How to Use Vaginal Weights for Incontinence

Stress incontinence can make laughing or sneezing anxiety-provoking for up to half of women over the age of 50, often leading to a urine leak. The most common non-surgical treatment for stress incontinence is aimed at strengthening the pelvic floor muscles, which help support your lower abdomen. Along with targeted exercises like Kegels, electrostimulation, biofeedback methods, and using small vaginal weights can also help you build muscle control to better manage your bladder capacity.

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How You Do It

Vaginal weights come in sets of progressively heavier cones equipped with a string or wire. When inserted into the vagina (like a tampon), these smooth weights are held in place thanks to the contraction of the pelvic floor muscles. Over time, the muscles are strengthened simply by keeping the weight from falling out.

The Regimen

  1. Get ready: Empty your bladder and ensure the weights are clean and free of cracks or other damage. 
  2. Pick the proper weight: Begin with the lightest weight available. Some systems use weights inserted into a capsule, while others include a variety of weights, each with its own string or wire. Insert the weight and try standing, walking, and even coughing without lying down; if the weight stays in place, try the next heaviest weight. Choose the heaviest one you can hold in place for a few minutes.
  3. Work your pelvic floor: Gradually increase the amount of time the vaginal weight is in place, up to a maximum of 15 minutes, twice a day. You can walk and move around, but you should remain standing rather than sitting or lying down for the best effect.
  4. When to move up to the next weight: Once you can keep the weight comfortably inserted for 15 minutes at a time, try the next heavier weight. It may take 2-3 months for your bladder control to improve.

Who Shouldn't Use Vaginal Weights

According to an extensive review published in 2013 in the Cochrane Database of Systematic Reviews regarding the effectiveness of vaginal cones or weights for incontinence, women who have a narrowed or scarred vagina will not be able to use these devices.

The weights should not be used at the same time as a tampon or a diaphragm, or if you have a vaginal infection or sexually transmitted disease.

The 2013 review concluded that vaginal weights are more effective than no treatment when used consistently and that they may be easier to teach and use than standard pelvic exercises (like Kegels). But some women found the weight training to be uncomfortable and stopped using the weights altogether.

Other Ways to Improve Bladder Control

Better pelvic floor strength is just one aspect of incontinence management.

Other strategies can include:

  • Bladder retraining, which involves holding your urine for progressively longer periods of time to boost the capacity of your bladder
  • Dietary changes such as eliminating spicy or acidic foods, caffeine, and eating more fiber

Finally, women with mild stress incontinence may find some relief simply in learning how to control the pelvic floor strength they already have, according to a study published in the International Urogynecology Journal in 2008. Nicknamed the "Knack", the move involves actively holding back or clenching the pelvic floor muscles just prior to and during a cough or sneeze. Unlike pelvic floor strengthening exercises which can take months to reap results, this pelvic clench was found to boost bladder control within as little as a week.

A note of caution regarding all pelvic floor exercises: don't practice them while you are urinating, since you are already using your pelvic muscles to urinate. Doing these exercises at the same time will not achieve the goals and can further impair your control.

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By Sharon Basaraba
Sharon Basaraba is an award-winning reporter and senior scientific communications advisor for Alberta Health Services in Alberta, Canada.