Is EMSELLA Suitable for Women Going Through Menopause?

Yes. EMSELLA can be suitable for women during perimenopause, menopause and postmenopause, particularly when pelvic floor weakness or urinary incontinence is contributing to symptoms.

Menopausal urinary and sexual symptoms can have several contributors, including tissue changes and pelvic-floor function. A pelvic-floor treatment does not replace assessment of other causes. Early research on HIFEM and female sexual-function scores provides a further discussion point for selected patients.

EMSELLA and sexual function in women: what has been studied? · EMSELLA, pelvic-floor exercises and bladder training: how are they different?

Hormonal changes around menopause can affect the pelvic floor, bladder, urethra and surrounding tissues.

Women may notice changes such as:

Australian health guidance recognises menopause as a factor that can contribute to pelvic floor weakness and urinary incontinence.

EMSELLA uses high-intensity focused electromagnetic technology to stimulate and strengthen the pelvic floor muscles while you remain fully clothed.

At ¹EM, Dr Emir assesses the symptoms you are experiencing and determines whether pelvic floor strengthening is likely to be helpful as part of your individual menopause and pelvic health plan.

Menopause involves a progressive decline in ovarian hormone production, particularly oestrogen.

These hormonal changes can affect several structures involved in urinary and pelvic health.

The Menopause Society notes that reduced oestrogen around menopause can affect the bladder and urethra and may contribute to:

At the same time, pelvic floor muscles can become weaker with ageing and hormonal change.

Healthdirect Australia specifically identifies hormonal changes associated with menopause as one factor that may weaken the pelvic floor.

For some women, these changes become noticeable during perimenopause.

For others, they appear years after periods have stopped.

The pelvic floor is a group of muscles supporting structures including the:

These muscles contribute to closing and supporting the urethra.

When pelvic floor strength or coordination decreases, bladder control can become more difficult.

This can contribute particularly to stress urinary incontinence, where urine leaks when pressure suddenly increases during activities such as:

Pelvic floor strengthening is therefore an established conservative approach to urinary incontinence.

Current European urological guidelines strongly recommend supervised intensive pelvic floor muscle training as first-line treatment for women with stress or mixed urinary incontinence, including older women.

EMSELLA® provides high-intensity focused electromagnetic stimulation, or HIFEM, to the pelvic floor muscles.

During treatment:

There is:

The aim is to repeatedly stimulate and condition the pelvic floor muscles.

Yes.

Importantly, we are no longer relying only on studies involving mixed-age groups of women.

A 2026 prospective study specifically evaluated 99 postmenopausal women with stress, urgency or mixed urinary incontinence.

Women received either:

Both groups experienced clinically meaningful improvement in urinary incontinence symptoms.

Women who combined EMSELLA® with pelvic floor exercises experienced greater average improvement than those receiving EMSELLA alone.

No treatment-related adverse events were reported.

This is particularly relevant for women considering EMSELLA during or after menopause because the study population directly reflects this stage of life.

Potentially, yes.

EMSELLA does not make voluntary pelvic floor exercises irrelevant.

In fact, the 2026 postmenopausal study found greater symptom improvement when EMSELLA was combined with structured Kegel exercises than with EMSELLA alone.

At ¹EM, the objective is not to make patients dependent on a machine.

It is to improve pelvic floor function.

Depending on your presentation, your broader plan may therefore include:

Yes, this is one of the strongest reasons to consider treatment.

EMSELLA and HIFEM therapy have been studied across several forms of urinary incontinence.

A 2025 systematic review and meta-analysis of seven studies found that HIFEM treatment was associated with improvements in urinary incontinence episodes, symptom scores and quality-of-life measures compared with control treatments.

A separate EMSELLA study of women with stress and mixed urinary incontinence reported significant improvements following six sessions, including reduced symptom scores and decreased pad use.

For menopausal women experiencing leakage, the first step is identifying the type of incontinence.

That pattern is typical of stress urinary incontinence.

Stress incontinence is often associated with reduced pelvic floor support.

You may notice leakage when:

This is exactly the type of presentation where assessing pelvic floor function can be particularly useful.

