What Does EMSELLA Actually Do?

EMSELLA uses high-intensity focused electromagnetic energy to stimulate thousands of powerful pelvic floor muscle contractions during a single treatment session.

EMSELLA uses electromagnetic stimulation to activate the nerves and muscles of the pelvic floor. The programme includes contraction and rest phases. BTL describes the approach as pelvic-floor re-education: a useful framework for explaining muscle activation and control within the wider bladder-control system.

How do the brain, bladder and pelvic floor work together? · Why pelvic-floor control includes relaxation as well as contraction · EMSELLA, pelvic-floor exercises and bladder training: how are they different?

Those repeated contractions are designed to activate, strengthen and re-educate weakened pelvic floor muscles.

The pelvic floor contributes to several important functions, including:

You remain fully clothed and seated throughout treatment.

There are no injections, internal probes or surgical procedures.

BTL Australia describes EMSELLA® as using HIFEM technology to trigger thousands of powerful pelvic floor contractions in a single session, with repeated stimulation intended to improve muscle tone, endurance and neuromuscular control. [1]

HIFEM stands for High-Intensity Focused Electromagnetic technology.

EMSELLA® generates an electromagnetic field through the treatment chair.

That field stimulates the motor nerves responsible for activating pelvic floor muscles.

The nerves then trigger repeated muscular contractions.

In other words, EMSELLA does not simply send a sensation into the pelvis.

It causes the pelvic floor muscles themselves to repeatedly contract.

This is why patients usually feel:

during treatment.

Your muscles normally contract when nerves tell them to.

EMSELLA uses electromagnetic energy to stimulate those nerves without requiring you to consciously initiate every contraction yourself.

As a result, the pelvic floor contracts repeatedly while you remain seated.

The energy is delivered through clothing, so treatment does not require an internal applicator.

This ability to stimulate deep muscle tissue is what distinguishes EMSELLA from treatments aimed primarily at the skin or superficial tissues.

BTL Australia states that EMSELLA produces thousands of powerful pelvic floor contractions during a single treatment session. [1]

These are sometimes described as supramaximal contractions.

The important point is not simply the number.

It is that the pelvic floor is repeatedly activated during approximately 30 minutes of treatment.

A normal voluntary pelvic floor exercise program requires you to consciously:

EMSELLA provides intensive, externally stimulated muscle activation during the treatment session.

The term is used by the manufacturer to describe the powerful contractions produced by high-intensity electromagnetic stimulation.

These contractions occur independently of your ability to voluntarily produce and maintain every contraction.

That can be useful because some people with pelvic floor dysfunction have difficulty:

EMSELLA provides a way of repeatedly stimulating the target muscle group during treatment.

Muscle responds to repeated activation.

The aim of an EMSELLA treatment program is to improve aspects of pelvic floor function such as:

BTL describes repeated HIFEM stimulation as helping strengthen the pelvic floor and improve neuromuscular control.

Clinical research also supports measurable improvements in pelvic floor function and urinary symptoms following a course of HIFEM treatment.

The pelvic floor supports the bladder and contributes to control of the urethra.

When these muscles are functioning effectively, they help maintain urinary continence.

When pelvic floor support is reduced, some people experience leakage during increases in abdominal pressure, such as:

This is often described as stress urinary incontinence.

Strengthening the muscles involved in continence can therefore improve bladder support and urinary control in appropriately selected patients.

Published clinical studies have reported improvements in urinary incontinence following HIFEM pelvic floor treatment.

One study included 75 women with stress, urge or mixed urinary incontinence who received six HIFEM sessions twice weekly.

After the sixth session:

Improvements continued at the three-month follow-up. [2]

These are study averages, not guaranteed individual outcomes.

A more recent EMSELLA® study involving 35 women with stress and mixed urinary incontinence also reported significant improvement after six sessions, with further improvement at one-month follow-up. [3]

Related article: Can EMSELLA® Help With Urinary Incontinence?

No.

In Australia, BTL states that EMSELLA® is intended to provide pelvic floor muscle strengthening in relation to several genitourinary conditions, including:

The device is included in the Australian Register of Therapeutic Goods under ARTG 302821.

That does not mean every person with one of these symptoms is automatically suitable.

The clinical question is still whether pelvic floor strengthening is relevant to the individual problem.

For selected women, pelvic floor strengthening may be relevant to symptoms such as:

The exact reason for treatment matters.

For example, urinary leakage when coughing or exercising may have a different clinical context from sudden urinary urgency.

At ¹EM, Dr Emir assesses the symptom pattern before recommending treatment.

Pregnancy and childbirth can place considerable strain on pelvic floor muscles.

After appropriate postpartum healing, EMSELLA® can provide intensive pelvic floor muscle stimulation for selected women experiencing:

At ¹EM, EMSELLA is not performed during pregnancy or within the first three months following childbirth.

After that point, treatment suitability depends on the individual's recovery and clinical assessment.

Related article: Can I Have EMSELLA After Pregnancy or Birth?

Hormonal changes around menopause can contribute to pelvic floor weakness and urinary symptoms.

