Female Pelvic Floor Muscle Resistance Training

Andrew Siegel MD   7/21/2018


            Kim Anami started the trend of vaginal weightlifting; visit her website at http://www.kimanami.com


 “In the preservation or restoration of muscular function, nothing is more fundamental than the frequent repetition of correctly guided exercises instituted by the patient’s own efforts.  Exercise must be carried out against progressively increasing resistance, since muscles increase in strength in direct proportion to the demands placed upon them.”

–JV Luck, Air Surgeon’s Bulletin, 1945

“Resistance exercise is one of the most efficient ways to stimulate muscular and metabolic adaptation.”

–Mark Peterson, PhD


Resistance training is a means of strength conditioning in which work is performed against an opposing force. The premise of resistance training is that by gradually and progressively overloading the muscles working against the resistance, they will adapt by becoming bigger and stronger. Pelvic floor muscle training (PFMT) using resistance optimizes pelvic floor muscle (PFM) conditioning, resulting in more power, stability and endurance and the functional benefits to pelvic health that accrue. It also helps to rebuild as well as maintain PFM mass that tends to decrease with aging.

Applying resistance training to the pelvic floor muscles

Resistance is easy to understand with respect to external muscles, e.g., it is applied to the biceps muscles when you do arm curls with dumbbells. Resistance training can be applied to the PFM by contracting your PFM against a compressible device placed in your vagina.  Its presence gives you a physical and tangible object to squeeze against, as opposed to basic training, which exercises the PFM without resistance. Resistance PFMT is similar to weight training—in both instances, the adaptive process gradually but progressively increases the capacity to do more reps with greater PFM contractility and less difficulty completing the regimen. In time, the resistance can be dialed up, accelerating the adaptive process.

In the late 1940s, Dr. Arnold Kegel devised the perineometer that enabled resistance PFM exercises. It consisted of a pneumatic vaginal chamber connected by tubing to a pressure manometer.  This device provided both a means of resistance and visual biofeedback. The chamber was inserted into the vagina and the PFM were contracted while observing the pressure gauge (calibrated from 0-100 mm mercury). With training, the PFM strength increased in proportion to the measured PFM contractions.

PFMT resistance tools

There are many PFM resistance devices on the market and my intention is to provide information about what is available, but NOT to endorse any product in particular. What follows is by no means a comprehensive review of all products. Some are basic and simple, but many of the newer ones are “high tech” and sophisticated means of providing resistance, biofeedback and tracking, often via Bluetooth connectivity to a smartphone. I classify the devices into vaginal weights, electro-stimulation devices, simple resistance devices and sophisticated resistance devices.  Within each category, the devices are listed in order of increasing cost.

Vaginal Weights

These weighted objects are placed in the vagina and require PFM engagement in order that they stay in position. They are not intended to be used with any formal training program but do provide resistance to contract down upon.

Vaginal Cones: These are a set of cones of identical shape but variable weights.  Initially, you place a light cone in your vagina and stand and walk about, allowing gravity to come into play. PFM contractions are required to prevent the cone from falling out. The intent is to retain the weighted cone for fifteen minutes twice daily to improve the strength of the PFM.  Gradual progression to heavier cones challenges the PFM.  (Search “vaginal cones” as there are several products on the market.)

Word of advice: Be careful not to wear open-toed shoes when walking around with the weighted cones…a broken toe is a possible complication!

Ben Wa Balls:  These are similar to vaginal cones but appear more like erotic toys than medical devices. There are numerous variations on the theme of weighted balls that can be inserted in your vagina, available in a variety of different sizes and weights.  Some are attached to a string, allowing you to tug on the balls to add more resistance. Another type has a compressible elastic covering that can be squeezed down upon with PFM contractions. Still others vibrate. There are some upscale varieties that are carved into egg shapes from minerals such as jade and obsidian. (Search “Ben Wa Balls.”)

Kim Anami is the queen of vaginal kung fu, a life and sex coach who advocates vaginal “weightlifting” to help women physically and emotionally “reconnect” to their vaginas and become more in tune with their sexual energy. Her weightlifting has included coconuts, statues, conch shells, etc.  According to her, vaginal weightlifting increases libido, lubrication, orgasm potential and sexual pleasure for both partners.                                                                                                                       

Electro-Stimulation Devices

These devices work by passive electrical stimulation of the PFM.  Electrical impulses trigger PFM contractions without the necessity for active engagement.  Many clinical studies have shown that electro-stimulation in conjunction with PFMT offers no real advantages over PFMT alone. Like the electrical abdominal belts that claim to tone and shape your abdominal muscles with no actual work on your part, these devices seem much better in theory than in actual performance.