Related article: Can EMSELLA Help With Urinary Incontinence?

This requires a little more assessment.

Urge urinary incontinence involves a sudden and difficult-to-control need to urinate.

You may experience:

Menopause itself can contribute to urinary urgency and frequency because reduced oestrogen affects the bladder and urinary tract.

HIFEM research has included women with urgency incontinence, and recent clinical research reported improvements across stress, mixed and urgency urinary incontinence following six treatments.

However, urgency has several possible causes.

At ¹EM, Dr Emir assesses the symptom pattern rather than assuming every urgency problem is simply caused by a weak pelvic floor.

Yes, potentially.

Mixed urinary incontinence combines:

Mixed symptoms are particularly common among older women.

Published EMSELLA research has included women with mixed urinary incontinence and reported significant improvements following treatment.

No single treatment addresses every physical change associated with menopause.

This distinction is important.

EMSELLA is primarily a pelvic floor muscle treatment.

It can be particularly relevant when symptoms involve:

However, menopause can also cause genitourinary syndrome of menopause, or GSM.

GSM can include:

These changes are related substantially to reduced oestrogen affecting vaginal and urinary tissues.

EMSELLA® strengthens muscles.

It does not replace treatment directed specifically at vaginal or urinary tissue changes related to reduced oestrogen.

Tell Dr Emir about both.

This is a good example of why a doctor-led menopause and pelvic health assessment can be more useful than treating one symptom in isolation.

You may have:

a pelvic floor component

and

a hormonal or genitourinary component

at the same time.

EMSELLA may address the pelvic floor component while another treatment may be appropriate for vaginal dryness or other genitourinary symptoms.

The treatments are not necessarily competing options.

They can address different parts of the same overall presentation.

Not automatically.

Painful intercourse during menopause is frequently related to vaginal dryness, tissue thinning and other changes associated with reduced oestrogen.

Pelvic floor dysfunction may also contribute in some women, but pain should be assessed rather than assumed to represent weakness.

In some patients, the pelvic floor may actually be excessively tight rather than weak.

That is another reason why indiscriminately strengthening every woman's pelvic floor is not good medicine.

Dr Emir can determine whether EMSELLA® appears relevant or whether another pelvic-health or menopause pathway should be considered.

No.

They are fundamentally different treatments.

Menopausal hormone therapy and local vaginal hormone therapies are directed at hormonal and tissue changes associated with menopause.

EMSELLA is designed to stimulate and strengthen pelvic floor muscles.

A woman may therefore potentially use EMSELLA while receiving appropriate menopause treatment, depending on her individual medical circumstances.

Do not stop or change prescribed menopause medication because you are considering EMSELLA.

Potentially, yes.

Hormone replacement therapy itself does not automatically make someone unsuitable for electromagnetic pelvic floor treatment.

Your medications should still be disclosed during your consultation.

Dr Emir will assess your medical history and determine whether any individual contraindication exists.

Vaginal oestrogen and EMSELLA target different aspects of menopausal pelvic health.

Local vaginal oestrogen can be used to address genitourinary tissue changes associated with menopause in suitable women.

EMSELLA provides pelvic floor muscle stimulation.

For someone experiencing both genitourinary symptoms and pelvic floor weakness, these approaches may potentially complement each other rather than requiring an either-or decision.

Any hormonal treatment should be discussed with the clinician managing your menopause care.

Potentially, yes.

You do not need to have completely stopped menstruating to develop pelvic floor or urinary symptoms.

Perimenopause involves fluctuating and declining hormone levels before the final menstrual period.

Healthdirect notes that bladder changes, including increased urinary frequency or discomfort, can occur during perimenopause.

If you are experiencing urinary leakage or pelvic floor weakness during this stage, EMSELLA can be assessed as a treatment option.

Yes.

There is no upper age cut-off based simply on having completed menopause.

The more important questions are:

The recent postmenopausal EMSELLA study specifically supports the relevance of pelvic floor electromagnetic treatment in this population.

It is common, but that does not mean you simply have to accept it.

Healthdirect lists menopause as a recognised risk factor for urinary incontinence and identifies hormonal changes as one factor that may weaken pelvic floor muscles.

