The Emsella Chair: Electromagnetic Pulses and Incontinence

The Emsella chair supposedly does Kegel exercises for you, but ob-gyn's aren't sure whether it can help with incontinence.

Kegels can be a useful exercise to keep your lower abdominal region healthy. These exercises can strengthen your pelvic floor muscles to treat a variety of conditions, especially incontinence (being unable to hold your urine). If you work with a physical therapist, they might recommend using weights called Kegel balls to help exercise those muscles. However, BTL Industries claims that patients can use their Emsella chairs as an exercise-free option to treat incontinence.

According to BTL Industries, the electromagnetic pulses from Emsella chairs may help strengthen your pelvic floor muscles. Learn more about these chairs, how they work, and whether they can help treat your incontinence.

What Are Pelvic Floor Muscles?

According to the National Library of Medicine, your pelvic floor muscles cradle your uterus, bowel, bladder, and other pelvic organs so they function properly. If your pelvic floor muscles become weak, you could be at risk for urinary, gastrointestinal, or vaginal conditions. As such, treatment for incontinence sometimes includes pelvic floor physical therapy.

What Is Urinary Incontinence?

Urinary incontinence, or incontinence, is when you urinate without control. There are three common types of incontinence: stress incontinence (caused by physical stress), urge incontinence (caused by bladder contractions), and mixed incontinence (a combination of different types of incontinence). This involuntary urination can often occur after you experience conditions affecting your abdomen, like pregnancy, bladder infections, and aging.

Both stress and urge incontinence can be caused by pelvic floor weakness—and training your pelvic floor muscles could help with both. The exercises can also generally make you better at holding in your pee because pelvic floor muscles can delay urination.

The Emsella Chair

The Emsella chair claims to strengthen your pelvic floor muscles and reduce incontinence with electromagnetic technology. When you sit on this non-invasive device, it uses electromagnetic pulses to cause supramaximal pelvic floor muscles contractions. That means the Emsella stimulates your muscles to become tenser than they usually would be able to contract—even tenser than Kegel exercises.

Typically, a full treatment lasts 6 sessions, spread over multiple weeks with two sessions a week. Each visit can cost around $300 and lasts about 28 minutes. They involve thousands of stimulated contractions, and should only cause tingling and sensations of pelvic floor contraction.

"The goal of the Emsella is to treat incontinence early so surgery isn't necessary" Carolyn Delucia, MD, ob-gyn and former director at VSPOT, a medical spa offering treatments for various vagina health issues in New York, told Health. "The chair uses electromagnetic energy technology to engage all the muscles of the pelvis at once." Plus, the device may have additional benefits. According to Dr. Delucia, "we also have women reporting secondary benefits like increased strength of orgasms."

The Science Behind the Emsella Chair

The Emsella uses a type of electromagnetic technology called a High-Intensity Focused Electromagnetic Field (HIFEM). It can directly cause muscle contractions without interfacing with your brain. And there is some research that shows HIFEM may effectively treat incontinence.

According to a 2019 Lasers in Surgery and Medicine article, HIFEM sessions reduced incontinence for 81% of the 75 research participants. Both women with stress incontinence and women with urge incontinence had improvements from six 28-minute long sessions of HIFEM (the same amount recommended on the BTL Emsella site). And three months after these trials, most participants still had fewer leaks before going to the bathroom, while sleeping, and during exercise. At that follow-up, 34% of participants no longer had incontinence.

Research studies on postpartum women in Russia support these findings. The authors published their results in a 2020 Sexual Medicine study and a 2021 Female Pelvic Medicine & Reconstructive Surgery. In their studies, researchers compared the effects of an Esmella chair, at-home electrical stimulation, and no treatment on pelvic muscle function. They found that the Esmella was the most effective by a significant amount—both in patient surveys and scans of their pelvic muscles.

However, these studies have some limitations. For example, the studies do not look at the long-term effects of HIFEM stimulation on pelvic floor muscles or incontinence. There also are not many studies around this relatively new tool, which is why some physicians hesitate to recommend HIFEM.

Drawbacks and Incontinence Treatment

While Kegels are known to help treat incontinence, the Emsella may or may not be a helpful treatment. "There are very few studies of quality on these tools," San Francisco-based OB-GYN Jen Gunter, MD, told Health. "Intravaginal electrical stimulation with specialized equipment can help some women with pelvic floor issues, but this is not that device."

Dr. Gunter added that she doesn't think patients should head to medispas if they're struggling with incontinence. "I would see a board-certified gynecologist, urologist, or urogynecologist, and a pelvic floor physical therapist instead," Dr. Gunter said.

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