EMfemme 360 in London: what it is, what the evidence shows, and who it suits

This guide is written by the team that offers EMfemme 360 at our clinic on Devonshire Place and reviewed by our clinician. It gives you what the device is and does, what the EMfemme 360 study and trials of similar devices measured, how it fits with pelvic floor training and vaginal oestrogen, what a session involves, who should not have it, and how it differs from the Emsella chair, which we also provide.

What EMfemme 360 is

Radiofrequency is an electrical current that heats tissue. In EMfemme 360 the current runs at 3.2 MHz from a slim applicator, the BTL-785-3, which the clinician inserts into the vaginal canal and moves slowly in and out so the whole circumference is warmed to between 40 and 45 degrees. A thermometer shows the tissue temperature on the screen, the device measures the tissue's resistance a thousand times a second and adjusts the power, and the clinician raises the setting from about 65% only as far as you find comfortable. The tip is single-use. The heating phase lasts about eight minutes; the appointment, with the consultation and the examination, about 30 in our practice. The manufacturer's clinical guide also describes an external protocol over the labia, the vaginal opening and the perineum, three to five minutes a zone; the published study treated the canal only.

The manufacturer's international page describes it as "the shortest non-invasive radiofrequency treatment for vaginal health, used both intravaginally and externally", meant to "improve vaginal laxity, labial laxity, and sexual dysfunction", and cites "83% of women reported pain-free sex after treatment" and "93% patient satisfaction", both marked "data on file"; the 83% matches the published study described below. Controlled heat in the mucosa and the tissue beneath is meant to increase blood flow and trigger remodelling of collagen and elastin over the following weeks. Small biopsy studies of other radiofrequency devices have shown new collagen after treatment; for EMfemme 360 the published measures are symptoms and examination scores, set out below.

What it is cleared for, and what the guidelines say

• In the United States, the BTL-785 platform with the BTL-785-3 applicator is 510(k) cleared, most recently in March 2026, "to provide heating for the purpose of elevating tissue temperature for selected medical conditions such as temporary relief of pain, muscle spasms, and increase in local circulation". The clearance covers tissue heating rather than a named intimate use, and a clearance is not an approval, so we never describe EMfemme 360 as FDA approved.
• The 2018 safety communication. On 30 July 2018 the US Food and Drug Administration warned against energy-based devices for vaginal "rejuvenation" or cosmetic procedures: "To date, we have not cleared or approved for marketing any energy-based devices to treat these symptoms or conditions, or any symptoms related to menopause, urinary incontinence, or sexual function", naming vaginal burns, scarring, pain during intercourse and chronic pain as possible harms. It wrote to several manufacturers, including BTL about the predecessor Ultra Femme 360, and recorded that they responded with adequate corrections. Those harms are why our clinician watches the tissue temperature on screen and sets the power by your feedback.
• In Europe and the UK, the manufacturer's UK site states the intended purpose of the EMfemme applicator as "the treatment of sexual dysfunction after vaginal delivery by means of improvement of vaginal laxity". That is its stated UK purpose; the labial and menopause uses we offer follow the manufacturer's international description and its cited study, and we tell you which is which at the consultation.
• What UK guidelines say. NICE's incontinence guideline puts supervised pelvic floor muscle training of at least three months first for stress and mixed incontinence, and its menopause guideline puts vaginal oestrogen first for vaginal symptoms. We follow that order: EMfemme 360 comes after first-line care, not instead of it.

Does EMfemme 360 work? What the evidence shows

In the EMfemme 360 study, most women who had been unable to have intercourse because of pain after the menopause could do so without pain two months after a course. In sham-controlled trials of similar radiofrequency devices, made by other manufacturers, women were about three times as likely to report a laxity improvement with active treatment as with sham. The detail is below.

