always, Attends, Poise, as well as supermarket own-brands and Boots’ StayDry range

Natracare and Cottons (incontinence range called Comfys) are smaller brands offering environmentally aware options, with particular care to use processes kinder to sensitive skin by using natural fibre materials and avoiding the use of parabens and bleaching processes.

How much urine leakage do incontinence pads hold?

The most common indicator of absorbency is a row of filled ‘drip’ or circle symbols to indicate the level of leakage they will contain.

In general, pads for ‘lighter’ bladder leakage look and feel like pantyliners. They come in boxes to keep them flat and compact. This makes a good starting point if you are looking for something to keep you confident and safe against a small leak (up to 6 teaspoons = 30ml). These would work for or a few drips or spurts if you move awkwardly, or cough unexpectedly with a full bladder.

If you suffer with more severe leakage, you will be worrying about getting wet clothes. Look at the pads in bags which will be more absorbent or disposable absorbent pants (see below).

A bad cough, hayfever, trying anything bouncy for a prolonged period could leak a small yogurt pot worth (= 100ml). Of if you have an irritable bladder (officially called overactive bladder) which can trigger a sudden urge and empty at the front door, or if you wait too long, you have the risk of potentially emptying most or all of your bladder (which could be 200ml – 400ml),

If you are getting wet when you do sport or play with your kids your priority should be to solve the bladder problem further. Talk to your physio about organising a full assessment.

TOP TIPS for using pads

Shape them – to create a gully (see video)
Put them a bit further forward in your knickers, as the bladder tube (urethra) is just below your pubic bone
Change them regularly to avoid irritating your skin
Wear knickers that hold them snug

#2 MODERN DISPOSABLE PANTS

If you need complete confidence that no matter which way you bend, stretch, move or lie you will have full protection in all directions these are better than a substantial pad that only protects the gusset.

ideal for night time leakage
exercise classes with lots of matwork or changes of position
crazy play with the kids
a bladder that struggles to make it to the toilet first thing in the morning
long car journeys or travel when toilets and timing are so uncertain.

The modern absorbent waterproof disposable knicker is technically sophisticated. Still a way to go on style (they are trying). Unfortunately, thye need to be big to be absorbent and need a deep waistband to hold them snug & safe. Available in standard white, cream and black. Some with dodgy flowers.

disposable incontinence pants knickers — Disposable pants

I don’t believe these could ever feel “normal” (as marketed). However, they do give mums freedom to move without worrying. Put a big pair of “PE” pants (aka Bridget Jones) over the top to make them a tad more “out of sight out of mind” (- and organise a physio appointment to solve this problem).

If you are often using disposable incontinence pads or pants definitely look at the next option, washable knickers. You will be amazed to see that you can get the same absorbency in a much more “normal” looking knicker. Worth the upfront costs and kinder to your skin as well as the environment.

#3 WASHABLE KNICKERS WITH INBUILT PROTECTION

We are so lucky to be in the era of textile research and design. I am delighted to see this being applied to continence underwear.

Advantages:

good for the environment.
great if you are usually fine but like to know you have back up.
more discreet if you need a thicker pad.
look much more like real knickers.
most are machine washable
available in a range of colours and styles
Natural products and airflow around your vulva, less irritation

Disadvantages:

once you are wet you need to change the whole knicker
some are not machine washable

Brands: washable incontinence knickers UK

Brand	will hold	same as…	Laundry
ProTech Dry High Waist Briefs (also called Maxi Pant)	30-60ml	2-3 tablespoons	Up to 60 degrees
Speax. Hi-Waist, Hiphugger, French Cut, Bikini	40ml	8 tsps	Cold wash, tumble or line dry
Speax Thong	15ml	3 tsps	Cold wash
Love Luna (Sainsburys), Lady Leaks No VPL, Lady Leaks Maternity Knickers, Lady Leaks Midi Knickers	30ml	6 tsps	cold machine wash, do not tumble
GiggleKnickers	30ml	6 tsps	40 degree, tumble or line dry
Hush Hush Seamless Panty or Lace waist panty	100ml	small yogurt pot
Wearever Underwear regular absrobancy Maximum absorbancy	175ml 650ml	half a cup or a full bladder	machine wash warm, tumble dry (cotton style only)

Pro-tech black knickers absorbent for incontinence

PROTECH DRY High Waist Brief (also called Maxi Pant)

made from sturdy cotton, 3 layer mesh-style gusset, surprisingly flat: an absorbant layer (40ml = 8 tsps), odour retention layer & wick away surface, smoothly sealed seams.

www.stressnomore.co.uk

* use SUPPORTEDMUMS at checkout for a 15% discount

SPEAX

From the manufacturers of Thinx period pants. Five different styles: from Hip Hugger, through classic bikini to thong. Varying prices depending on style £16 – £24 .

