Aquaflex Review – Is Aquaflex Right for You?

Aquaflex Review – Aquaflex Pelvic Floor Exercise System for Women Aquaflex Pelvic Floor Exercise System

Aquaflex is a popular system of vaginal weights designed to improve pelvic floor strength and treat stress incontinence (leakage of urine e.g. with coughing and sneezing).

This Aquaflex review is designed to help you know whether Aquaflex suits you.

Aquaflex Review Contents

Read on now to learn;

  • Aquaflex contents
  • Benefits of using Aquaflex
  • Is Aquaflex right for you?
  • How the system works
  • Who may find Aquaflex beneficial
  • What is great about this product
  • Potential drawbacks of using Aquaflex cones
  • Who may find Aquaflex difficult to use
  • Potential issues with sustained contractions with vaginal weights

Aquaflex Contents Aquaflex Contents

The Aquaflex weights are housed in a durable plastic, aqua coloured storage case (shown right)

Inside the case you will find:

  • 2 hollow plastic cones each with a cord attached to the base
  • 1 Large cone: 27 mm diameter, 65 mm long
  • 1 Small cone 20 mm diameter, 65 mm long
  • 4 circular weights (2x20g, 1x10g, 1x5g)

Benefits Aquaflex Pelvic Floor Exercise System

This system of vaginal weights is promoted by the manufacturers for a range of pelvic floor health issues including:

  • Stress urinary incontinence (leakage with increased pressure on the bladder e.g. coughing, sneezing, laughing or exercising)
  • Strengthening pelvic floor muscles for general health
  • Preparation for pelvic floor muscles strength prior to pregnancy (not during pregnancy)
  • Postnatal pelvic floor strengthening.

Is Aquaflex Right for You? Click Here to Order Aquaflex

Women can benefit from Aquaflex appropriate are those with:

  • Small to moderate vaginal vault space (usually women who have had minimal pelvic floor muscle trauma during childbirth). See next section for how to measure your vaginal vault space.
  • Awareness of their pelvic floor muscles.
  • Ability to contract their pelvic floor muscles.

What is great about Aquaflex ?

  • Using the cones correctly may improve your awareness of being able to contract your pelvic floor muscles.
  • You can progressively increase your weights by increasing the weight you can lift and thereby increase the challenge to your pelvic floor muscles.
  • The weights can be used to strengthen in standing which is the position pelvic floor muscles need to be trained in to improve pelvic floor control for your ever day activities.
  • The cones are smooth as they are well moulded and screw apart readily for cleaning, decreasing likelihood of contamination or infection.
  • The carry container closes firmly and is discreet

Any potential drawbacks using Aquaflex?

  • They may not suit the woman with a larger vaginal vault for whom the larger vaginal balls may be a preferable weight.
  • They are not recommended for use by women with pelvic prolapse owing to the difficulty in correct positioning of the cones.
  • Many weighted pelvic exercisers carry the risk of being used incorrectly; if weights are too heavy, incorrect technique and inappropriate training volume so you need to ensure that you use them correctly.

How Aquaflex Works How Aquaflex Works

The manufacturers say that the cones work through an automatic reflex mechanism that they say occurs when the cone is inserted into the vagina. Mobilis state that the pelvic floor muscles contract automatically around the vaginal cone and that this helps the woman identify her pelvic floor muscles.

It is well known however that following a vaginal delivery, many women lose the ability for reflex contraction of their pelvic floor muscles.  Placing a weight in the vagina will not regain the reflex ability of the pelvic floor muscles to work.

Instead Aquaflex can be used with active pelvic floor exercises for strengthening and challenging the pelvic floor muscles to work harder.

Who may find using the Aquaflex cones challenging to use?

1. Women with very weak pelvic floor muscles

Many women have pelvic floor damage as a result of pregnancy and childbirth. These ladies are often completely unable to contract their pelvic floor muscles and also have very poor sensation in their pelvic floor as a result of associated nerve damage or lack of use.

Women often lose the ability of their pelvic floor muscles to contract automatically with childbirth and as a result they leak urine when they cough, sneeze or exercise. These ladies benefit most from professional guidance from a physiotherapist or continence nurse to learn how to correctly find and feel their pelvic floor muscles, and then work towards progressively strengthening them before using vaginal weights.

2. Women with larger vaginal vault

Some ladies who have had pelvic floor damage from very large babies, forceps deliveries and breech births, have a large vaginal vault space.

It is fairly easy for you to test your vaginal size simply by inserting one or two lubricated fingers into your vagina. If you can feel the inside walls of their vagina sitting against your finger or two fingers can usually manage to use the smaller or larger cone. Women with a larger vaginal vault (more than two finger spaces), sometimes cannot feel the larger 25mm diameter sized cone and/or they report that it falls out of their vagina.

Women that have difficulty retaining a vaginal cone in the vagina will often benefit from trying pelvic exercise balls which are are elliptical in shape and have a larger diameter than vaginal cones, making them easier for some women to sense their pelvic floor muscles working.

