How to Use Vaginal Weights for Incontinence

They're tiny, but powerful

Woman reviewing medical records with her doctor
Hero Images/Getty Images

Stress incontinence can make laughing or sneezing a dangerous undertaking 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 support your lower abdomen.  Along with targeted exercises like Kegels, electrostimulation, and biofeedback methods, small so-called "vaginal weights" can also help you build muscle control to better manage your bladder capacity.

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 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: Go the bathroom 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 their 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 that 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 remain standing rather than sitting or lying down for best effect.
  1. 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 to really notice your bladder control is improving.

Who Shouldn't Use Vaginal Weights

According to an extensive review published in 2013 in 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 are suffering from a vaginal infection or sexually transmitted disease.

While the 2013 review concluded that vaginal weights are more effective than no treatment at all when used consistently - and may be easier to teach (and employ) than standard pelvic exercises like Kegels - 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. Bladder retraining - which involves holding your urine for progressively longer periods of time to boost the capacity of your bladder - and dietary changes such as eliminating spicy or acidic foods, caffeine, and eating more fiber can all contribute to better bladder control.

Finally, women with more 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 ​urinating.


Age Page: Incontinence. US National Institute on Aging Public Information Sheet. Accessed October 24, 2014.

Herbison GP, Dean N. Weighted vaginal cones for urinary incontinence. Cochrane Database of Systematic Reviews 2013, Issue 7. Art. No.: CD002114.

Perkins J, Johnson CM. "Vaginal Weights for Pelvic Floor Training: a Multiple Participant Case Report." Physiother Theory Pract. 2012 Oct;28(7):499-508. doi: 10.3109/09593985.2011.653708.

Miller, Janis M; Sampselle, Carolyn; Ashton-Miller, James; Hong, Gwi-Ryung Son; DeLancey, John O.L. "Clarification and Confirmation of the Knack maneuver: the Effect of Volitional Pelvic Floor Muscle Contraction to Preempt Expected Stress Incontinence." International Urogynecology Journal 06/2008, Volume 19, Issue 6, pp. 773 - 782.

Continue Reading