• The EMfemme 360 study (2022). 35 postmenopausal women with severe pain on intercourse and vaginal atrophy had three eight-minute sessions a month apart and were assessed two months after the last. Of those who had been unable to have intercourse, 83% could do so without pain; a vaginal health score rose from 7.7 to 18.7 on a 5 to 25 scale; pain at examination fell from 6.6 to 1.4 on the scale used; 93% were satisfied. It was a single group without a comparison arm, followed for two months, in women with painful intercourse after the menopause, the use it speaks to most directly.
• Similar radiofrequency devices, laxity. These trials used other manufacturers' devices, mostly multipolar radiofrequency with a pulsed magnetic field, where EMfemme 360 is monopolar. A 2026 systematic review found three sham-controlled radiofrequency trials in which women were about three times as likely to report a laxity improvement with active treatment as with sham, and two trials in which the sexual function score rose by 1.6 points on a 2 to 36 scale. A 2024 trial of 76 women with vaginal atrophy found the laxity score better than sham at four, six and twelve months, a vaginal health score better than sham at every visit before twelve months, and sexual function scores that did not differ from sham. Pelvic floor training comes first for laxity, and we check at the consultation that you have had it.
• Similar devices, menopause symptoms. Four small trials comparing radiofrequency with vaginal oestrogen (156 women) found radiofrequency about level with oestrogen, with a borderline edge on the total sexual function score (2026).
• Incontinence. EMfemme 360 is not our treatment for leakage. For leakage we provide the Emsella chair at the same address, US-cleared for urinary incontinence, after a continence assessment.

What that adds up to: women in these studies reported improvements in comfort, lubrication and a sense of laxity in the months after a course, and the trials with a sham arm show the treatment itself accounts for part of it. Results have been followed for up to twelve months, and we review you at six months to plan what comes next.

Who EMfemme 360 suits, and who it does not

It suits a woman with a sense of vaginal laxity after a vaginal delivery who has already had supervised pelvic floor training or cannot do it; a woman who wants the external protocol for labial laxity, set out in the manufacturer's clinical guide; or a woman with discomfort during intercourse or dryness around the menopause, the group the published study treated, once vaginal oestrogen and moisturisers have been discussed: our doctor covers them at the consultation, and your GP prescribes them if you want them. In every case a doctor examines you first, checks that nothing else needs treating, and tells you what to expect from your course.

We will tell you at the consultation if it is not the right treatment, for example for:

• Anyone seeking treatment for urinary leakage. Leakage needs its type established and a supervised pelvic floor programme first; the treatment we provide for it is the Emsella chair, US-cleared for urinary incontinence, at the same address.
• Anyone who has not been examined. Prolapse, infection, atrophy that needs oestrogen, and anything that needs a gynaecologist come first.
• Anyone expecting a "tightening" result, a cosmetic change to the labia, or a result that lasts for good. The studies measured symptoms and examination scores, followed for up to twelve months, and we review you at six months.
• Pain on intercourse that has not been assessed. Pain has causes that need a diagnosis before any heat treatment.

Who should not have it, from the manufacturer's clinical guide, which we hold (its list runs to 33 items; these are the main ones), checked by the doctor at your consultation:

• Pregnancy, breastfeeding or IVF treatment; the postpartum period; menstruation on the day.
• An infection or inflammation in the area, including a sexually transmitted infection, active sores, psoriasis, eczema, a rash or rosacea; impaired immunity; tuberculosis or hepatitis; a fever.
• Any metal or fixed implant near the area or the return electrode, which covers pelvic mesh and may cover a copper coil; a pacemaker, defibrillator or any active implant.
• Skin cancer or any current cancer, a history of malignant cancer, pre-malignant moles; radiotherapy or chemotherapy.
• A clotting disorder or anticoagulants; cardiovascular disease; collagen disease; a skin autoimmune disease; isotretinoin in the last 12 months.
• Surgery, dermabrasion or a peel in the area in the last three months; unhealed wounds.
• Reduced sensation in the area, acute nerve pain or neuropathy, kidney or liver failure, poorly controlled diabetes or another endocrine disorder, varicose veins or swelling in the area.
• A prolapse beyond the vaginal opening with a thin wall to the back passage.
• Being in a pelvic floor physiotherapy programme at the time: the manufacturer lists it as a contraindication, so we treat you after the programme, not during it.
• Cervical screening is not mentioned by the manufacturer; as our own precaution we ask that yours is up to date.