How to use and strengthen with the Aquaflex Pelvic Floor Exercise System

1. How to feel your pelvic floor muscles working using Aquaflex cones

Mobilis provide worthwhile advice that having appropriately inserted the empty cone, rest your finger on the base of the cone and to try to contract your pelvic floor muscles.

You should feel the cone lifting away from the tip of your finger. If the cone pushes out of your vagina you are probably not using the correct muscles. This can be a useful way for you to find your pelvic floor muscles and can be performed when you are lying down on your side or standing up to give you some feedback about whether or not your muscles are actually lifting and squeezing as they should.

2. How to strengthen your pelvic floor muscles

The manufacturer’s recommendations for strengthening using the cones:

Insert the cone, standing and walking around for one minute and then start to add weights if you experience no problems. The goal is to work up to the weight you can retain in your vagina for one minute as your ‘exercising cone weight’ and then progress to using this weight walking around for 15-20 minutes.

There may be some potential problems with sustained (prolonged) pelvic floor muscle holds using vaginal weights:

  1. Research into strength training tells us that our muscles strengthen best when they contract and fully relax rather continually contraction for long periods of time. This is the reason that when you go to the gym or fitness class you lift and lower a weight repetitively rather than holding it up for 15-20 minutes at a time. Pelvic floor muscles are skeletal muscles, just the same as the other muscles we perform strength exercises for in the gym and we may benefit from training our pelvic floor muscles using weights in this manner.

 Manufacturers recommendations for when not to use Aquaflex:

  • During or just after intercourse
  • Whilst using a vaginal diaphragm or cap
  • During pregnancy
  • With a pelvic prolapse
  • During menstruation
  • In the presence of vaginal infection.

Where to Buy Aquaflex

Aquaflex can be purchased through some online women’s pelvic health specialist stores.

Inside Out Book & DVDABOUT THE AUTHOR, Michelle Kenway

Michelle Kenway is a Pelvic Floor Physiotherapist and author of Inside Out – the Essential Women’s Guide to Pelvic Support, along with Dr Judith Goh Urogynaecologist. The Inside Out exercise DVD and book show women how to strengthen the pelvic floor and exercise effectively with pelvic floor safe exercises.

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We Welcome Your Comments


  1. Thanks for your reply , I shall get one after the baby and keep doing my pelvic floor excersises x

  2. Jessie Ingram says


    I am just wondering why you can’t use Aquaflex during pregnancy?
    If you are advised to do kegel excersise throughout pregnancy then why can’t I use this product?

    • Michelle Kenway says

      Hi Jessie

      The issue using Aquaflex during pregnancy is to do with the risk associated with inserting an object into the vagina and near the cervix (premature labour) rather than the pelvic floor exercises. Women should wait until after their doctor’s 6 week check up following childbirth and seek approval to use Aquaflex at this time

      All the best

  3. Hi Michelle,
    Am a little unsure whether this product is right for me. I have a stage 2 bladder prolapse . How long does one have to use the weights for ? Is it an everyday exercise routine to maintain pelvic floor strength, or does one “recover” and then move on to regular pelvic floor exercise for maintainence?

    • Michelle Kenway says

      Hi Dale

      Some ladies with prolapse have difficulty using Aquaflex as the prolapse can push the cone out of position. Vaginal weights like Aquaflex are seen as an additional measure above and beyond basic pelvic floor exercises and they are by no means a magic cure when it comes to strengthening the pelvic floor.

      The research that has been done into pelvic floor strengthening for prolapse involved unweighted daily pelvic floor exercises. The key is to progress to the point where your good technique can be maintained during strong pelvic floor exercises standing upright (rather than lying down). Having said this some ladies find that vaginal ball strengthening is better than weighted cone (Aquaflex) since the ball can be better retained within the vagina – just let me know if you want more information on this.

      All the best

      • Hi Michelle. I have just purchased the cones without realising that you are not supposed to use them with a prolapse. I had my son 5 months ago which ended up being a forceps/ episiotomy and ventouse delivery. I now realise I have a prolapse and am desperate to find something to help me stop this from getting any worse as its a great concern as I want to get back to an active lifestyle and also carry further children. I have seen a physio who has said do pelvic floor but also would like to try more than this.

        Any advice would be greatly appreciated.



        • Michelle Kenway says

          Hi Katy

          Yes Katy I understand you feeling the way you do. I’ve seen this information about Aquaflex cones and I can only think that the issue is with the Aquaflex cones moving out of position because of the prolapse. Women with severe prolapse will be unable to insert the cones and retain them in position. Aside from this for women with mild to moderate prolapse conditions I really con’t see the problem, it might be worth your time contacting the manufacturers or distributors and asking them for their reasons. Some other weighted ball devices are actually recommended for women with prolapse so there is definitely inconsistency and lack of understanding in this area.

          All the best

          • Hi Michelle,

            I have a very mild bladder prolapse and my physio has actually recommended I purchase and use Aquaflex. Just out of interest though, you mention weighted ball devices. I have heard about jade eggs, is this what you refer to?

