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
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 £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 £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’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 £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.
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.
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