Do Pelvic Floor Trainers Work? What the Studies Say About Perifit-Style Kegel Devices

Pelvic floor training works. The gadget is optional. There's strong evidence that regular Kegel exercises can cure or improve bladder leaks, especially the kind that happen when you cough, sneeze or jump. App-connected trainers like Perifit can help you find the right muscles and actually stick with the routine, but the largest independent trial found that adding biofeedback to well-supervised training made no extra difference after two years.

So a trainer is worth it for some people and a waste for others. Below is what the research shows, who benefits from a device, who should skip it and see a pelvic floor physical therapist instead, and how to do Kegels correctly either way.

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What is a pelvic floor trainer?

Most at-home trainers are a small, soft probe that you insert into the vagina. Sensors measure pressure or movement when you squeeze, and a phone app turns that into feedback, often a simple game: squeeze and the character goes up, relax and it comes down. This is a home version of biofeedback, a technique physical therapists use to show you whether you're contracting the right muscles. ACOG notes that in-home biofeedback devices are available (ACOG).

Other devices work differently. Vaginal weights or cones give you something to hold in place, and electrical stimulation units contract the muscles for you with a mild current (Mayo Clinic). This article focuses on app-based biofeedback trainers, the most popular type.

Does pelvic floor muscle training work?

Yes, and the evidence is solid. A 2018 Cochrane review pooled 31 trials with 1,817 women. Compared with no treatment, women with stress incontinence who did pelvic floor muscle training were about eight times more likely to report being cured: 56% versus 6%. For any type of incontinence, cure rates were 35% versus 6% (Cochrane review, Dumoulin et al., 2018). The authors concluded that training should be part of first-line treatment.

Mayo Clinic says that if you make Kegels a habit, you can expect results in a few weeks to a few months, such as leaking less often (Mayo Clinic). The catch is that last part: a habit. Most people stop doing their Kegels long before then, and many never learn to do them correctly in the first place.

Do pelvic floor trainers work better than plain Kegels?

This is where the evidence gets mixed.

• The big independent trial: no extra benefit. The OPAL trial randomized 600 women with stress or mixed incontinence in the UK. Both groups got six appointments with a continence therapist over 16 weeks. One group also used electromyographic biofeedback in the clinic and at home. After 24 months, symptom scores were nearly identical (8.2 versus 8.5 on a 21-point scale), and the authors said routine biofeedback shouldn't be recommended (Hagen et al., BMJ, 2020).
• A device beat written instructions. In a 2022 remote trial with 363 women, those who trained with a motion-sensing vaginal device for 8 weeks improved more than those following a written and narrated home program, and had fewer stress leaks on a bladder diary (Weinstein et al., Obstetrics and Gynecology, 2022). That device wasn't Perifit.
• Perifit's own real-world data looks good, with caveats. In an analysis of 6,060 women who bought a Perifit and filled in symptom questionnaires, average symptom scores fell from 8.4 to 4.6 after about 300 training games, and 85% of those who reached that point reported improvement (Perrier and Aumont, 2024). The authors work for the company, there was no comparison group, and the later time points only include women who kept training and answered the surveys, which tends to make results look better.

Put together: a trainer doesn't make the muscles stronger than good Kegels would. What it can do is replace part of what a therapist provides, feedback that you're squeezing the right muscles and a reason to keep going. If you already have a pelvic floor physical therapist, you probably don't need one. If you're doing Kegels alone from a leaflet and aren't sure they're working, it can help.

Who a pelvic floor trainer is for, and who should skip it

A trainer makes the most sense if:

• You leak a little when you cough, sneeze, laugh, run or jump (stress incontinence), or have mixed leaks
• You've tried Kegels but can't tell whether you're doing them right
• You like data and games, and know you won't stick with a routine otherwise
• Seeing a pelvic floor physical therapist isn't possible right now because of cost, distance or waitlists

Skip the trainer, or check with a clinician first, if:

• You have pelvic pain, pain with sex, or trouble emptying your bladder or bowels. These can be signs that your pelvic floor is too tight and can't relax, not too weak. Cleveland Clinic explains that in this kind of pelvic floor dysfunction, treatment focuses on relaxing and coordinating the muscles, usually with physical therapy and biofeedback guided by a therapist (Cleveland Clinic). More squeezing can make it worse.
• You leak a lot, or your bladder overflows. Mayo Clinic says Kegels are less helpful for people who leak large amounts with a sneeze or cough, and for overflow incontinence.
• You're pregnant or recently gave birth. Kegels are often encouraged during and after pregnancy, but ask your clinician before you insert any device, and wait until you've been cleared after delivery.
• You feel a bulge or pressure in the vagina, have blood in your urine, or have burning or pain when you pee. Get checked first.