            Thank you for any feedback you can offer

            • Michelle Kenway Physiotherapist says

              Hi Rhea

              There are many weighted ball devices available that can be used to assist pelvic floor training however I am not referring to the Jade eggs developed more as a pleasure device for some women. Some women find that the Aquaflex cones slip out of place and that the weighted balls are more readily held in place. You can see more on weighted ball devices here


  4. Hi I’ve been using the Aqua flex for approximately 8 weeks with good results. My problem is, over the last 8 days I’ve gone from being able to hold 35g in the small cone for 20 mins to only being able to use 5/10g in the small cone for 10-15 mins. How have I managed to go backwards???? I can’t seem to get any higher in weight after 8 days!! I haven’t had a period, I’ve been using them of a morning. Any advice would be greatly appreciated.

    • Michelle Kenway says

      Hi Kate
      Thanks for your question.

      I do wonder about the rationale for using Aquaflex by inserting Aquaflex cones for 20 mins at a time and hoping for a reflex contraction of the pelvic floor muscles. In many women after vaginal delivery the capacity for reflex contraction of these muscles is lost so this is potentially a useless technique for these ladies. I think Aqauflex may be more effectively used with traditional pelvic floor exercises to load the pelvic floor muscles however this is yet to be proven in research.

      More relevant to your question however is that with sustained pelvic floor muscle contractions, these muscles fatigue. We don’t encourage women to walk around with them activated for extended periods of time. Sometimes pelvic floor tension as a result of lack of pelvic floor relaxation where the pelvic floor muscles become unable to relax and this can cause weakness in the pelvic floor muscles and the issues you are desribing in your question.

      In this situation I would lower the weight to a manageable level and use the cones in a lift lower manner with pelvic floor exercises making sure to fully relax the pelvic floor muscles back to resting level and rest briefly before the next contraction. This can be repeated up to 8-10 times in a row for 3 sets of exercises, just like regular strength training.

      Let me know how you go Kate

  5. Hi Michelle can this system be you used after a hysterectomy and if so how long should you wait after your op? I am nearly 7 weeks and am experiencing some leaky bladder problems. I have been doing regular pelvic floor exercises and some days I don’t leak too much and other days it seems to be more. Thanks for any advice you can give me.

    • Michelle Kenway says

      Hi Ali
      Yes the system can be used after a previous hysterectomy however wait until fully healed internally (takes up to 3 mths). Pelvic floor exercises after hysterectomy are the way to address bladder problems post op plus watching your caffeine intake and those bladder irritants known to increase urinary incontinence. Post op hysterectomy exercises progress to upright standing and then increasingle stronger.

      This online video on pelvic floor exercises after vaginal surgery will give you further information too

      Hope this helps you out Ali
      Best wishes

  6. How far should i put it in? Should the tip be inside or outside? And if it falls out will I benefit from useing it laying down? I can feel the walls of my vagina with 1 finger inserted and I don’t leak so I’m not sure where I’m going wrong? Iv had two baby’s naturally and I’m 36 :-)

    • Michelle Kenway says

      Hi Hannah
      When using Aquaflex for pelvic floor exercises, it is important to position the cones incorrectly. The lowest margin of the cone should rest just above your pelvic floor muscles, these are located at a level approximately 2cm inside the vagina. You can test the correct position standing up by inserting the cone and then contracting your pelvic floor muscles. You should feel the string lift slightly or if you touch the cone it should lift slightly with the contraction and then lower down as the pelvic floor muscles relax. This action should be repeated just like weight training any muscle group – unfortunately you can’t see these muscles however they work by contracting and relaxing like all skeletal muscles.

      All the best

  7. rachie Williams says

    Can this device be used with a mirena coil??? Thanks

    • Michelle Kenway says

      Hi Rachie
      I have checked the Aquaflex documentation and there is nothing mentioned about Mirena coil and use with Aquaflex. The Aquaflex instructions state to avoid using Aquaflex; with a diaphragm or cap, during or just after intercourse, with a prolapse, during pregnancy, during menstration or with a vaginal infection. The issue I could forsee would be with the removal of the cones to ensure that the threads that attach to the stem of the Mirena are not pulled inadvertently so as to remove the Mirena, particularly if the threads are long. Contact Neen Healthcare, the distributors or Aquaflex to be sure on this one. There is no documentation for this in the Mirena instructions either.

      Thanks for your interesting question!

  8. Kylie Dargue says

    I’m not sure if ive got the cones in correctly, ive had Aqua flex for only two days and im already on the small cone with all the weights. its last correct?

    • Michelle Kenway says

      Hi Kylie
      Yes this is correct – the small cone is often the progression and if this is well retained within the vagina the pelvic weights are progressed over time. The larger cone is suited to women with larger internal size and/or weak pelvic floor muscles where the cone cannot be retained. Sounds as though you are on track!

    • Why can’t you use this product during your pregnancy?

      • Author: Michelle Kenway Pelvic Floor Physiotherapist says

        Hi Jane
        This is no pelvic exercises should be inserted into the vagina during pregnancy – there is always a risk to the pregnancy inserting foreign objects