The main knicker is a quality silky material (not cotton), gusset is subtle. Fun colours!

Speax incontinence pads are silky & colourful

NB: they are cold wash only (no bleach or fabric softener) with low tumble dry which you might miss in the instructions (and then be very cross about!). Answers to other FAQs here:

shethinx.com

Giggle Knickers

A fresh feeling, environmentally aware, small company with a quality range of machine washable cotton pants designed to replace a liner.

Brief or high waisted £12.99-£14.99

www.giggleknickers.co.uk

GK are zero rated for VAT as long as you are an individual and you don’t buy more than 9 at a time. Compostable mailing bags.

Love Luna (Sainsburys)

Good budget choice. Silky material 91% nylon, gusset is 100% polyester with cotton padding, quite a wide stiff gusset, so a little more ‘aware’ that you are wearing them, than more expensive brands.

3 styles: full knickers, no VPL workout knickers, maternity knickers

£12 per pair.

www.tuclothing.sainsburys.co.uk

Wearever

A ‘sturdier’ look but this range can cope with more leakage than the more fashion based ranges. Variety of styles, colours and absorbancies (regular or maximum).

pair shown here are silky panel at front with lace panel at back

available from iMedicare at www.mypelvichealth.co.uk

You are eligible for VAT relief on your order if you are an individual purchasing Wearever for the treatment of incontinence.

What will suit you best?

Probably a mixture of different things! Life is sweet with all it’s variety, messy moments, strategic plays and aspirational hopes. No one product will solve a typical situation or day. Be open minded, treat yourself. Mums matter.

And don’t forget – you can CURE this!

80% of women can improve or completely cure their incontinence through the simplest strategy of sticking to a 3 month programme of pelvic floor exercises. Best success comes from a 1:1 assessment of your situation and a bit of supervision by a specialist physiotherapist. You can self refer to an NHS physio or many private clinics all over the UK.

Look after yourself, share your troubles with a friend, encourage other women to seek help. #No More Miserable Mums

Please let us know which products you like best in the comments below or join our conversations @supportedmums. Have you changed your life through the right knickers or exercises?

Content Disclaimer:

The information contained above is provided for information purposes only. The contents of my blogposts, articles and my videos are not intended to amount to advice and you should not rely on any of the contents of if you are not a face to face client of mine. Professional and/or medical advice should be obtained before taking or refraining from taking any action as a result of the contents of this article. Amanda Savage disclaims all liability and responsibility arising from any reliance placed on any of the contents of this article, blog or video.

EVB capris may help support your pelvic floor when running

EVB Sports Shorts: an active mum’s best friend?

17th May 202111th October 2021Leave a comment

Is running making you feel leaky, heavy or vulnerable? EVB Sports Shorts could be your new BF.

What are EVB Sports Shorts?

EVBs (as they are affectionately called) are sports kit – shorts, capris or leggings. Specially designed for women who feel vulnerable when they run or take part in higher impact activities. Women’s health physiotherapists recommend them for those who need to find discreet ways to manage a bladder or prolapse problem. They add an extra layer of support to your body from the outside. Special panels lift and protect your bladder and pelvic organs.

Full disclosure: this post is not sponsored but I received a free pair of shorts to trial. If you find this article helpful and decide that you would like to buy a pair, please use my affiliate link – there is no extra cost to you but a small share to me, which helps to support this site.

Would you benefit?

Do you find your bladder leaks a few kms in? Or get a feeling that your entire lower half moves about too much as you pick up your pace? Or that you beloved run is counterproductive at the moment – straining and fatiguing your core muscles? Do you finish feeling leaky, achey and with vaginal or anal heaviness, spoiling the rest of your day?

Sound familiar? These specialised sports shorts/leggings have helped mums with these symptoms.

How do they work? More support everywhere that matters…

EVB Sports Shorts are made of a specialist high quality stretch material. This is designed to create more lift and support for the perineum and abdominal wall. They aim to BE your essential support muscles while you work on recovering yours (with your pelvic floor exercises).https://supportedmums.com/pelvic-floor-school/

They are not just guess work or cosmetic. Their inventor, Yvonne Brady, is a chartered engineer (as well as mum of 3 and regular marathon runner). Her company have invested over a million in R & D, including projects with physios, to design-in specialised support panels. These are in the gusset, to support the pelvic floor and in the front panel to support the abdominal wall.

