The Chair That Might Save Your Sex Life—and Your Pelvic Floor

When Ilana, a 58-year-old schoolteacher in Miami, first heard about a buzzy new pelvic floor treatment called Emsella, she wasn’t looking to improve her sex life. She just wanted to stop peeing on herself when she laughed. Or sneezed. Or got caught too far from a bathroom. “It got to a point where I had to cross my legs every time I laughed," she says. “I kept thinking, I don’t want to be broken. I was peeing sideways!”

A friend mentioned she was getting a bladder lift—a surgery where the bladder is physically suspended with mesh or sutures. That seemed extreme. And kegels weren’t much more appealing. “Too much work,” she says. So when her doctor suggested Emsella—a noninvasive chair that stimulates deep pelvic floor contractions while you sit fully clothed—she enthusiastically signed up.

“After a few sessions, something changed. The accidents stopped. Her pelvic muscles felt stronger. And unexpectedly, sex with her husband got better—much better. “I could feel friction again. I could orgasm again—and faster. My husband definitely noticed. And so did I.”

Pelvic floor symptoms like urgency, leakage, and decreased sensation aren’t new—they’ve long been linked to the hormonal shifts of menopause, the physical stress of childbirth, and the natural effects of aging. But recently, doctors have begun noticing an uptick in cases, particularly among patients taking GLP‐1 medications like Ozempic and Wegovy. These drugs can cause rapid weight loss, which often includes a loss of lean muscle mass. “The drugs don’t target your pelvis,” says Amanda Neri, PT, DPT, a pelvic floor physical therapist and founder of the Pelvic Institute. “But when you lose muscle quickly, and you’re not strength training or eating enough protein, the stabilizing muscles that support your pelvic organs weaken. And you feel it.” Call it Ozempic pelvis.

Chloe, a 44-year-old mom who is on a GLP-1 and based in London, had the procedure five times in the last year. It tightened her up so much that, at first, her husband was stymied. He was like, 'Why is your body rejecting me?' I couldn't stop laughing. I kept saying, "It's not me!" In the end, Chloe, who initially sought treatment to help with incontinence, was thrilled with the results: "I never imagined that after pushing out two kids, I could basically shrink my vagina back, so I really got two for one. I no longer pee when I laugh—and I have amazing sex. Now I go back for tune-ups every three to six months."

While Ilana wasn’t taking GLP1-s, she is part of another broader cultural shift that’s fueling new interest in treating these long-overlooked issues. As more women in their 40s and 50s are speaking openly about menopausal symptoms like incontinence, sexual dysfunction, and pelvic floor laxity, they’re actively seeking options that don’t involve surgery, hormones, or shame. That’s part of the reason Emsella—a chair-based treatment originally cleared by the FDA in 2018 for stress incontinence—is suddenly generating buzz for its off-label benefits, including enhanced vaginal tone, improved sensation, and stronger orgasms. It also explains why the global pelvic floor electric stimulator market is projected to grow nearly 12 percent annually through 2030, according to Grand View Research.

The treatment itself is disarmingly simple: You sit fully clothed in a small, Smurf-blue chair while the device delivers high-intensity focused electromagnetic (HIFEM) pulses that stimulate motor neurons in the perineum. “A 28-minute session can result in tens of thousands of pelvic-floor contractions,” explains Suzanne Gilberg, MD, a board-certified ob-gyn based in West Hollywood. “It’s far more efficient than guided PT or attempting kegels on your own.”

“I didn’t even realize how much sensation I’d lost until I got it back. I could feel friction again. I could orgasm again—and faster. My husband definitely noticed. And so did I.” —Ilana, 58

Indeed, the company that makes Emsella claims that one session is equivalent top doing 20,000 kegels, and there is some credible scientific literature behind it. Gilberg conducted a small pilot study showing subjective improvement in patients with mild to moderate stress incontinence after a 4-to-8-week protocol. And a 2019 study involving 75 women found significant improvements in both urinary symptoms and sexual satisfaction post-treatment.

Angela Wilson, MD, an ob-gyn with Montefiore Einstein Advanced Care in New York, says that two key advantages Emsella has over kegels are the volume of contractions and the elimination of user error. “You can’t ‘do them wrong,’ and you don’t fatigue,” she says. But she cautions that results vary—and maintenance is typically required. Treatment plans generally include six 28-minute sessions over three weeks, with follow-up sessions every six to twelve months. Prices can range from $1,800 to $3,000, and the treatment is not covered by insurance.

Paul Jarrod Frank, MD, a cosmetic dermatologist in New York, has offered Emsella in his practice for several years. “Most of the feedback has been really good,” he says. “It improves the musculature around the sexual organs, increases blood flow, and anecdotally, we’ve seen improvements in sexual function in both men and women.” He often recommends it in combination with core and glute stimulation (using Emsculpt) to create what he calls a “core-to-floor” protocol.

Of course, Emsella isn’t a one-size-fits-all solution. Some patients experience only partial improvement. Others, especially those dealing with tension rather than weakness in the pelvic floor, may need a different kind of intervention altogether.

Pelvic floor physical therapist Jenn Perna, DPT, OCS, founder of Vivid Women’s Health, emphasizes the importance of a full-body assessment. “Your pelvic floor rarely functions in isolation,” she says. “We look at breath, hips, core stability—even ankle mobility. Sometimes the issue is that the pelvic floor is too tight, which can make it difficult to empty the bladder or orgasm.” In those cases, treatments like Emsella may actually exacerbate symptoms. “Tight muscles aren’t strong muscles,” she adds. “They need to be down-trained before you build strength.”

If your pelvic floor feels like a mystery, don’t panic. As Perna says, “If Emsella doesn’t work for you, it doesn’t mean you’re unfixable. It just means there’s more to explore.”

“I was skeptical,” says Ilana, who now considers it part of her regular maintenance routine like Botox or fillers. “I no longer feel that gaping sensation. And I can have an orgasm faster—it’s like I’m 25 or 30 again. Sex is better for my husband now—and better for me. So I’m a happy camper.”