EMfemme 360 is an applicator made by BTL for its Exion platform. A slim, single-use tip delivers radiofrequency at 3.2 MHz to the vaginal tissue, warming it to 40 to 45°C, the range in the US clearance summary. The device measures the tissue's resistance a thousand times a second and adjusts the power, and an integrated thermometer shows the tissue temperature. BTL's account is that the controlled heat stimulates collagen production and improves vaginal laxity; the one published study measured the result as pain on intercourse, the vaginal health score and vaginal pH. The treatment takes eight minutes inside the canal and can be extended to the labia and the perineum (the skin between the vagina and the back passage) outside. Every session is at EMfemme 360 London, 8 Devonshire Place, after a doctor's examination, with the course in writing.
What the warmth does
- Inside the canal: the tip is moved slowly along the walls, warming the lining and the tissue beneath it. In the published study, 35 postmenopausal women had three sessions a month apart. Their vaginal health score, which scores elasticity, secretions, pH, the lining and moisture, rose from 7.7 to 18.7 on a 5 to 25 scale, and the pH fell from 6.6 to 4.6, towards the acidic range of healthy tissue.
- Outside: the same energy over the labia, the vaginal opening and the perineum, three to five minutes a zone in the manufacturer's clinical guide, where the manufacturer describes the aim as improving labial laxity; no EMfemme 360 study has measured that result, and we say so on the labia page.
- What it is not: a laser, a muscle treatment or a hormone. For the pelvic floor muscles the Emsella chair is the device, and the EMfemme 360 or Emsella page explains.
What the clearances and guidelines say
In the US the applicator is FDA-cleared to heat tissue for the temporary relief of pain and muscle spasm and an increase in local circulation; no US clearance names a vaginal or intimate use. The US regulator said in 2018 that it had cleared no energy-based device for menopause symptoms, incontinence or sexual function. BTL's stated purpose for the UK is the treatment of sexual dysfunction after vaginal delivery by improving vaginal laxity; its international description names vaginal laxity, labial laxity and sexual dysfunction, without the childbirth limit. NICE puts vaginal oestrogen first for vaginal and urinary symptoms of the menopause and supervised pelvic floor training first for stress and mixed leaks. We treat within that frame: after a doctor's examination, beside the care NICE puts first, and with the evidence stated as it is.
The session
A doctor examines you at the first visit, goes through the list of conditions that rule the treatment out, and takes your starting scores. For the treatment you undress from the waist down and lie as for a smear test; the single-use tip is opened, fitted and lubricated, and moved slowly inside the canal for eight minutes while the console reads the temperature. Most women describe warmth, the practitioner turns the energy down if you want, and a female practitioner can deliver the treatment if you ask. You dress and leave; in our practice we advise no intercourse, tampons or baths for 24 to 48 hours. In the published study, the first session caused discomfort, some bleeding and irritation in women with severe tissue thinning, and a watery discharge, bleeding, itching or burning for a day or two were common, mostly after the first session. No complication or serious side effect was reported.
Who it suits, and who it does not
Women with laxity after childbirth who have done their pelvic floor training, and women with dryness, discomfort or pain with intercourse after the menopause, beside or after vaginal oestrogen. It is not for leaks. The manufacturer's registered trial excluded, among other things, pregnancy, breastfeeding and IVF, a metal coil or any metal implant in the area, and a pacemaker or other electrical implant. It also excluded a current or past cancer, an infection or inflammation in the area, surgery in the area within three months, a bleeding disorder or blood thinners, a prolapse beyond the entrance, and uncontrolled diabetes. In our practice we also wait for unexplained bleeding, thrush or a urinary infection to be seen, for a period to pass, and for anyone trying to conceive. The FAQ lists the main ones, and the doctor goes through the full list with you.
Not sure you are suitable? Ask the clinician, it is free
Book a free consultation
Call EMfemme 360 London on 0207 043 8130 or use the form below. The doctor examines you, says whether EMfemme 360 fits your symptoms, and sets out the course in writing. The full guide covers the rest.
