Sexual dysfunction is one of the most common health concerns that patients bring to my practice — and one of the least discussed. Research shows that sexual dysfunction affects roughly 41% of women and 31% of men, yet many patients suffer in silence for years before seeking help, often because they don’t know that effective, non-invasive treatments exist.
A key part of my work at VitalityMD has been exploring how pelvic floor health directly influences sexual function — and what happens when we strengthen those muscles using advanced technology rather than relying solely on medication or surgery. Earlier this year, I co-authored a narrative review alongside Dr. Carolyn DeLucia, Dr. Patricia Wallace, and Dr. Judson Brandeis, published in the International Journal of Advanced Studies in Sexology, examining the clinical evidence for one such technology: HIFEM.
The review analyzed six clinical studies involving 147 patients. The results provide compelling evidence that strengthening the pelvic floor can meaningfully improve sexual function in both women and men.
Understanding the Connection: Pelvic Floor and Sexual Function
The pelvic floor muscles are not just about bladder control. They play a direct, active role in sexual function — in both sexes. In women, they support vaginal tone, facilitate genital arousal, promote blood flow to the genital area, and are directly involved in orgasmic function. Research has shown that the ability to contract these muscles appropriately during intercourse is linked to orgasmic potential.
In men, pelvic floor muscles contribute to erectile rigidity, ejaculatory control, and orgasm intensity. Weakness or dysfunction of these muscles has been associated with diminished arousal, reduced genital sensitivity, and performance-related concerns including erectile dysfunction.
When the pelvic floor becomes weak — whether from aging, hormonal changes, childbirth, or deconditioning — sexual function can decline across multiple domains. Urinary incontinence during sex can add another layer of avoidance and anxiety. Strengthening these muscles addresses the root cause, not just the symptom.
How HIFEM Technology Works
HIFEM (High-Intensity Focused Electromagnetic) technology delivers focused electromagnetic fields that penetrate up to 10 cm into pelvic tissues, inducing supramaximal muscle contractions — far more intense than anything achievable through voluntary exercise. Unlike electrical stimulation, the magnetic field bypasses the skin without surface heating. These contractions facilitate neuromuscular re-education, strengthening and restoring function to the pelvic floor. Animal studies have demonstrated that HIFEM uniquely produces both muscle hypertrophy and hyperplasia simultaneously — something no other non-invasive method has been shown to achieve.
What the Clinical Evidence Shows
Our review synthesized findings from six studies — four focused on women, two on men, and one on a mixed-gender older adult population. Here are the key findings across all studies.
Women
| Sexual satisfaction & desire | 76% |
| Orgasm frequency | 60–62% |
| Arousal | 54% |
| Lubrication | 52% |
| Partner intimacy | 44% |
| Emotional comfort | 33% |
Men
| Penile tissue density | 69% |
| Erection maintenance | 37% |
| Intercourse satisfaction | 24% |
| Orgasm frequency | 19% |
| Ejaculatory frequency | 11% |
Long-Term Durability
One multicenter study tracked outcomes at both 6 and 12 months. At one year, patients maintained improvements in orgasm frequency (62%), lubrication (46%), and sexual satisfaction (48%). The emotional and relational benefits also held, with the partner-related domain improving by 25% — reflecting better communication and greater mutual enjoyment between partners.
Beyond Sexual Function: Continence and Quality of Life
Sexual dysfunction and urinary incontinence often coexist — and one frequently worsens the other. Fear of leakage during sex causes anxiety and avoidance, which compounds the sexual dysfunction itself. The reviewed studies showed that HIFEM treatment addresses both concerns simultaneously.
In a study of 75 patients treated for urinary incontinence, 81% experienced symptom reduction at three months, 70% reduced pad use, and leakage during physical activity dropped by 58%. In the older adult study, over 50% of participants reported improvements in sexual performance alongside enhanced functional independence, core strength, and overall quality of life. More than 92% said they would recommend the treatment to family and friends.
Why This Approach Is Different
Pharmacological treatments for sexual dysfunction — such as PDE5 inhibitors for men or hormonal therapies for women — address symptoms without targeting the underlying neuromuscular dysfunction. Surgical options carry higher risk and recovery demands. HIFEM offers a fundamentally different pathway: it directly strengthens the muscles that drive sexual function, without medication, without surgery, and without requiring active patient participation during the treatment.