If your bladder leaks when you run EVB shorts give extra support to your abdominals and pelvic floor

Ultrasound studies have shown they mimic the role of the pelvic floor muscles. They lift the bladder neck and prevent the anterior vaginal wall from moving down. Also it may be that better positioned muscles and tissues will themselves function better. Or the better positioning will train them to do what they should be doing when you run.

Reality Check – I tried them out..

I had seen and heard physios rave about these. But I like to try things out for myself before highlighting them here. I asked Yvonne to send me a pair to try and to show my mums in clinic.

Sizing – do it properly – no guessing

You size yourself by measuring your waist and hip size. NB: Not guessing!! It’s really important that you have the right size for NOW. Not who you would like to be! They need to be really tight to work well. However, if they are too tight they will they be horribly uncomfortable. And I worry that you would risk the waist band pushing down into your tummy. There is a useful video guide to sizing on their website

Styles:

The shorts, capris and leggings are intended as outerwear (knickers on underneath) – available in black

The “Boxer Brief” is available black or nude to wear underneath other clothing.

Getting them on:

They come beautifully packaged with clear instructions.

They warn that fitting into them first time can take a few minutes due to the technology they supply. Everything reassures you that you can pull them hard. “they will not rip”, it says, but I had to read that twice to have confidence! It really is a wiggle process to get them over your hips and pulled right up to give gusset support. Once you get there (!) they do fit like a second skin (with benefits) and were entirely comfortable.

Initially I wasn’t sure about the “look” for going out out. I am not normally a tight tight shorts person and a more fairweather jogger. But you will see on the website pictures & happy testimonials of proper mum runners! They are meant to be worn as your outerwear, shorts or capri style, with normal underwear underneath. However, the bottom-conscious could easily fit another pair of leggings/looser clothes over the top.

Returns & Exchanges

Yvonne is passionate about her EVBs and wants women to feel confident to make an investment in themselves. Customer support is quick and responsive with generous & fair exchange & returns policies.

I support women designing for women.

I firmly believe that self-care is not self-indulgence. Looking after our bodies after birth is essential. Exercise is fundamental to both physical & mental wellbeing. Fit mums enrich their own and their kids’ lives.

We live in a modern world. With amazing technological inventions to help us enjoy our sports & hobbies and care for our bodies. Mums need Good Kit too.

Even happier to recommend them now I’ve tried them: ww.evbsport.com

Content Disclaimer:

The information contained above is provided for information purposes only. The contents of my blogposts, articles and my videos are not intended to amount to advice and you should not rely on any of the contents of if you are not a face to face client of mine. Professional advice should be obtained before taking or refraining from taking any action as a result of the contents of this article. Amanda Savage disclaims all liability and responsibility arising from any reliance placed on any of the contents of this article, blog or video.

Vadgets! Podcast with Why Mums Don’t Jump

30th April 202131st August 2021Leave a comment

My first ever podcast experience this week. In which I tried to demystify the world of pelvic floor gadgets & devices. And was delighted that Helen Ledwick, talented presenter of the Why Mums Don’t Jump, award-winning podcast, coined the term “vadgets” !

It’s a big topic, vadgets! We managed to cover the difference between electrical stimulation, biofeedback, vaginal weights and reminder apps. Even touched on EVB shorts and good underwear!

A gallery of Vadgets discussed:

Kegel8 vaginal cones are available on prescription now

Kegel8 Mother Nuture is also a TENS machine

Pelvic floor Biofeedback and stimulation machines

Do you like learning through listening to podcasts ? I hope this will be a useful conversation to listen to. Get your head around what each type of vadget does. And why you might (or might not) want one.

Want to learn more? We have a whole section on pelvic floor gadgets and devices (aka vadgets) here on the Supported Mums website. We offer knowledgeable depth about how they work, discerning reviews & comparisons, tips and advice on everything from electrical stimulation, biofeedback, vaginal weights and pessaries, phone apps and online fitness options. Choose the “gadget girl” section from the menu bar above.

Listen to us in Season 2 Episode 8: Pelvic Floor Gadgets.

Why Mums Don’t Jump is a wonderful resource. Interesting interviews with mums and health professionals about living with bladder and prolapse issues after childbirth. Highly recommended.