How to do Kegels correctly (with or without a device)

Mayo Clinic's step-by-step method is a good baseline (Mayo Clinic):

1. Find the right muscles. Squeeze the muscles you'd use to stop passing gas or to stop peeing midstream. You should feel a slight lift and pull inside, not your belly or buttocks clenching.
2. Lift, hold, release. Imagine sitting on a marble and lifting it upward. Hold for 3 seconds, then relax fully for 3 seconds.
3. Isolate and breathe. Keep your abs, thighs and buttocks relaxed, and don't hold your breath.
4. Do three sets a day. Work up to 10 to 15 squeezes per set. Try one set lying down, one sitting and one standing.
5. Don't practice while peeing. Stopping your stream is only for finding the muscles once. Doing Kegels while emptying your bladder can keep it from emptying fully and raise the risk of a urinary tract infection. NIDDK gives the same warning (NIDDK).

The relax phase matters as much as the squeeze. If you can't feel your muscles let go, that's useful information to bring to a clinician.

Perifit and other options worth considering

These are based on each product's listing and the studies above.

Perifit

The Perifit is the best-known app trainer on Amazon. You insert the probe, open the app and play short games by squeezing and relaxing. The listing says it was developed with pelvic floor physical therapists and includes seven exercise programs. Its strength is the feedback. The Perifit study cites earlier research showing the sensors can tell a proper squeeze from pushing down, which is a common mistake. Its weakness is that it only works if you keep using it, and the main study behind it was run by the company. If you buy one, give it at least two to three months of regular sessions before you judge it.

Pads for the meantime

Training takes weeks to months. In the meantime, use pads designed for bladder leaks rather than period pads. Poise Ultra Thin pads are a discreet, moderate-absorbency option for small leaks, and Poise says their top layer locks away more wetness than leading period pads. If you need heavier protection, step up the absorbency rather than doubling up.

Physical therapy

ACOG lists Kegels, pelvic floor physical therapy and biofeedback among the first treatments to try for urinary incontinence, along with bladder training, weight loss when it applies, and support devices like a pessary (ACOG). A therapist can check that you're contracting the right muscles, which is exactly what a home device is trying to imitate. Ask your insurer whether pelvic floor physical therapy is covered; many people don't know to ask.

When to see a doctor about bladder leaks

Leaking urine is common, but it isn't something you just have to live with. See your clinician if leaks are getting worse, if they keep you from exercise or social plans, or if you notice urgency, burning, blood in your urine, pelvic pain or a vaginal bulge. Treatments go well beyond Kegels: bladder training, pessaries, medications for urgency, vaginal estrogen in some cases, and surgery such as a midurethral sling for stress incontinence (ACOG).

FAQ

Do pelvic floor trainers really work?

They work to the extent that they help you do pelvic floor training correctly and consistently. Training itself has strong evidence behind it. The best independent trial found biofeedback added nothing on top of well-supervised training, but devices may help people training alone at home.

How long does it take to see results from a pelvic floor trainer?

Mayo Clinic says most people who do Kegels regularly see results in a few weeks to a few months. In Perifit's real-world data, improvements kept growing over roughly 50, 100 and 300 sessions.

Is Perifit worth it compared with free Kegels?

If you can find the right muscles and keep a routine, free Kegels do the same job. Perifit is worth it if you've struggled with technique or motivation and can't easily see a pelvic floor physical therapist.

Can you do too many Kegels?

It's possible, especially if your pelvic floor is already tight. In that case, more squeezing without learning to relax can make pain or trouble emptying worse, according to Cleveland Clinic. Follow a structured plan, include full relaxation between squeezes, and stop and get checked if you have pain.

Are Elvie and Perifit the same?

They're similar: both are app-connected vaginal trainers that give you feedback while you do Kegels. They differ in sensor design, app and price. I couldn't find a head-to-head trial comparing the two.

Can I use a pelvic floor trainer after giving birth?

Many people do, but wait until your clinician clears you after delivery, usually at your postpartum checkup. If you have pain, heavy bleeding or a bulging feeling, see a clinician before you start.

This article is for informational purposes and doesn't replace advice from a healthcare professional.

Sources

• Dumoulin C et al. Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women. Cochrane Database Syst Rev, 2018 – PubMed
• Hagen S et al. Effectiveness of pelvic floor muscle training with and without electromyographic biofeedback for urinary incontinence in women. BMJ, 2020 – PubMed
• Weinstein MM et al. Digital Therapeutic Device for Urinary Incontinence: A Randomized Controlled Trial. Obstet Gynecol, 2022 – PMC
• Perrier ET, Aumont L. Pelvic Floor Muscle Training Using the Perifit Device for the Treatment of Urinary Incontinence: A Pragmatic Trial Using Real-World Data, 2024 – PMC
• Kegel exercises: A how-to guide for women – Mayo Clinic
• Urinary Incontinence – ACOG
• Treatments for Bladder Control Problems – NIDDK
• Pelvic Floor Dysfunction – Cleveland Clinic

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