Vaginal Cones for Pelvic Floor Reeducation

A proven exercise method for the treatment of
urinary stress incontinence

Weighted vaginal cones, which are used as an exercise method for retraining the pelvic floor muscles (also known as the perineum), have been around for about 25 years. They were developed to help women exercise their pelvic floor muscles and treat urinary stress incontinence.

Concept of Vaginal Cones

The concept of vaginal cones – also known as vaginal weights – is very simple. It consists of a set of small cones, identical in shape and size but of increasing weights. The exercise, which should be performed 15 minutes twice a day, consists of inserting a cone in the vagina, starting with the lightest one you can comfortably retain and replacing it with increasingly heavy cones as your pelvic floor muscles become stronger. As soon as you stand up or walk, the cone tends to slip out of the vagina. The sensation of the cone slipping immediately triggers an involuntary contraction reflex of the pelvic floor muscles around the cone. This is what helps you to strengthen your pelvic muscle contractions. If you are able to keep the cone in the vagina for approximately 15 minutes with only a slight voluntary contraction effort, you have achieved one goal and can graduate to the next cone in the following session.

Benefits of Vaginal Cones

Pelvic floor exercises using vaginal cones have proven very effective, especially in the treatment of urinary stress incontinence or moderate prolapse.

Pelvic floor exercises using vaginal cones have a number of advantages:

• Exercises with vaginal cones are performed at home, in private, without medical assistance. While doing your 15-minute session with a cone inserted in your vagina, you keep walking around and going about your household activities, since that is part of your exercise. Therefore the exercises require a short time commitment.
• Vaginal cones help targeting and contracting the right muscles. Once a selected cone is inserted in the vagina, the pelvic muscles contract automatically (by reflex) around the cone to hold it in. This reflex mechanism forces you to contract only the right muscles, i.e. the pelvic floor muscles. The other groups of abdominal or buttock muscles tend to contract as well when you are doing exercises involving voluntary contraction of the pelvic floor muscles, such as Kegel exercises, which affects the efficacy of the exercise.
• Observing your progress from one cone to the next heavier one and the fact that your pelvic floor muscles are getting stronger every day will make you feel motivated to keep it up and do your exercise sessions regularly. As your pelvic muscles regain their tone, you will notice diminished urinary leak frequency, and you will gradually be able to leave them behind.

More information on the use of vaginal cones from:

Pelvic Floor Reeducation with LadySystem® Vaginal Cones

Video Presentation from the Society of Obstetricians and Gynaecologists of Canada (Part 2 – Non Invasive Continence Therapy)

The Canadian Continence Foundation's Fact Sheet about Vaginal Cones

SOGC Clinical Guideline: Conservative Management of Urinary Incontinence