How to change Squeezy App settings for a beginner

11th April 202111th October 2021Leave a comment

Beginners Guide to change Squeezy App settings –

How to slow the speed down
shorten the “slow” holds
create a pattern to suit a beginner
less (or more!) reminders!

I LOVE squeezy app but my (minor) bugbear is that the default settings it comes with are actually the “end goal”. In the long run you want to be able to hold for 10 seconds 10 times in a row but I don’t come across too many beginners who can manage that! Not easy for beginners, and for many people a bit demoralising at first try. If you could perform like that already you likely wouldn’t need the app!

How to tweak the settings if you are a true beginner…

Go to the green-ish petal “exercise plan”.
Set yourself timings for THREE times a day.
scroll down to find the “Professional Mode” and turn it ON

Make the Slow Ones “shorter” holds

then go back to the “Slow exercises” and change to:
- the number of reps to 8
- squeeze time 5 seconds
- Hold time 0
- Relax time 5 seconds
- rest time 0

Now they will be shorter on/offs to get you started. Little and often through the day.

More Tortoise than Hare?

Then go to “quick exercises” and change the dial to TORTOISE speed = Speed A. This will mean that they don’t come at you so fast giving you more time to release between contractions.

Lose the sub-max exercises for now…

Then go to “sub-maximal exercises” and choose repetitions = 0

Or a tweak if you’re a bit bored of the pre-set “slow” pattern

Our brains get bored easily and switch off a bit once something becomes familiar. Wake yourself up a bit with a pattern change:

Go to the green-ish petal “exercise plan”.
scroll down to find the “Professional Mode” and turn it ON
then go back to the “Slow exercises” and change to:
- the number of reps to 10
- squeeze time 4 seconds
- Hold time 4 seconds
- Relax time 4 seconds
- rest time 4 seconds

How do you do yours?? Do share your tips, tricks and successes – join the conversations @supportedmums

Content Disclaimer:

The information contained above is provided for information purposes only. The contents of my blogposts, articles and my videos are not intended to amount to advice and you should not rely on any of the contents of if you are not a face to face client of mine. Professional advice should be obtained before taking or refraining from taking any action as a result of the contents of this article. Amanda Savage disclaims all liability and responsibility arising from any reliance placed on any of the contents of this article, blog or video.

Squeezy App: because we don’t remember To Do Them…

7th April 202111th April 2021Leave a comment

Squeezy App review:

Checklist (tick all that apply)

I Mean to do my pelvic floor exercises but then I Forget.
I drift off partway through my routine.
I like to do them at top speed to get them done
I always feel guilty that I should have done more
I can’t remember how many you’re supposed to do a day?
umm… what are you supposed to do again?

Easy Solution…

NHS Squeezy App. It counts for you. It reminds you. It gives you a happy little chart and messages to tell you how clever you are when you do them. All for £2.99.

NHS Squeezy app reminds you to do your pelvic floor exercises

So download it NOW (or re-upload it if you already had it but it’s now back in the cloud….).

Other app features (which you may not have noticed!)

bladder diary – are you drinking too much or not enough?
reminders – set the perfect timings for you
record of your exercising – to feel pleased with yourself!
information about how to do your squeezes

And on the Squeezy website:

videos about how to do the exercises or change the settings
a Directory to help you find a physio

Beginners might want to change the settings

My only (minor) bugbear with it is that the default settings are actually your end goal (10 second holds, 10x in a row). And the Quick squeezes are really quick!!. Follow these instructions to make Squeezy App more user friendly for a beginner.

Any questions? Do ask in the comments below – you won’t be the only one with the same query!

Field Guide: Pelvic floor muscle biofeedback gadgets and devices

Field Guide: pelvic floor biofeedback gadgets

1st March 202119th July 20211 Comment

There has been a recent explosion in “fem-tech” options, particularly pelvic floor biofeedback devices. On the one hand this is empowering women to improve their exercising in the privacy of their own homes, on the other hand resulting in a more than a little confusion about what they do. With most devices over £100 it is important to spend your money wisely.

Pelvic floor Biofeedback devices

Generally, we advise that if you can already contract your pelvic floor muscles then you don’t need to do passive pelvic floor muscle stimulation. Your muscles will develop quicker by doing ‘active’ exercises where the brain initiates the activity rather than a machine. Check out the videos on our Pelvic Floor School.

