A vaginal cone is a small, weighted device shaped like a tampon that you insert into the vagina to strengthen the pelvic floor muscles. It works on a simple principle: your muscles must contract to hold the cone in place, giving them a workout much like holding a small weight in your hand trains your grip. Vaginal cones are one of several tools used to treat or prevent pelvic floor weakness, which can lead to urinary incontinence and other problems.
How Vaginal Cones Work
A vaginal cone set typically includes several cones of the same size but increasing weight, ranging from about 20 grams to 70 grams. You start with the lightest cone you can hold in place for about one minute, then work your way up to heavier cones over weeks or months as your muscles get stronger.
Once inserted, gravity pulls the cone downward. Your pelvic floor muscles sense this and reflexively contract to keep it from slipping out. This is essentially a form of biofeedback: the cone staying in place tells you the muscles are engaging correctly, and if it starts to slide, you know to squeeze harder. Many women find this easier to learn than standard Kegel exercises, where it can be difficult to tell whether you’re contracting the right muscles.
A typical training session lasts about 15 to 20 minutes, done once or twice a day. You can use them while standing and going about light daily activities, which adds a functional element to the training since your pelvic floor needs to work during movement, not just while lying down.
Who Benefits From Using Them
Vaginal cones are primarily used by women with stress urinary incontinence, the type of leaking that happens when you cough, sneeze, laugh, or exercise. This is the most common form of incontinence in women and is often caused by weakened pelvic floor muscles after childbirth, during menopause, or following certain surgeries.
Research supports their effectiveness. A large review of clinical trials found that women using vaginal cones were significantly more likely to report improvement or cure of incontinence compared to women who received no active treatment. The cones performed roughly on par with pelvic floor muscle training (Kegels) and electrostimulation therapy, suggesting they’re a reasonable alternative rather than a clearly superior or inferior option. About 70% of women in studies reported some degree of improvement after using weighted cones for several weeks.
They may be less suitable for women with very weak pelvic floors who cannot hold even the lightest cone, women with vaginal infections, or those who are pregnant. Women with pelvic organ prolapse beyond a mild stage should check with a pelvic health specialist before using them.
Vaginal Cones vs. Kegel Exercises
The biggest advantage of cones over standard Kegels is the built-in feedback. Studies estimate that up to 30% of women perform Kegel exercises incorrectly, often bearing down or squeezing their abdominal muscles instead of their pelvic floor. A cone removes much of the guesswork. If it stays in, you’re doing it right.
Cones also add progressive resistance, something that’s hard to achieve with Kegels alone. Just as you’d increase the weight of a dumbbell as you get stronger, moving to a heavier cone challenges the muscles in a measurable way. This progressive overload is a well-established principle in muscle training.
On the other hand, Kegels are free, can be done anywhere without a device, and allow you to practice different contraction patterns (quick flicks, long holds) that cones don’t specifically train. Many pelvic floor physiotherapists recommend a combination of both approaches. Some women also find cones uncomfortable or simply prefer not to use an insertable device, and that’s a perfectly valid reason to stick with exercises alone.
How to Use a Vaginal Cone
Before your first use, wash the cone with warm water and mild soap. You insert it the same way you would a tampon, with the weighted end pointing downward and the removal string (if it has one) hanging outside the body. A small amount of water-based lubricant can make insertion more comfortable.
Start by standing up and trying to hold the lightest cone for one minute. If that’s easy, try walking around for a few minutes. Once you can comfortably retain a cone for 15 to 20 minutes during light activity, move up to the next weight. Most women progress through the full set over the course of four to six weeks, though the timeline varies. Some find they plateau at a certain weight, and that’s normal.
Clean the cone with soap and water after each use and store it in its case. Silicone cones can also be sterilized by boiling. Avoid sharing cones between users.
What to Expect From Treatment
Most clinical trials show measurable improvement within four to six weeks of regular use. Some women notice changes sooner, particularly a better ability to “catch” a sneeze or cough without leaking. Full results typically take two to three months of consistent training.
The improvements are not always dramatic. In studies comparing cones to no treatment, the number of incontinence episodes typically dropped by about half, and some women became fully continent. Results tend to be best for mild to moderate stress incontinence. Severe cases often need additional interventions.
Like any exercise program, the benefits fade if you stop. Many women use cones as an initial training tool and then transition to maintenance Kegel exercises a few times per week to preserve their gains.
Where to Get Vaginal Cones
Vaginal cones are available without a prescription. You can find them online, at pharmacies, and through pelvic health physiotherapy clinics. Prices for a set typically range from $25 to $60. Medical-grade silicone cones are generally preferred over plastic ones for comfort and hygiene.
Some newer products market themselves as “pelvic floor weights” or “kegel weights” rather than vaginal cones, but the concept is the same. A few modern versions use a single unit with interchangeable internal weights rather than separate cones, which can be more convenient. Regardless of the design, the training principle of progressive resistance remains identical.