Across all studies reviewed, no serious adverse events were reported. Treatment involves sitting in a chair for approximately 28 minutes per session, typically six sessions over three weeks. There is no disrobing, no downtime, and no recovery period.
Who May Benefit Most
- Women experiencing decreased arousal, difficulty reaching orgasm, or reduced lubrication — particularly after menopause or childbirth
- Men with mild-to-moderate erectile dysfunction or ejaculatory concerns related to pelvic floor weakness
- Patients of any gender experiencing urinary incontinence that interferes with sexual confidence
- Older adults seeking non-invasive improvements in both pelvic floor and core muscle function
- Individuals who prefer a non-pharmacological, non-surgical approach to sexual health
“Strengthening the pelvic floor addresses the root cause of sexual dysfunction, not just the symptoms — and the clinical evidence is building.”
Frequently Asked Questions
What is HIFEM treatment for sexual dysfunction?
HIFEM (High-Intensity Focused Electromagnetic) technology is a non-invasive treatment that strengthens the pelvic floor muscles through deep neuromuscular stimulation. By inducing supramaximal contractions — stronger than what voluntary exercise can achieve — HIFEM rebuilds pelvic floor strength, which plays a direct role in sexual arousal, orgasm, lubrication, and erectile function. A peer-reviewed narrative review of six clinical studies involving 147 patients found consistent improvements in sexual function for both women and men.
Does Emsella help with sexual dysfunction?
Emsella is a HIFEM-based device manufactured by BTL Industries. Published clinical studies have shown that Emsella treatment can improve sexual satisfaction and desire by up to 76%, orgasm frequency by up to 62%, and lubrication by up to 52% in women. In men, erection maintenance improved by 37% and penile tissue density increased by 69%. These benefits have been shown to persist at 12-month follow-up in at least one study.
Can HIFEM help with erectile dysfunction?
Yes. Clinical studies reviewed in this narrative review found that men treated with HIFEM experienced a 37% improvement in erection maintenance, a 24% improvement in intercourse satisfaction, and a 69% increase in penile tissue density measured by ultrasound — suggesting improved blood flow and vascularization. HIFEM therapy may be particularly beneficial for men with mild-to-moderate erectile dysfunction linked to pelvic floor weakness.
How does pelvic floor strength affect orgasm?
The pelvic floor muscles are directly involved in orgasmic function in both women and men. They contract rhythmically during orgasm, and research has shown that women with stronger pelvic floor muscles score significantly higher on measures of sexual desire, excitement, and orgasmic function. HIFEM induces supramaximal contractions that strengthen these muscles, which may explain why clinical studies consistently report improvements in orgasm frequency of 60% or more following treatment.
How many HIFEM sessions are needed for sexual health improvement?
In the studies reviewed, patients typically received six HIFEM sessions over approximately three weeks, with each session lasting about 28 minutes. Improvements were reported as early as the first follow-up assessment, and in one study, benefits persisted at 12-month follow-up. No serious adverse events were reported in any study.
Does HIFEM also help with urinary incontinence?
Yes. Because HIFEM strengthens the pelvic floor muscles that control both sexual function and bladder continence, it addresses both issues simultaneously. In a study of 75 patients, 81% experienced reduced incontinence symptoms at three months, 70% reduced pad use, and leakage during physical activity dropped by 58%. For patients whose sexual confidence is affected by urinary leakage during intimacy, this dual benefit is particularly meaningful.
Is HIFEM treatment safe?
Across all clinical studies included in this narrative review, no serious adverse events were reported. HIFEM treatment is non-invasive, requires no disrobing, involves no downtime, and does not require active patient participation. The electromagnetic field bypasses the skin without causing surface heating, distinguishing it from electrode-based stimulation methods.
Published Research
Shari Caplan, Carolyn A. DeLucia, Patricia Wallace, Judson Brandeis. “HIFEM Technology in the Treatment of Sexual Dysfunction: A Narrative Review of Clinical Evidence.” International Journal of Advanced Studies in Sexology. 2026; 8(1): 24–34. DOI: doi.org/10.46388/ijass.2026.8.3
Ready to Strengthen Your Foundation?
HIFEM pelvic floor therapy is available at VitalityMD Toronto. If sexual dysfunction or urinary incontinence is affecting your quality of life, book a consultation to find out whether this non-invasive approach may be right for you.