EMSELLA® does not treat menopause itself.

Instead, it can strengthen pelvic floor muscles where reduced pelvic floor function is contributing to symptoms.

It may therefore be relevant for selected women experiencing:

Other menopausal symptoms, such as vaginal dryness or genitourinary tissue changes, may require different treatment.

Related article: Is EMSELLA Suitable for Women Going Through Menopause?

Men have pelvic floor muscles too.

Those muscles contribute to:

EMSELLA® provides the same fundamental mechanism in men: electromagnetic stimulation produces repeated pelvic floor contractions.

Clinical research has specifically investigated HIFEM treatment in men with urinary incontinence following radical prostatectomy.

Related article: Does EMSELLA Help Men as Well?

After radical prostatectomy, some men experience persistent urinary leakage.

Pelvic floor muscles contribute to urinary continence following prostate surgery.

A 2025 EMSELLA study involving 27 men with persistent post-prostatectomy urinary incontinence used six treatment sessions twice weekly.

Urinary symptom scores and pad use improved following treatment and continued improving at one-month follow-up. [4]

EMSELLA® does not reverse prostate surgery.

Its role is to stimulate and strengthen the pelvic floor muscles involved in continence.

Certain male pelvic floor muscles contribute to erection rigidity and maintenance.

For selected men, improving pelvic floor strength may therefore support sexual function.

However, erectile dysfunction can also result from:

EMSELLA strengthens the pelvic floor.

It should not be described as treating every possible cause of erectile dysfunction.

Related article: Can EMSELLA Support Men With Erectile Dysfunction?

The pelvic floor forms part of the deeper muscular system involved in pelvic and trunk function.

BTL Australia describes EMSELLA® as supporting improved pelvic stability as well as bladder control. [1]

However, EMSELLA® should primarily be understood as a pelvic floor strengthening treatment.

If a patient's main goal is broader abdominal, back or core muscle strengthening, another treatment pathway may be more appropriate.

At ¹EM, this distinction matters because EMSCULPT NEO can be used for selected muscle-strengthening applications outside the pelvic floor.

There is an overlap in the goal, but they are not the same thing.

Both approaches aim to improve pelvic floor muscle function.

You consciously contract the pelvic floor yourself.

Success depends on:

Electromagnetic energy stimulates repeated contractions during treatment.

You do not have to voluntarily initiate every contraction.

The two approaches can also complement one another.

Pelvic floor exercises remain valuable even when EMSELLA® is part of the treatment plan.

Not necessarily.

Pelvic floor physiotherapy and EMSELLA provide different tools.

A pelvic floor physiotherapist can assess and address issues including:

EMSELLA provides intensive electromagnetic muscle stimulation.

Some patients may benefit from one approach.

Others may benefit from both.

The right treatment depends on the actual problem.

It is more accurate to describe EMSELLA® as a pelvic floor muscle strengthening treatment.

It should not be presented as a procedure that physically or surgically tightens vaginal tissue.

Improved pelvic floor muscle function may alter how some women experience pelvic support or sexual function, but the mechanism is muscular rather than a surgical reduction in vaginal dimensions.

No.

There is no internal probe.

You remain fully clothed while sitting on the treatment chair.

This is one of EMSELLA®'s most distinctive practical advantages compared with some other forms of pelvic floor treatment.

Treatment usually feels like powerful repeated pelvic floor contractions.

You may experience:

The treatment should feel intense rather than painfully uncomfortable.

BTL Australia states that treatment should be stopped if a patient reports uncomfortable pain.

There is generally no required downtime.

BTL states that patients can return to normal activities immediately after treatment.

That can usually include:

Temporary muscular awareness or fatigue can occur because the pelvic floor has been repeatedly stimulated.

Related article: Is There Any Downtime After EMSELLA?

A typical session lasts approximately 28 to 30 minutes.

BTL Australia's patient guidance describes a typical treatment as around 30 minutes.

At ¹EM, the standard initial course is usually:

6 sessions

2 sessions per week

approximately 3 weeks

Related article: How Many EMSELLA Sessions Are Recommended?

EMSELLA is muscle treatment.

One period of stimulation is not the same as completing a strengthening program.

Published clinical research commonly uses six sessions delivered twice weekly.

Repeated treatments provide a period of progressive muscle stimulation, after which symptoms and function can be reassessed.

Some people report noticing changes early.

However, the standard treatment program involves multiple sessions and published research generally evaluates outcomes after completion of the treatment course and during follow-up.

You should therefore not judge the likely result of the entire program from one session alone.

That depends on why you are being treated.

For urinary incontinence, useful outcomes can include:

Clinical studies have also used validated measures such as the International Consultation on Incontinence Questionnaire Short Form, or ICIQ-SF, to quantify changes.

The goal at ¹EM is not simply to complete six sessions.

It is to establish whether the symptoms that brought you to treatment have changed.

For appropriately selected patients, HIFEM pelvic floor treatment has generally been well tolerated in published research.

It is still not suitable for everybody.

Important contraindications include certain:

BTL Australia's current EMSELLA® information specifically states that treatment should not be applied in patients with electronic or metal implants.

