By Karen Buckalew, MN, APRN-C, MSCP | Boutiq Medical Clinic, Orlando, FL
Pelvic floor therapy sounds clinical. For a lot of patients, it also sounds intimidating. The combination of a sensitive area of the body, a treatment they have never experienced before, and uncertainty about what the appointment actually involves is enough to make people hesitant to book, even when they know they need it.
At Boutiq Medical Clinic in Orlando, Florida, we use Emsella, a non-invasive BTL device that delivers pelvic floor therapy without any internal examination, undressing, or physical contact. Knowing exactly what to expect is usually what moves patients from hesitation to action. Here is the complete picture.
Contents
What Is Emsella and How Is It Different from Traditional Pelvic Floor Therapy?
Traditional pelvic floor physical therapy typically involves an internal examination by a specialized physical therapist and a combination of manual techniques, biofeedback, and guided exercises. It is effective but requires multiple in-person sessions and involves a level of physical intimacy that many patients find difficult to initiate.
Emsella takes a different approach. It uses High-Intensity Focused Electromagnetic (HIFEM) technology delivered through a specially designed chair. You sit fully clothed on the chair, and the device delivers focused electromagnetic energy through the seat, inducing thousands of supramaximal pelvic floor muscle contractions per session. A single 28-minute Emsella session produces approximately 11,200 pelvic floor contractions, the equivalent of thousands of Kegel exercises, without any voluntary effort, internal examination, or physical contact.
This makes Emsella accessible to patients who would not pursue traditional internal pelvic floor PT, and highly effective for those managing urinary incontinence, pelvic floor laxity, or post-partum recovery concerns.
Learn more about Emsella at Boutiq Clinic including candidacy and what conditions it addresses.
What to Wear to Pelvic Floor Therapy
This is one of the most searched questions about pelvic floor therapy, and the answer for Emsella is simple: wear whatever you are comfortable in. You remain fully clothed throughout the entire session. No undressing, no gowns, no draping.
The only consideration is metal. The electromagnetic field from Emsella can interact with metal objects on or near your body. Before your session, you will be asked to remove:
- Any metal jewelry, belts, or accessories near the treatment area
- Keys, coins, or other metal objects from pockets
- Any metal-containing undergarments, including underwire bras if you are also being treated in adjacent areas
Comfortable, non-restrictive clothing is recommended simply because you will be sitting in the chair for 28 minutes, but there is no clinical reason to wear anything specific. Most patients come directly from work, errands, or other appointments without changing.
One practical note: remove your smartphone and any wearable devices like smartwatches before sitting in the chair. Electromagnetic energy from the device can affect electronics.
Before Your Appointment: What to Do
Emsella requires minimal preparation. There are no dietary restrictions, no medications to stop, and no pre-treatment protocols. A few practical points:
- Arrive to your appointment having used the bathroom. A full bladder is not required, and some patients find the pelvic contractions more comfortable with a recently emptied bladder
- Remove metal items before sitting in the chair, as noted above
- Let your Boutiq provider know about any implanted metal devices, including pacemakers, intrauterine devices, metal joint replacements, or surgical hardware in the pelvic region. These are contraindications or require discussion before proceeding
- Inform your provider if you are pregnant. Emsella is not used during pregnancy
At your first visit, your Boutiq provider will conduct a brief intake to review your health history and discuss your specific pelvic floor concerns. This helps ensure Emsella is appropriate for your situation and that the treatment is calibrated to your starting point.
During Your Session: What Actually Happens
The session lasts 28 minutes. Here is the sequence:
- You sit fully clothed in the Emsella chair, positioned so that the electromagnetic applicator is directly beneath the pelvic floor
- Your Boutiq provider adjusts the device settings and begins the treatment at a comfortable intensity
- The device delivers a sequence of electromagnetic pulses that cause rapid, involuntary pelvic floor muscle contractions
- The intensity is gradually increased during the first few minutes as your muscles adapt to the stimulus
- You remain seated for the full 28 minutes and can read, use your phone, or simply relax during the session
- At the end, the session concludes and you can immediately stand and leave
There is no recovery period, no wound care, and no restrictions on activities after your session. Most patients return directly to their normal schedule, including exercise.
How It Feels
This is the question most patients are most curious about and most reluctant to ask. The honest description: unusual but not painful.
The electromagnetic pulses cause your pelvic floor muscles to contract involuntarily in a rapid sequence. Patients commonly describe it as a strong tingling or vibrating sensation in the pelvic region, with distinct muscle contractions they can feel but not control. The sensation can be surprising at first, particularly if you have never experienced this type of neuromuscular stimulation before.
The intensity is fully adjustable. Your provider increases it gradually based on your comfort level. Most patients reach the therapeutic intensity level within a few minutes of the session beginning. The sensation changes throughout the session as the device cycles between active contraction phases and brief rest periods.
The Emsella sensation is unlike anything most patients have experienced, and that unfamiliarity is often what makes people uncertain before their first session. Almost universally, patients who come in nervous leave describing it as much more manageable than they expected.