Many women quietly adapt their lives around bladder symptoms.

That can mean:

These adaptations can gradually feel normal.

They are still symptoms worth assessing.

You can still develop pelvic floor weakness or urinary incontinence during menopause.

Childbirth is only one risk factor.

Pelvic floor function is also influenced by:

So EMSELLA assessment is not limited to women who have previously given birth.

That is also common.

Pelvic floor function reflects the cumulative effects of many factors across life.

Previous pregnancy or childbirth may contribute, while menopause and ageing can add further changes later.

The important question is what is contributing to the symptoms now.

Potentially, when pelvic floor function is part of the issue.

The pelvic floor contributes to sexual function, and HIFEM studies have evaluated sexual-function outcomes as secondary measures.

A recent study of women with urinary incontinence reported improvements in some sexual-function domains following HIFEM treatment.

However, menopause-related sexual symptoms can also result from:

EMSELLA should therefore not be marketed as a universal treatment for menopausal sexual dysfunction.

At ¹EM, the standard initial program is typically:

6 sessions

2 sessions per week

approximately 3 weeks

Each treatment takes around 30 minutes.

Your symptoms and progress are assessed rather than assuming that every woman needs ongoing treatment indefinitely.

Related article: How Many EMSELLA Sessions Are Recommended?

You sit fully clothed on the treatment chair.

You will feel repeated contractions through the pelvic floor.

Women commonly describe:

Treatment intensity is adjusted progressively.

There is no internal applicator.

After treatment, most suitable patients can return directly to normal daily activities.

For appropriately selected women, published HIFEM and EMSELLA® studies have generally reported good short-term tolerability.

The 2026 study involving 99 postmenopausal women reported no treatment-related adverse events.

A systematic review of HIFEM for female urinary incontinence likewise found no significant safety issue highlighted in most included studies, although the authors noted that larger and higher-quality trials are still needed.

Age or menopause alone does not determine treatment suitability.

Medical history does.

Important contraindications can include:

If you have an implanted device or significant medical history, tell the team before treatment.

Related article: Who May Not Be Suitable for EMSCULPT NEO or EMSELLA?

A previous hysterectomy does not automatically tell us whether EMSELLA is appropriate.

Relevant factors include:

A remote, uncomplicated hysterectomy may be very different from recent or complex pelvic surgery.

Dr Emir can review your history before treatment.

Pelvic floor strengthening may be relevant in some women with prolapse symptoms, but significant prolapse deserves appropriate assessment.

Symptoms can include:

EMSELLA should not simply be used to avoid investigating these symptoms.

There is also evidence in menopausal women with urinary incontinence and cystocele showing symptom improvement following EMSELLA, although surgery achieved greater anatomical correction in women with established grade 2 cystocele.

This illustrates an important principle:

EMSELLA is a muscle-strengthening treatment, not a surgical anatomical repair.

Because several different mechanisms can produce remarkably similar symptoms.

For example, urinary urgency might relate to:

Similarly, sexual discomfort might relate to:

At ¹EM, the purpose is not simply to establish that you are menopausal and therefore sell EMSELLA.

The process is:

What changed, and when?

Stress leakage, urgency, mixed symptoms, pelvic floor weakness or another presentation.

Including menopause treatment, surgery, medications and implanted devices.

EMSELLA makes the most sense when pelvic floor strengthening has a role.

Some menopause-related symptoms may need treatment beyond pelvic floor stimulation.

If EMSELLA is appropriate, your treatment program can then be tailored to your presentation.

Yes, potentially. Treatment suitability is based on your symptoms and medical history rather than whether your periods have completely stopped.

Yes. EMSELLA has been studied specifically in postmenopausal women with urinary incontinence.

Hormonal changes associated with menopause are one recognised factor that can contribute to pelvic floor weakness. Ageing and other lifetime factors also play a role.

Yes, potentially. Pelvic floor strengthening is particularly relevant to stress and mixed urinary incontinence, and EMSELLA has direct clinical evidence in postmenopausal women.

It may help selected patients, but urgency can have several causes and should be assessed before treatment.

