Electrical Stimulation for Stress Leaks: What the Evidence Shows
Bladder & Pelvic FloorArticleHome and clinic devices that stimulate the pelvic floor with mild electrical pulses are sold for leaks with coughs and sneezes. A Cochrane review of 56 trials found stimulation probably beats doing nothing, but couldn't say whether it matches pelvic floor exercises. UK guidance reserves it mainly for women who can't squeeze those muscles on their own. Here is who it suits.
In this article
Electrical stimulation uses a small probe or skin pads to send mild pulses that make the pelvic floor muscles contract. It’s offered in clinics and sold as home devices for stress leaks, the kind that come with coughs, sneezes and jumps.
What 56 trials found
A Cochrane review gathered 56 trials with 3,781 women.1
| Compared with | Result |
|---|---|
| No treatment | About 66 in 100 cured or improved with stimulation, versus 38 in 100 without; women were roughly twice as likely to call themselves cured (moderate-quality evidence)1 |
| Pelvic floor exercises | No clear difference; low-quality evidence1 |
| Exercises plus stimulation vs exercises alone | No clear added benefit; low-quality evidence1 |
Side effects were rare: nine women across all the trials reported one.1 A quarter of the trials were at high risk of bias, including from industry funding.1 The authors couldn’t say whether stimulation is as good as exercises.1
Who it suits
UK national guidance doesn’t recommend stimulation routinely, either for urge leaks or added to exercises.2 It says to consider stimulation or biofeedback for women who can’t contract their pelvic floor muscles on their own, to help them get started and stick with it.2
So the questions are:
- Can you squeeze? A pelvic health physical therapist can check. If you can, supervised exercises are the first step. See can pelvic floor exercises help? and am I doing Kegels correctly?
- If you can’t, stimulation or biofeedback can help you find the muscle.2
- Are your leaks urge leaks? Different options apply. See nerve stimulation for overactive bladder.
For related devices, see magnetic chairs, Kegel trainers and pelvic floor apps.
Try: “I’ve tried Kegels for three months and I’m not sure I’m squeezing anything. Can you check my pelvic floor, and would electrical stimulation or biofeedback help me?”
Laugh, Sneeze, Jump covers this in Chapter 9, “When It’s Been Years,” in a section called “The Next Rungs.” Its Three-Day Read sorts your leaks into effort and urge, which decides which rungs, stimulation included, are built for you. See the book.
This article is for general educational purposes only and is not medical advice. It isn't a substitute for diagnosis or treatment from a qualified healthcare professional who knows your health history. Don't use a vaginal stimulation device if you're pregnant, have a pacemaker or implanted device, active infection or unexplained bleeding, unless your clinician approves. See a clinician for leaks with burning, blood in urine or a bulge in the vagina. Girl Playbook does not endorse any specific product, test, or provider.
Girl Playbook sells this book. It provides education and worksheets, not individualized medical care.
Sources
The research behind this article, in the order it’s cited. How we source our articles.
- Cochrane Database of Systematic Reviews (abstract via PubMed), 2017Electrical stimulation with non-implanted devices for stress urinary incontinence in women (opens in a new tab)abcdefg
- National Institute for Health and Care Excellence, 2019Urinary incontinence and pelvic organ prolapse in women: management (NG123), Recommendations (opens in a new tab)abc
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