Emsella vs kegels: cost, evidence and which to try first
Most “Emsella vs kegels” pages come from clinics that sell the chair. We don’t. How each works, what it costs, what the evidence shows, and when to see a doctor.
Updated ·Written by the Dr. Kegel editorial team · clinical review pending
This guide is for women. Read the version for men →
Short answer
Emsella is an FDA-cleared chair that uses electromagnetic energy to make your pelvic floor contract while you sit clothed — usually six 28-minute sessions over three weeks, paid out of pocket. Kegels are free, first-line and backed by stronger evidence. For most people, a few months of proper kegel training should come first.
Search “Emsella vs kegels” and almost every result comes from a clinic that sells Emsella. We don’t sell it, and we don’t sell devices. We do make a kegel training app — so we have a bias too, and we’ll show our working.
How each one works
Kegels (pelvic floor muscle training) are exercises you do on purpose: squeeze and lift the muscles that stop gas and urine, hold, then fully relax. You learn to use them when it matters — a squeeze before you cough, sneeze or lift. That timing skill is part of what reduces leaks.
Emsella is a chair made by BTL. You sit fully clothed while it uses high-intensity focused electromagnetic energy (HIFEM) to make your pelvic floor contract. The manufacturer says one 28-minute session produces thousands of kegel-like contractions. You feel tingling and tightening. There’s no downtime.
Emsella vs kegels at a glance
Prices checked September 2026 from published clinic prices — check current price locally.
| Kegels | Emsella | |
|---|---|---|
| What moves the muscle | You do | The chair’s electromagnetic field |
| Where | Anywhere, including at home | Clinic or med spa |
| Typical course | Daily; at least 3 months before judging results (NICE) | 6 sessions of about 28 minutes, twice a week for 3 weeks |
| Maintenance | Keep a few sets a week | Clinics often suggest sessions every few months |
| Cost | Free, or an app or physio visits | Roughly $1,200–$3,000+ per course out of pocket (see Emsella cost) |
| Insurance | Physio may be covered by some plans | Usually not covered |
| Evidence | Cochrane review of many trials; first-line in guidelines | Smaller studies; few sham-controlled trials |
| Teaches you control | Yes — you practise the squeeze and its timing | No — contractions are passive |
| Teaches you to relax | Yes, if done properly (squeeze and full release) | No |
| Not suitable for | People whose pelvic floor is too tight (start with relaxation) | Pregnancy, pacemakers and other electronic implants, metal implants such as a copper IUD |
What the evidence says
Kegels. A 2018 Cochrane review of 31 trials found pelvic floor muscle training can reduce or stop urinary leaking for many women, compared with no training. NICE recommends a supervised program of at least 3 months as first-line care for stress and mixed incontinence. Results depend on doing them correctly and consistently.
Emsella. The chair is FDA-cleared for rehabilitation of weak pelvic muscles and urinary incontinence in men and women. Published studies exist, and clinics often quote satisfaction figures from them, but the evidence base is small, many studies are short and uncontrolled, and only a few sham-controlled trials exist. A clearance means the device can be marketed; it doesn’t tell you how it compares with a good kegel program.
What “11,200 kegels in 28 minutes” really means
You’ll see this figure on many clinic pages. It describes how many muscle contractions the chair triggers in one session — it’s a manufacturer figure, not a result. More contractions don’t automatically mean better control. Kegels work partly because you learn when to squeeze: bracing before a cough, a sneeze or a heavy lift. A chair can’t teach that timing. That’s why many clinicians who offer Emsella still recommend doing your own training between and after sessions.
What an Emsella session is like
You sit on the chair fully clothed for about 28 minutes. Most people feel tingling and strong tightening in the pelvic floor; the intensity is adjusted to what you can tolerate. You can drive home and go back to work straight after. Clinics usually ask about implants, pregnancy and your medical history before the first session. If a clinic doesn’t ask, that’s a warning sign.
