In brief
Electromagnetic stimulation of the pelvic floor (EMS) is an intimate medicine treatment, without a scalpel: seated and clothed on a chair, a focused electromagnetic field causes thousands of contractions of the pelvic muscles, like an intense, guided workout. It is used mainly for urinary incontinence, in women and men, and for recovery after childbirth. The studies are encouraging, but mostly small and with short follow-up.
What electromagnetic stimulation of the pelvic floor is
The pelvic floor is the group of muscles that closes the pelvis at the bottom and supports the bladder, uterus and rectum. When it weakens, because of childbirth, age, menopause or prostate surgery, there may be urine leakage, reduced sensation during intercourse or a feeling of poor support.
Electromagnetic stimulation acts on these muscles from the outside. The chair generates a focused electromagnetic field that passes through clothing and tissues and activates the nerves of the pelvic muscles, causing deep, repeated contractions. In the literature the technique is referred to by the acronyms HIFEM (High-Intensity Focused Electromagnetic, high-intensity focused electromagnetic field) or FMS (functional magnetic stimulation).
The magnetic field induces depolarisation of the motor neurons, that is, the nerve fibres that control the muscles, and causes them to contract without the patient having to do anything. These are called «supramaximal» contractions because, in number and intensity, they go beyond what can be achieved voluntarily with Kegel exercises: in one session the muscles contract thousands of times. It is the same technology used, with different applicators, to tone the abdomen and buttocks.
Who it is for
In women
- Urinary incontinence: stress (leakage with coughing, sneezing, running), urge or mixed.
- Recovery after childbirth, to restore tone to the pelvic floor.
- Support for sexual function, when it is linked to a weak pelvic floor.
- After an intimate surgery procedure, such as vaginoplasty, together with physiotherapy, to regain muscle control and tone.
In men
- Urinary incontinence after prostate surgery (radical prostatectomy), the most studied male indication.
- Some centres also offer it for erection quality and ejaculation control, but the evidence for these uses is still scarce.
How the treatment is carried out
The session
You sit on the chair fully clothed, with no need to undress, apply gel or use internal (vaginal or anal) probes. During the session, which lasts 30 minutes the first time and 45 minutes from the second onwards, you feel rhythmic contractions and a tingling sensation in the perineal area; the intensity is adjusted gradually according to your tolerance. Once the session is over you return straight away to your activities.
The course
Generally six sessions are carried out, two a week, over about three weeks: the first lasts 30 minutes, to allow neuromuscular adaptation and to get used to the sensation, the following ones 45 minutes. Depending on the response, maintenance sessions can be scheduled.
With physiotherapy
Stimulation does not replace awareness and active rehabilitation of the pelvic floor with a physiotherapist, but it can be used alongside them. It is particularly useful for those who find it hard to contract the right muscles voluntarily or have poor proprioception, that is, who do not «feel» well where the muscles are and how they work: the induced contractions help to identify them, and the exercises help to maintain the result over time.
When it cannot be done
The treatment is not carried out in the presence of:
- pacemakers, defibrillators or other implanted electronic devices;
- metal implants in the pelvic area, hips or lumbar spine, including some copper intrauterine devices;
- pregnancy;
- current infections, unexplained bleeding, tumours in the treated area or recent surgery in the area.
For this reason, before starting, I always take a complete medical history.
What the studies say, honestly
- A meta-analysis of 11 randomised studies with 612 patients (He, 2019) concluded that magnetic stimulation improves the symptoms of urinary incontinence compared with sham treatment, although protocols differed widely between studies.
- In the multicentre study by Samuels (2019) on 75 women with incontinence, after six sessions with the chair symptom scores improved by an average of 64% at three months and almost half of the patients who used pads stopped using them. The study, however, had no control group.
- In men who had prostate surgery, a small study of 27 patients (Tosun, 2025) reported that pad use roughly halved and complete continence was achieved in about half of the cases at one month, again without a control group.
In brief: the results are encouraging and side effects are minimal, but large, controlled studies with long follow-up are still lacking. We do not know for certain how long the benefit lasts over time, and top-up sessions are likely to be needed.
Prima comprendere («Understand first»): the consultation
At the first consultation, which lasts from half an hour to an hour, I ask what kind of leakage or symptoms you have, since when and what you have already tried. If the problem is not simple muscle weakening, for example a prolapse or incontinence that requires urological or urogynaecological investigation, I prefer to tell you so and direct you to the right pathway.
Side effects
- Soreness or fatigue of the pelvic muscles in the 24–48 hours after the session, as after a workout, mild and temporary.