What a session is like, step by step

1. Consultation and examination. A doctor takes your history, including childbirth, menopause, continence and any pain, examines you, and tells you what the first-line options are and whether you have had them. If you need pelvic floor physiotherapy, vaginal oestrogen or a gynaecologist first, we refer you and plan EMfemme 360 for after it where it fits. Consultations and follow-up reviews are free, and a female practitioner can deliver the treatment if you ask.
2. Preparation. You undress from the waist down and lie as for a smear test. A new single-use tip goes on the applicator, with a water-based gel, in our practice.
3. The treatment. In our practice the applicator is inserted a few centimetres and moved slowly in and out, with a return electrode on your back or thigh as the manufacturer's guide specifies. You feel warmth building, "comfortable heat" in the manufacturer's words; the clinician raises the power only as far as you say is comfortable and the screen shows the tissue temperature. The heating phase lasts about eight minutes, the manufacturer's standard setting within a range of two to ten.
4. Straight after. You dress and go. Some women notice a little discharge, spotting or irritation for a day or two, particularly after the first session; in the published study most women had some of these.
5. The course. Three sessions, a week apart in our practice, inside the manufacturer's range of two to fourteen days; the published study spaced them a month apart. We review you six months after the course.

How many sessions, when you see the result, how long it lasts

Results you can check

Our reviews are collected through review.clinic, and the badge on this page links to them: 4.9 out of 5 from 49 reviews in October 2026, with 100% of reviewers saying the treatment was worth it. Each review is one patient's experience. At your six-month review you compare how you feel against the notes we took before you started.

EMfemme 360 compared with the alternatives

EMfemme 360 vs Emsella. Different devices for different problems, both made by BTL, and we provide both at 8 Devonshire Place. Emsella makes the pelvic floor muscles contract and is US-cleared for urinary incontinence; EMfemme 360 warms the vaginal tissue for laxity and discomfort with intercourse. At the consultation we tell you which fits your symptoms.

EMfemme 360 vs pelvic floor training. Supervised training comes first, and EMfemme 360 is for after it: for women who have done the training, or who cannot do it. We check at the consultation and refer you for training if you have not had it.

EMfemme 360 vs vaginal oestrogen. For menopausal dryness and painful sex NICE puts vaginal oestrogen first and lists moisturisers and other options for women who cannot or prefer not to use it. EMfemme 360 contains no hormone, and in four small trials radiofrequency was about level with vaginal oestrogen on sexual function scores. Our doctor goes through both with you at the consultation.

EMfemme 360 vs vaginal laser. NICE says vaginal laser should not be offered for menopausal genitourinary symptoms outside a randomised trial (2024); that advice covers laser, not radiofrequency. We use radiofrequency, after the first-line options.

EMfemme 360 vs surgery. EMfemme 360 is non-surgical: no anaesthetic, no cuts, no hormones, and no trial compares it with surgery.

Side effects and rarer risks

Expected, from the EMfemme study: a watery discharge in 70% of women, bleeding in 50%, itching at the opening in 45%, a burning feeling in 30% and painful urination in 20%, mostly after the first session, mild, and gone within one to two days. The authors reported no complications.

Reported by the US regulator and in adverse-event reports, with how often unknown: burns, scarring, pain during intercourse, persistent pain and loss of sensation. They are why the screen shows the tissue temperature, the power rises only as far as you say is comfortable, and reduced sensation in the area is a reason not to treat.

The risk to know about is an untreated condition: a prolapse, an atrophy that needs oestrogen, a pain with a cause, a leakage that needs a continence assessment. The doctor's examination at your consultation exists to catch that, and if something needs treating first we refer you and plan EMfemme 360 for after it.

How to choose an EMfemme 360 clinic in London

• Ask who examines you and what they are. Ours is a doctor, and this guide is reviewed by Dr Marie Duggan, GMC 7488383. A female practitioner can deliver the treatment if you prefer.
• Ask whether you have had the first-line treatment for your symptom, and whether the clinic will refer you for it. If nobody mentions pelvic floor training or vaginal oestrogen, ask why.
• Ask what the device is cleared for, and what it is being offered to you for. This guide sets out both, and we go through them with you at the consultation.
• Ask for the evidence behind any percentage. Ours come from the published EMfemme 360 study: 35 women, three sessions, assessed at two months.
• Ask about the tip. Single-use; ours is opened in front of you.
• Ask what happens if it hurts, bleeds or burns, and who you call.
• Ask what the course will feel like and what to expect afterwards. This guide gives you the study's figures so you can compare.

Aftercare

Our advice, pending the manufacturer's aftercare sheet: a little discharge, spotting or irritation for a day or two is expected and a panty liner is enough; avoid intercourse, tampons, baths, swimming and saunas for 24 to 48 hours; and do not book a session during your period. Tell us about bleeding that is more than spotting, pain, a burning that lasts beyond two days, a fever, a change in sensation, or any pain during intercourse that is new, and call us, or 111 out of hours, for anything that worries you.

Frequently asked questions