App-Connected Kegel Trainers: What the Research on Biofeedback Shows

Pelvic floor trainers are small devices you insert into the vagina that measure your squeezes and show them on a phone app, often as a game. They’re sold to stop leaks when you laugh, sneeze or jump, and they can cost far more than a few sessions of exercises. Here is what the research on this kind of feedback found, and where it fits.

Pelvic floor training works. The question is what a device adds.

The UK’s NICE¹ guideline recommends supervised pelvic floor muscle training for at least three months as the first treatment for stress or mixed incontinence, with at least 8 contractions three times a day.¹ NIDDK notes that physical therapists trained in pelvic floor therapy can help you do Kegel exercises correctly.²

A device is a way to see your squeeze. The research question is whether seeing it helps more than training without it.

What the review found

A Cochrane³ review looked at 24 trials with 1,583 women that compared pelvic floor training with and without feedback or biofeedback.⁴

• Women who had biofeedback were more likely to report that their leaks were cured or improved.⁴
• But in many trials, the biofeedback group also had more time with a health professional. The reviewers couldn’t tell whether the device or the extra coaching made the difference.⁴
• Many trials were at moderate to high risk of bias, and the programs varied widely.⁴

The authors concluded biofeedback may add benefit, and called for research to separate the device’s effect from extra contact.⁴ The review’s search ran to 2010, before most phone-connected trainers were on sale.

NICE¹ goes further, advising against routinely adding pressure-measuring or electrical biofeedback devices to pelvic floor training.¹

What about vaginal weights?

Weighted vaginal cones are another home option. A Cochrane³ review of 23 small trials found some evidence they work better than no treatment for stress incontinence and may be about as effective as pelvic floor training, while calling the conclusion tentative.³

When a trainer may still help

• You can’t tell whether you’re squeezing the right muscles. Ask a pelvic floor physical therapist to check your technique first, then decide whether a device would help you keep going at home.
• You need motivation. If a game keeps you training every day, that has value. Ask your therapist how to use it alongside your program.

Before you buy

1. Get the type of leak assessed. Stress, urgency and mixed leaks are treated differently.¹
2. Check the return window, since a fair trial of training takes at least three months.¹
3. Ask whether insurance covers pelvic floor physical therapy. Supervised therapy is the recommended starting point.¹
4. Clean and store it as directed, and stop if it causes pain or bleeding.

Try: “I leak when I sneeze and I’m thinking about buying a pelvic floor trainer. Could you check that I’m doing the exercises right, and would a device help me?”

Laugh, Sneeze, Jump includes an appointment prep sheet. Use it to record when you leak and what you’ve tried, so your first physical therapy visit starts with useful details.