No. EMSELLA stimulates pelvic floor muscles. Vaginal dryness during menopause is commonly related to reduced oestrogen and may require a different treatment approach.

Potentially, yes. HRT does not automatically exclude EMSELLA treatment. Your medications and medical history should still be reviewed.

Not simply because you are considering EMSELLA. Do not alter prescribed menopause treatment without discussing it with the clinician managing your care.

Pelvic floor strengthening may support some aspects of sexual function, but menopausal sexual symptoms can have multiple causes.

No. Menopausal pelvic floor weakness and urinary symptoms can occur in women who have never given birth.

Most ¹EM programs begin with six sessions, usually twice weekly over approximately three weeks.

No referral is required to request a consultation at ¹EM.

Urinary leakage, urgency and pelvic floor weakness become more common around menopause, but common does not mean untreatable.

For many women, the useful question is:

Is pelvic floor weakness contributing to what I am experiencing, and would strengthening it improve my symptoms?

That is what your consultation is designed to establish.

At ¹EM, Dr Emir can assess your symptoms, medical history and menopause context and determine whether EMSELLA® pelvic floor strengthening is appropriate.

Where another menopause-related issue is contributing, that can also be recognised rather than treating every symptom as a pelvic floor problem.

CTA heading: Strengthen Your Pelvic Floor Through Menopause

CTA description: Book a complimentary ¹EM consultation to discuss bladder changes, pelvic floor strength and whether EMSELLA® is appropriate for you.

CTA button: Book Your Complimentary Consultation

Internal links:

EMSELLA® at ¹EM

Can EMSELLA® Help With Urinary Incontinence?

How Many EMSELLA Sessions Are Recommended?

Is EMSELLA Safe?

Who May Not Be Suitable for EMSCULPT NEO or EMSELLA?

1. Healthdirect Australia. Pelvic Floor Exercises.

Australian health guidance identifies hormonal changes associated with menopause as one factor that can weaken the pelvic floor and explains the role of pelvic floor strengthening in bladder control.

2. Healthdirect Australia. Post-menopause and Urinary Incontinence.

Healthdirect recognises increased urinary frequency and urinary incontinence among symptoms that may occur after menopause and identifies menopause as a risk factor for poor bladder control.

3. Efficacy of Combining Kegel Exercises with EMSELLA-Based Pelvic Floor Muscle Electrostimulation in Postmenopausal Women with Involuntary Urinary Leakage. 2026. PMID 42187519.

This prospective comparative study included 99 postmenopausal women with stress, urgency or mixed urinary incontinence. Both EMSELLA® alone and EMSELLA® combined with Kegel exercises produced clinically meaningful improvements, with greater improvement in the combined-treatment group. No treatment-related adverse events were reported.

4. Noninvasive High-Intensity Focused Electromagnetic Therapy in Women With Urinary Incontinence: A Systematic Review and Meta-Analysis. Neurourology and Urodynamics. 2025.

Seven studies were included. HIFEM was associated with improvements in urinary incontinence episodes, symptom scores and several quality-of-life measures, while the authors noted heterogeneity and the need for stronger future studies.

5. Effectiveness of High-Intensity Focused Electromagnetic Therapy in Women With Urinary Incontinence. International Urogynecology Journal.

Women with stress, mixed and urgency urinary incontinence underwent six HIFEM treatments, with significant improvements in urinary symptoms and quality-of-life measures reported after treatment and at three months.

6. The Menopause Society. Menopause Symptoms.

The Menopause Society describes urinary urgency, frequency and incontinence among genitourinary changes that can develop as oestrogen levels decline around menopause.

This article provides general health information and does not replace individual medical or menopause assessment. Menopausal urinary, vaginal and sexual symptoms can have several causes. EMSELLA® specifically targets pelvic floor muscle function and suitability should be assessed according to your symptoms, medical history and individual circumstances.

A 2026 prospective comparison involving 99 postmenopausal women reported greater improvement in urinary-symptom scores with EMSELLA plus a structured Kegel programme than with EMSELLA alone at three months. This supports discussing how device treatment and voluntary pelvic-floor training may work together within a personalised plan.

Read the study.