The four letters behind every pelvic floor chair advert
HIFEM is the technology clinics are selling when they offer a chair you sit on fully clothed. Here is what it means, what a session involves, and who it is not suitable for.
Quick answer
HIFEM stands for high intensity focused electromagnetic energy. It is a clinic technology that uses a rapidly changing magnetic field to trigger involuntary muscle contractions without touching or entering the body, and it is the mechanism inside pelvic floor chairs such as BTL's Emsella. You sit fully clothed, the device fires pulses into the pelvic region, and your pelvic floor contracts far more times than you could manage on your own. It is not the same as a kegel, because you are not the one switching the muscle on, and it is not suitable for everyone. Anyone who is pregnant or has an implanted electronic or metal device is normally screened out.
The session length most clinics advertise for a pelvic floor chair treatment, sat fully clothed.
Sessions in a typical advertised course, usually spread across a few weeks, with top ups often suggested afterwards.
The minimum trial of pelvic floor muscle training that NICE guideline NG123 recommends as first line care before escalating.
What HIFEM actually means
Break the acronym apart and it explains itself. High intensity refers to the strength of the field. Focused means it is aimed at a specific area rather than scattered. Electromagnetic is the mechanism: a coil inside the device generates a rapidly changing magnetic field. When that field passes through tissue it induces an electrical current in the nerves that supply nearby muscle, and the muscle contracts in response.
The important part for you is that last step. The contraction is involuntary. Your brain did not send the signal, the machine did. That is the whole selling point, and it is also the whole limitation.
How it differs from a kegel
When you do a pelvic floor contraction yourself, several things happen at once. You locate the muscle, you send the signal, you coordinate it with your breath, you hold it, and then you fully release it. Every one of those is a skill, and every one of them can go wrong. That is exactly why so many mums are doing them imperfectly without knowing it, something we unpick in our guide to telling whether you are doing a kegel correctly.
HIFEM skips the first two steps entirely and does not really address the rest. The muscle fires because it was made to. Nothing about the timing, the release or the coordination with the rest of your deep core is being trained, and coordination is where most everyday symptoms actually sit. Our article on pelvic floor work beyond kegels covers what that fuller picture involves.
What a session actually involves
| Stage | What happens |
|---|---|
| Screening | A health questionnaire covering pregnancy, implants, metal, and how long ago you gave birth |
| Assessment | Ideally a pelvic health clinician checks what is actually going on before any treatment is sold |
| The session | You sit fully clothed on the chair, typically for around 28 minutes, while intensity is gradually increased |
| Sensation | A strong tingling or tapping with visible muscle activity. It should not be painful |
| Afterwards | No downtime. You can drive home and carry on with your day |
| The course | Commonly around six sessions over a few weeks, with top ups often recommended later |
Who it is not for
Electromagnetic devices carry standard contraindications, and a responsible clinic screens for them before taking your money. Treatment is normally ruled out or requires specialist sign off if you are pregnant, or if you have a cardiac pacemaker, a defibrillator, a neurostimulator, a metal implant or plate in the treatment area, or a copper coil, depending on the provider's policy. Clinics also set their own minimum time since birth.
None of that is a reason for alarm. It is a reason to answer the screening questionnaire honestly and to ask questions if something about your history is unusual. If you are not sure whether your own situation qualifies, ask your GP before you ask the clinic, and read how to get a GP referral for postpartum physio while you are at it.
Where it sits in the treatment ladder
Guidelines do not open with technology. NICE guideline NG123 puts supervised pelvic floor muscle training first for stress urinary incontinence, recommending a trial of at least three months before moving on to other options, and the NHS gives the same practical advice to keep going for around three months before judging whether it is working. Clinic devices sit further up that ladder, generally for people for whom the conservative route has genuinely been tried or is not workable.
That ordering is not gatekeeping. It reflects the fact that the cheapest intervention is also the one that teaches you something you keep. If you want the honest cost and value comparison for the chair specifically, we worked through it in our review of whether an Emsella chair is worth it after birth.
The short version
HIFEM is a legitimate way to make a muscle contract when you cannot make it contract yourself. It is not a way to learn a skill, and leakage after birth is usually a skill and pressure problem as much as a strength one. Understand which problem you have before you buy a solution to the other one. Results vary from mum to mum.
Learn the contraction first
Whatever you decide about clinic treatments, the foundation is the same: find the muscle, contract it correctly, release it fully, and then connect it to your breathing and your deep core so it works when you cough, lift and run. That takes clear instruction and a plan short enough to actually do while the baby naps.
The affordable place to start
Mumma Glow is the affordable, one time, no subscription option, the budget alternative to programs like MUTU. Core Reconnect teaches the breath, deep core and pelvic floor connection step by step at home, with no monthly fee. Use code GLOW20 for 20% off. It is general education, not individual treatment, and results vary from mum to mum.
Frequently asked questions
What does HIFEM stand for?
High intensity focused electromagnetic energy. It describes a device that uses a rapidly changing magnetic field to make muscles contract without anything touching or entering the body.
Is HIFEM the same as electrical stimulation?
Not quite. Electrical stimulation usually delivers current through electrodes or an internal probe in direct contact with tissue. HIFEM induces the current using a magnetic field from outside the body, which is why you stay fully clothed.
Can you use a pelvic floor chair while breastfeeding?
Policies differ between providers, so ask the clinic directly and mention it during screening. Clinics also set their own minimum time since birth, which is a separate question worth asking.
Does HIFEM replace pelvic floor exercises?
No. It produces contractions but does not teach you to time, control or release the muscle yourself, and it does nothing about how you manage pressure when lifting. Most clinicians treat it as an addition to pelvic floor muscle training rather than a substitute.
Who should avoid it?
Standard screening rules out pregnancy and implanted electronic or metal devices such as pacemakers, defibrillators, neurostimulators and implants in the treatment area, with a copper coil handled according to the clinic's own policy. Always disclose your full history and check with your GP if anything is uncertain.
Sources: National Institute for Health and Care Excellence (NICE) guideline NG123, urinary incontinence and pelvic organ prolapse in women; NHS guidance on pelvic floor exercises; American College of Obstetricians and Gynecologists (ACOG) patient guidance on pelvic floor disorders; BTL Emsella manufacturer product and safety information, including published contraindications.
This article is general education and not medical advice. Mumma Glow is not affiliated with BTL, Emsella or any clinic offering these treatments. Results vary from mum to mum. Please speak to your GP, midwife or a women's health physiotherapist about your own symptoms, and always disclose your full medical history before any clinic treatment.