Intensity: This is a battery-powered erotic device that looks like the popular “rabbit” vibrator sex toy.  It consists of an inflatable vaginal probe that has an external handle. It has contact points on the probe that electro-stimulate the PFM and vibrators for both clitoral and “G-spot” stimulation. It has 5 speeds and 10 levels of stimulation. Cost is $199 (Pourmoi.com).

ApexM:  This device is intended for use by patients with stress urinary incontinence.  It consists of an inflatable vaginal probe and control handle. It is inserted inside the vagina, inflated it for a snug fit and powered on.  Electric current is used to induce PFM contractions. The intensity is increased until a PFM contraction occurs, after which the device is used 5-10 minutes daily. Cost is $299 (Incontrolmedical.com).

Simple PFMT Resistance Devices

These are basic model, inexpensive resistance devices. They consist of varying physical elements that you place in your vagina to give you a tangible object to contract your PFM upon. They provide biofeedback to ensure that you are contracting the proper muscles. Some offer progressive resistance while others only a single resistance level.

These devices can be used in conjunction with the specific programs that were specified in a previous blog entry.  To do so, repeat the 4-week program for your specific pelvic floor dysfunction while incorporating these devices into the regimen. You may discover that the 4-week programs using the devices that offer progressive resistance become too challenging as you dial up the resistance level. If this is the case, you can continue with the first week’s program while increasing the resistance over time. Customize and modify the programs to make them work for you, as was recommended for the tailored programs without using resistance.

Educator Pelvic Floor Exercise Indicator:  This is a tampon-shaped device that you insert into your vagina. It is attached to an external arm that moves when you are contracting the PFM properly, giving you positive feedback. Cost is $32.99 on Amazon (Neenpelvichealth.com).

Gyneflex: This is a flexible V-shaped plastic device that is available in different resistances. You insert it in your vagina (apex of the V first) and when you squeeze your PFM properly, the external handles on each limb of the V close down, the goal being to get them to touch. Cost is $39.95 (Gyneflex.com). The Gyneflex is similar in form and function to hand grippers that increase grip strength. 

Pelvic Toner:  Manufactured in the UK, this is a spring-based resistance device that you insert into your vagina.  It has an external handle and two internal arms that remain separated, so the device must be held closed and inserted. When your hold is released the device springs open and, by contracting your PFM, you can close the device. It offers five different levels of resistance. Cost is 29.99 British pounds (Pelvictoner.co.uk).

Magic Banana: This is a PFM exerciser that consists of a loop of plastic and silicone tubing joined on a handle end. The loop is inserted in the vagina and squeezed against.  When the PFM are contracted properly, the two arms of the loop squeeze together. Cost is $49.99 (Magicbanana.com).

KegelMaster: This is a spring-loaded device that you insert in your vagina and is squeezed upon. It has an external handle with a knob that can be tightened or loosened to provide resistance by clamping down or separating the two arms of the internal component. Four springs offer different levels of resistance. Cost is $98.95 (Kegelmaster.com).

Kegel Pelvic Muscle Thigh ExerciserThis is a Y-shaped plastic device that fits between your inner thighs.  When you squeeze your thighs together, the gadget squeezes closed. This exerciser has NOTHING to do with the PFM as it strengthens the adductor muscles of the thigh, serving only to reinforce doing the wrong exercise and it is shameful that the manufacturer mentions the terms “Kegel” and “pelvic muscle” in the description of this product.

To be continued next week, with a review of sophisticated PFMT resistance devices.

Wishing you the best of health,

2014-04-23 20:16:29

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Dr. Andrew Siegel is a physician and urological surgeon who is board-certified in urology as well as in female pelvic medicine and reconstructive surgery.  He is an Assistant Clinical Professor of Surgery at the Rutgers-New Jersey Medical School and is a Castle Connolly Top Doctor New York Metro Area, Inside Jersey Top Doctor and Inside Jersey Top Doctor for Women’s Health. His mission is to “bridge the gap” between the public and the medical community.

Dr. Siegel has authored the following books that are available on Amazon, iBooks, Nook and Kobo:

MALE PELVIC FITNESS: Optimizing Sexual & Urinary Health

THE KEGEL FIX: Recharging Female Pelvic, Sexual and Urinary Health


PROMISCUOUS EATING: Understanding and Ending Our Self-Destructive Relationship with Food

These books are written for educated and discerning men and women who care about health, well-being, fitness and nutrition and enjoy feeling confident and strong.

Dr. Siegel is co-creator of the male pelvic floor exercise instructional DVD (female version is in the works): PelvicRx

New video on female pelvic floor exercises:  Learn about your pelvic floor


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One Response to “Female Pelvic Floor Muscle Resistance Training”

  1. Female Pelvic Floor Muscle Resistance Training Part 2: Sophisticated PFMT Devices | Our Greatest Wealth Is Health Says:

    […] Maximizing our health by promoting wellness; bridging the knowledge gap between physicians and the community. « Female Pelvic Floor Muscle Resistance Training […]

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