However, if you WANT to work with a gadget to do active exercises, a biofeedback device can enhance your practice. Particularly, if you need to work on your brain skills (co-ordination, multi-tasking, downtraining) as much as your isolated muscle strength & endurance (which they can be helpful for too).

How to they work?

The action of your muscles contracting is relayed to a machine which “shows” you what you are doing. There are several different ways this can be done.
- Some machines pick up the electrical signal from your muscles while some respond to pressure.
- Some give you a visual picture of what you are doing,
- others beep or vibrate in response to your contraction.
Biofeedback devices are great to correctly identify your pelvic floor muscles in different positions. They also ensure you are contracting correctly and also help you focus on relaxing fully between contractions
These gadgests let you see how well your muscles contract and relax.
They give targets to aim for to improve strength, endurance and co-ordination.
Practice more complicated tasks. Skills you need for real life or your sport.
Make exercising a bit more fun (!) and interesting. This will help you to keep up long-term practice (rather like a piece of gym-kit for your pelvic floor!)

Examples of pelvic floor biofeedback devices:

To be professional, I do not recommend a single specific product or supplier. But I have aimed to narrow down the list of options for you. Please do read customer reviews to help you make your decision. Specialist physiotherapists, like myself, have units in clinic for you to try before you buy.

Electrical biofeedback devices: with connecting wires

Peritone EMG biofeedback unit and Simplex EMG biofeedback unit are the ones we have used in our clinic for many years (same device in different packaging). Many physiotherapy departments have these for you to use at your visit and/or to borrow. Just like French women train in their postnatal rehabiliation sessions.

They are effectively two parts. You place a small internal electrode (called a Periform, which is single person use, into the vagina. Then put your clothes back on!. Then link your internal device by a cable to the handheld Pelvitone or Simplex unit (we can loan one of these to you).

When you contract your pelvic floor muscles their electrical activity registers on the screen. This makes the lights change from orange to green and gives an audible beep.

You can practice your quick maximum power squeezes seeing how high you can make the lights go. Also, practice keeping the lights green while you cough or try moving your arms or legs. There is also a work/rest function which ‘counts’ the endurance holds for you and tells you your average squeeze score at the end.

These devices are widely available from lots of online sellers +/- £160 (including the Periform).

Pelvic floor training devices: which connect via bluetooth to a phone app

Elvie Trainer

Elvie £169

The Elvie updates the design of the traditional units above. It is popular as it has modern smart phone visuals, easy charting & a sense of community amongst users.

I have one I can show you in clinic but the internal device (the pebble) is the expensive part, and understandably single use only, so I’m afraid you can’t try before you buy.

It is a discreet, attractive, wireless bluetooth pebble-shaped device. This goes inside the vagina. Use an app to turn your phone into the biofeedback monitor/exercise tracker. No cables between you and the phone but you can’t put knickers back on or the bluetooth can’t connect. It is beautifully packaged and well designed by women. It can be used in the second trimester of pregnancy but is not recommended for the 1st and 3rd trimesters.

Elvie is officially available “on prescription” but sadly, I don’t know anyone whose managed to get one this way.

Pericoach System

Pericoach System £145

Pericoach System shows your pelvic floor contractions as clear graphs on your phone. Pre-set programmes guide you to practice exercises twice daily and, like the Elvie, uses algorythms to automatically progress you as you improve your skills. You can give you physiotherapist access to your data so that she can guide you virtually.

Pelvifly/K-Goal

Pelvifly is a package connecting the K Goal pressure sensor to a phone app for sensitive imaginative pelvic floor biofeedback with sophisticated integration to a remote physiotherapist if required

Pelvifly £189 with basic plan. Subscription for full integration with a physiotherapy coach.

Pelvifly is a package connecting the K Goal pressure sensor to a phone app for sensitive imaginative biofeedback games with sophisticated integration to a remote physiotherapist if required

The largest of the internal probes, which will suit those who find more petite devices fall out too easily. It responds to the pressure of your pelvic floor squeezes. This is particularly useful for those who need to learn to relax the pelvic floor (called downtraining). Pelvifly offers the greatest variety of challenges with innovative vibrant visuals – including butterflies visiting flowers, rockets flying through tunnels, basketballs into hoops and an engaging octopus!

The BASIC plan (no further cost after purchase) sends you a muscle test once a month and daily challenges. With a SMART subscription (£24/month) you will have more programs to follow to suit your chosen goals. Pelvifly are rapidly expanding their telehealth services. With a CARE package (£96/month) you will be connected, virtually, to a Pelvicoach (a specialist physiotherapist) who can interact remotely to set up bespoke assessment and training programmes, support your progress, exchange messages and save and print your progress reports.