Pros and cons
Kegels
- Pros: free; do them anywhere; strongest evidence; teach control you use every day; include relaxation.
- Cons: take weeks to months; easy to do wrong without guidance; you have to stick with it.
Emsella
- Pros: no effort; clothed; short course; may help people who can’t produce a voluntary squeeze.
- Cons: expensive and usually not covered; maintenance costs; smaller evidence base; passive — doesn’t teach timing or relaxation; not for people with certain implants or during pregnancy.
If you leak during exercise
Leaks when you run, jump or lift are stress leaks — the type with the strongest evidence for pelvic floor training. Training also lets you practise “the knack”: a quick squeeze just before impact. A chair can’t train that timing. Emsella may be worth discussing if you’ve trained properly for months with a physio and still leak.
Men comparing the two have different questions — prostate surgery, dribbling, erections. See Emsella vs kegels for men.
Who each option is for
Start with kegels if you haven’t done 3 months of proper training, you leak with coughs, sneezes or exercise, you’re in the first year after having a baby, or you’re around menopause and noticing new leaks.
Emsella may be worth discussing with a clinician if you’ve done a supervised program and hit a plateau, a physio has found you can’t produce a voluntary squeeze, and the cost is manageable for you.
Skip both and get checked first if you have pelvic pain, pain with sex, or trouble emptying your bladder — your pelvic floor may be tight rather than weak. Take the Tight or weak? check.
Try a free program before you pay for a chair
Before spending $1,000 or more, give yourself a fair trial:
- Learn the squeeze and the release. Our kegels for women guide, and if you leak when you run or jump, leaking during exercise.
- Train daily with our free kegel timer.
- Track leaks for 3 days with the bladder diary so you can see progress.
- After a few months, if you’re not improving, see a pelvic floor physical therapist. They can tell you whether anything extra — biofeedback, e-stim or Emsella — makes sense.
Disclosure
We make Dr. Kegel for Men and are building Dr. Kegel for Women, so we benefit if you choose kegels. We have no relationship with BTL or any Emsella provider, and there are no affiliate links on this page. Last updated September 23, 2026.
Frequently asked questions
Is Emsella better than kegels?
There's no strong evidence that it is. Kegels have the larger, more established evidence base and are recommended as first-line training. Emsella's research is smaller, with few sham-controlled trials. It may suit people who can't do a voluntary squeeze, but it doesn't teach you to use your muscles in daily life.
How many Emsella sessions do you need?
The usual course is six sessions of about 28 minutes, twice a week for three weeks. Many clinics also suggest maintenance sessions every few months. Ask the clinic what's included in the package price and what they expect after the first course.
Does insurance cover Emsella?
Usually not. Clinics and insurance guides report that most insurers treat it as an out-of-pocket expense, although some clinics say HSA or FSA funds can be used. Ask your plan directly before you book.
Can I do kegels and Emsella together?
Yes, and many clinics suggest it. Emsella makes the muscles contract, while kegels teach you to squeeze on purpose — before a cough, sneeze or lift. If you choose Emsella, keep doing your own training so you keep the control you build.
Can I use Emsella after having a baby?
Emsella isn't used during pregnancy. After birth, most women start with gentle pelvic floor training and wait for their postnatal check before any device. Ask your clinician. Leaking in the first months often improves with training alone.
Sources
- BTL Emsella — BTL (manufacturer)
- EMSELLA for Urinary Incontinence — UC Irvine Department of Urology
- BTL Emsella Chair Versus Sham for the Treatment of Stress Urinary Incontinence (NCT04133675) — ClinicalTrials.gov
- Chair-Based Magnetic Pelvic Floor Stimulation and Female Sexual Function in Women with Urinary Incontinence: A Systematic Review — PMC
- Pelvic floor muscle training for urinary incontinence in women — Cochrane
- Quality statement 4: Supervised pelvic floor muscle training — NICE
This page is general education about exercise, not a diagnosis or treatment plan. Talk to a clinician about symptoms that are new, severe or getting worse.