- Tingling or discomfort during the session, which is managed by reducing the intensity.
- No benefit: not everyone responds in the same way.
Frequently asked questions
What is electromagnetic stimulation of the pelvic floor?
It is an intimate medicine treatment, without a scalpel: seated and fully clothed on a chair, a focused electromagnetic field causes deep, repeated contractions of the pelvic muscles in order to strengthen them.
Do I need to undress?
No. You sit on the chair fully clothed: the magnetic field passes through clothing. No gel or internal probes are used.
How many sessions are needed?
Generally six sessions, twice a week: the first lasting 30 minutes, the following ones 45 minutes. Depending on the response, maintenance sessions can be scheduled.
Does it hurt?
No. You feel rhythmic contractions and a tingling sensation; the intensity is adjusted to your tolerance. After the session there may be slight muscle soreness.
Does it work for men too?
Yes, mainly for incontinence after prostate surgery, with encouraging results in small studies. For erection and ejaculation the evidence is still scarce.
Does it replace surgery?
No. It strengthens the muscles but does not repair structures: an advanced prolapse or structural vaginal laxity requires a surgical assessment.
Can I have the chair alone, without exercises?
You can, but the result tends to last less. Stimulation does not replace active pelvic floor rehabilitation: the two work better together, and the exercises help maintain over time the tone obtained with the sessions.
Who cannot have it?
People with a pacemaker or other implanted electronic devices, metal implants in the pelvic area (including some copper intrauterine devices), pregnant women, and those with infections or bleeding in the area.
How long does the result last?
We do not know for certain: studies have follow-ups of only a few months. Top-up sessions are likely to be needed, and pelvic floor exercises help maintain the benefit.
Scientific bibliography
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He Q, Xiao K, Peng L, et al. – An effective meta-analysis of magnetic stimulation therapy for urinary incontinence
Source: Scientific Reports, 2019 – Nature
What it covers: analysis of 11 randomised studies with 612 patients: magnetic stimulation improves symptoms, leakage episodes and quality of life compared with sham treatment, although protocols were very heterogeneous.
Why it matters: it is the broadest synthesis of controlled studies on magnetic stimulation in incontinence.
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Samuels JB, Pezzella A, Berenholz J, Alinsod R – Safety and efficacy of a non-invasive high-intensity focused electromagnetic field (HIFEM) device for treatment of urinary incontinence and enhancement of quality of life
Source: Lasers in Surgery and Medicine, 2019 – Wiley
What it covers: 75 women with incontinence treated with six sessions on the electromagnetic chair: average symptom improvement of 64% at three months and a marked reduction in pad use, with no significant side effects.
Why it matters: it is the reference study on the six-session protocol; it has no control group.
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Tosun H, Akinsal EC, Bas U, et al. – Evaluating the efficacy of high-intensity focused electromagnetic (HIFEM) therapy for postprostatectomy incontinence in men
Source: Therapeutics and Clinical Risk Management, 2025 – Dove Press
What it covers: 27 men with incontinence after radical prostatectomy treated with six sessions: pad use roughly halved and complete continence in about half of the patients at one month.
Why it matters: it documents the use of stimulation in men; small case series and short follow-up.
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Medically reviewed by Dr Giulio Maria Maggi, Plastic Surgeon — last review:
Article written by
Dr Giulio Maria Maggi
Aesthetic Plastic Surgeon — Turin, Asti and Alessandria
Medical Director — Aesthetic Clinic (Turin)
Registered with the Turin Medical Council (Ordine dei Medici di Torino) no. 20595
Full Member of AICPE (Italian Association of Aesthetic Plastic Surgery) (verify)
Expertise and fields of interest
Dr Maggi gained specific training in intimate medicine and surgery by working for 12 years alongside Prof. Renato Marten Perolino, urologist and plastic surgeon, at Villa Maria Pia Hospital and, privately, at Clinica Fornaca and Clinica Cellini in Turin. From him he learned male-to-female gender-affirming surgery and he was first operator in breast augmentation procedures on Prof. Perolino's patients undergoing gender transition. He also trained internationally with Prof. José Guerrero Santos in Guadalajara and with Prof. Andrew A. Jacono in New York, for the Deep Plane Facelift technique.
He is particularly dedicated to:
- Functional and aesthetic intimate surgery, male and female
- Deep Plane facelift
- Blepharoplasty
- Liposculpture and fat grafting (lipofilling)
- Breast surgery
- Body contouring
Clinical approach: «Prima comprendere» ("Understand first"). No promises of results: indications, risks and limits explained frankly, so that every patient can make a truly informed choice.