After Your Session: What to Expect
Immediately After
You may notice a sensation similar to having done an intense workout targeting the pelvic floor, a mild awareness of the muscles that were just activated. This is normal and typically resolves within a few hours. Some patients notice a slight tingling sensation that persists briefly after the session ends.
There is no downtime. You can drive yourself to and from the appointment, return to work, exercise, and carry out all normal activities immediately.
In the Days After
Some patients notice very mild pelvic soreness for 24 to 48 hours after the first session, similar to mild post-exercise muscle soreness. This typically resolves on its own and is less pronounced with subsequent sessions as the pelvic floor muscles adapt to the treatment.
You may begin to notice early improvements in bladder control or pelvic floor sensation within the first week to two weeks, though the most significant results develop over the course of the full treatment series.
How Many Sessions and When You See Results
| Session | What Typically Happens |
| Session 1 | Body adapts to electromagnetic stimulus; some patients notice mild early improvement |
| Sessions 2-3 | Muscle conditioning intensifies; early results in bladder control becoming noticeable for many |
| Sessions 4-6 | Most patients report significant improvement in urinary leakage, urgency, and pelvic floor tone |
| 3-6 months post-series | Continued improvement as collagen remodeling in pelvic floor tissue matures |
| Maintenance (1-2x year) | Sustains results long-term |
The standard Emsella protocol is 6 sessions over 3 weeks, typically scheduled twice per week with at least one rest day between sessions. Clinical studies show that the majority of patients experience meaningful improvement in urinary incontinence symptoms after completing the full protocol, with results continuing to develop for up to 6 months as muscle and connective tissue changes mature.
Who Benefits Most from Emsella?
Emsella is appropriate for a wide range of patients:
- Women experiencing stress urinary incontinence (leaking with coughing, sneezing, laughing, or exercise)
- Women with urge incontinence (sudden, difficult-to-control urge to urinate)
- Post-partum patients looking to restore pelvic floor strength after vaginal delivery
- Perimenopausal and postmenopausal women managing the pelvic floor changes associated with declining estrogen
- Men experiencing urinary incontinence, particularly after prostate procedures
- Anyone who cannot or does not consistently perform Kegel exercises effectively on their own
Karen Buckalew, MN, APRN-C, MSCP, brings her expertise as a certified menopause practitioner to pelvic floor health at Boutiq. She assesses each patient's specific pelvic floor concerns and determines whether Emsella alone or in combination with other treatments, including BHRT, is most appropriate for their situation.
We serve patients throughout Orlando, Winter Park, Maitland, Altamonte Springs, and surrounding Central Florida. Consultations are available in-person and virtually for patients across Florida.
Ready to Take the First Step Toward a Stronger Pelvic Floor?
Book a pelvic floor consultation at Boutiq Medical Clinic in Orlando, FL. Karen will review your symptoms and determine whether Emsella is right for you.
Boutiq Medical Clinic | Orlando, FL
Book Your Emsella Consultation.
Frequently Asked Questions
Is pelvic floor therapy embarrassing?
Emsella at Boutiq involves no internal examination, no undressing, and no physical contact. You sit fully clothed in a chair for 28 minutes. Many patients who avoided traditional pelvic floor physical therapy because of discomfort with the internal examination find Emsella significantly more accessible. The conversation with Karen about your pelvic health is private, clinical, and approached with the same matter-of-fact professionalism as any other health concern.
How long does a pelvic floor therapy session take?
Each Emsella session takes 28 minutes. Including check-in, positioning, and a brief post-session check-in with your provider, plan for approximately 40 to 45 minutes for the full appointment.
How long does pelvic floor therapy take to work?
Many patients notice early improvements in bladder control within the first one to two weeks of beginning treatment. The most significant improvement typically occurs after the full series of 6 sessions is complete, with continued development over the following 3 to 6 months as the pelvic floor muscle conditioning and connective tissue changes mature. Most patients report meaningful reduction in urinary leakage symptoms by the end of their treatment series.
Can men get pelvic floor therapy with Emsella?
Yes. Emsella is effective for men experiencing urinary incontinence, particularly following prostate surgery or as a result of prostate enlargement. The treatment approach and positioning are the same as for women. Karen evaluates male patients individually to determine the appropriate treatment parameters.
Can I do pelvic floor therapy if I have an IUD?
An IUD is a contraindication for Emsella because it is an intrauterine metal device that may be affected by the electromagnetic field. Please inform your Boutiq provider before your session if you have an IUD or any other implanted metal device in or near the pelvic region. Karen will discuss your options and whether an alternative approach is available.
Does Boutiq offer Emsella in Orlando, FL?
Yes. Emsella pelvic floor therapy is available at Boutiq Medical Clinic in Orlando, FL, administered by Karen Buckalew, MN, APRN-C, MSCP. We serve patients throughout Central Florida.
Medical Disclaimer: This article is for informational purposes only and does not constitute medical advice. Emsella is a medical device with specific contraindications. Please consult with a qualified healthcare provider before beginning any pelvic floor treatment. Individual results vary.