Pressure Biofeedback devices

kegel8 trainer for pelvic floor biofeedback uses a pressure system

Kegel 8 Biofeedback Pelvic Trainer £94.99

Kegel8’s biofeedback pelvic trainer uses a pressure system where you squeeze on a larger tube (NB latex covering) which moves a dial on the hand held unit. Unsophisticated but effective for checking what you are doing and therefore a relatively inexpensive option

Epi-no Delphine Plus birth trainer can also be used for pressure pelvic floor biofeedback can be used in pregnancy

Epi-No Delphine Plus £99.99

Eip-No’s primary purpose is a tool to stretch the perineum in preparation for vaginal delivery. It can also be used as a biofeedback tool before & after birth. The dial lets you visualise the amount of squeeze pressure you are creating with your muscle contraction.

Epi-No (like the Kegel8 Trainer) is less sensitive than the electrical biofeedback or bluetooth devices. However, the advantage of the Epi-No is that it is certified for use through your whole pregnancy. It can also be used in the latter part of pregnancy (after 37 weeks) to help to stretch the vaginal opening. A recent study * did not show evidence of a protective effect of the Epi-No device on birth trauma, however, anecdotally many women feel it has helped with their confidence to relax the vaginal opening in preparation for birth.

*Kamisan Atan I, et al. BJOG 2016 Does the Epi_No birth trainer prevent vaginal birth-related pelvic floor trauma? A multicentre prospective randomised controlled trial.

Other trainers

Vibrance Pelvic Trainer

The Vibrance Pelvic Trainer is a petite internal device which vibrates when you correctly contract your pelvic floor muscles. The device is easy to insert but you may need to hold it in position. There are no wires, or external unit, the vibration is felt in the device itself.

This device could also be useful as a ‘bridge’ back to penetrative sex, if you don’t want to use a traditional vibrator. You could practice inserting the trainer at your own pace. You might find the vibration element helpful to re-sensitise your tissues. They are available directly from www.vibrancepelvictrainer.co.uk £140.83 with VAT exemption.

This links to a digitally annotated instructional video for Vibrance PFT on youtube:https://www.youtube.com/watch?v=n8IoqefRzTU

Note about VAT exemption

If you have had a problem for more than 3 months, you can declare yourself as having a ‘chronic medical condition’ and do not have to pay VAT. There will be a form to complete. This does not apply to the Elvie which is registered as an exercise tracker not a medical device. Not all the online suppliers can offer this service.

Combined Stim & Biofeedback Machines

You can buy combined units which do both functions. However, these are surprisingly expensive (and a bit fiddly). If you feel you need both systems I usually suggest you buy two separate simpler units and switch between them.

Lubricating gel

You will need a water-based lubricating gel to help the insertion of the devices. It is essential to help the electrical devices to operate correctly. A simple, in-expensive, chemist-own or basic brand name is theoretically all you need. If you have concerns about ingredients you may prefer an organic version. Do read my posts about the difference between water-based and oil-based lubricating products.

Not sure what YOU need?

Get clarity first

If you are not too sure how good your muscles are then before you spend ANY money on a gadget or device I would highly recommend an hour spent with a specialist physiotherapist! Your appointment will be £70-90 outside London.

Our role at physiotherapy is to do an internal assessment of your pelvic floor muscles. We will check how well they are working and teach you how to get the best from them – you may not need any gadgets at all! And if you do we can help you make the best choice for your needs.

Try before you buy

Many physio clinics can loan you both muscle stimulation and biofeedback units to try out at home. To see how well they work for you before you consider buying your own. (NB you still have your own internal probe – no sharing of those!).

It is particularly important to consider an individual assessment by a specialist physiotherapist if you are at all worried that your pelvic floor muscles might be too tight rather than too weak.

Physios can also teach you active exercises , which require no equipment at all! We usually combine pelvic floor exercises with appropriate abdominal muscle work as these two areas need to work well together for best support of our internal organs.

Please don’t hesitate to be in touch if you have further questions. Readers would love to know your experiences if you would be happy to share?

Savage, A.M (2021). Handheld biofeedback devices to enhance pelvic floor muscle training. Journal of Pelvic, Obstetric & Gynaecological Physiotherapy, 128, 54-57