Related article: Is EMSELLA Safe?

Because knowing how the machine works is not the same as knowing whether it is appropriate for you.

Pelvic floor symptoms can have several possible causes.

For example:

Simply strengthening every pelvic floor indiscriminately would therefore not be good clinical care.

Dr Emir and the ¹EM clinical team consider factors including:

If EMSELLA makes sense, a personalised treatment program can then be recommended.

EMSELLA® uses high-intensity focused electromagnetic energy to stimulate thousands of powerful pelvic floor contractions during a treatment session.

These contractions are intended to strengthen and re-educate pelvic floor muscles.

EMSELLA® targets the pelvic floor muscle group.

These muscles contribute to urinary continence, pelvic support and aspects of sexual function.

That is the treatment goal.

Clinical research has reported improvements in pelvic floor function and urinary symptoms following HIFEM treatment.

BTL Australia states that EMSELLA triggers thousands of powerful pelvic floor contractions during a session.

Not exactly.

Both target pelvic floor muscles, but EMSELLA® uses electromagnetic stimulation to produce involuntary contractions rather than relying exclusively on voluntary exercises.

Yes, where appropriate.

Pelvic floor exercises can complement EMSELLA rather than competing with it.

It may help selected patients where pelvic floor dysfunction contributes to urinary incontinence.

Yes. EMSELLA® can strengthen the male pelvic floor and has been studied particularly for urinary incontinence following prostatectomy.

Potentially, once postpartum recovery is sufficiently advanced and treatment has been assessed as appropriate.

It may be appropriate where pelvic floor weakness or urinary incontinence contributes to menopausal symptoms.

No. Treatment is performed while you remain fully clothed.

Approximately 30 minutes.

The standard initial ¹EM program is usually six treatments, scheduled twice weekly over approximately three weeks.

Generally, no required downtime. Most suitable patients can return to normal activities immediately afterwards.

The concept behind EMSELLA is straightforward.

Sit down.

Remain fully clothed.

Allow high-intensity electromagnetic energy to repeatedly activate your pelvic floor muscles.

Those repeated contractions form an intensive pelvic floor strengthening treatment without surgery, injections or an internal device.

The more important question is whether strengthening those muscles is likely to improve your particular symptoms.

That is where the clinical assessment matters.

Whether the concern is urinary leakage, postpartum pelvic floor weakness, menopause-related bladder changes, men's pelvic health or post-prostate rehabilitation, the first step is determining whether the pelvic floor is contributing.

At ¹EM, Dr Emir can assess your symptoms and medical history and determine whether EMSELLA® is an appropriate part of your personalised treatment plan.

CTA heading: See What a Stronger Pelvic Floor Could Change

CTA description: Book a complimentary ¹EM consultation to understand your symptoms and find out whether EMSELLA® pelvic floor strengthening is appropriate for you.

CTA button: Book Your Complimentary Consultation

Internal links:

EMSELLA® at ¹EM:https://emsella.1em.com.au/

¹EM:https://1em.com.au/

Related article: Can EMSELLA® Help With Urinary Incontinence?

Related article: How Many EMSELLA® Sessions Are Recommended?

Related article: Is EMSELLA® Safe?

Related article: Does EMSELLA® Help Men as Well?

Related article: Can I Have EMSELLA® After Pregnancy or Birth?

Related article: Is EMSELLA® Suitable for Women Going Through Menopause?

1. BTL Aesthetics Australia. EMSELLA® Provider Information.

BTL Australia describes EMSELLA® as using HIFEM technology to trigger thousands of powerful pelvic floor contractions to activate and re-educate weakened muscles, improve muscle tone and endurance and support bladder control. It lists EMSELLA® under ARTG 302821.

2. Samuels JB, Pezzella A, Berenholz J, et al. Safety and Efficacy of a Non-Invasive High-Intensity Focused Electromagnetic Field Device for Treatment of Urinary Incontinence and Enhancement of Quality of Life. Lasers in Surgery and Medicine. 2019. PMID: 31172580.

Seventy-five women with stress, urge or mixed urinary incontinence received six HIFEM treatments. Significant improvements in urinary incontinence scores and pad use were reported following treatment and at three-month follow-up.

3. Is the High-Intensity Focused Electromagnetic Energy an Effective Treatment for Urinary Incontinence in Women? Therapeutics and Clinical Risk Management. PMID: 39640007.

Thirty-five women with stress or mixed urinary incontinence received six EMSELLA® treatments twice weekly. Urinary symptom scores and pad use improved after treatment and at one-month follow-up.

4. Therapeutic Goods Administration. ARTG 302821. BTL Medical Technologies Pty Ltd, Deep-tissue electromagnetic stimulation system, professional.

The TGA records ARTG 302821 as an active Class IIa deep-tissue electromagnetic stimulation medical device supplied by BTL Medical Technologies Pty Ltd.

This article provides general health information and does not replace individual medical assessment. Pelvic floor, urinary and sexual-health symptoms can have different underlying causes. Treatment suitability should be determined according to your symptoms, medical history and applicable contraindications.