I have lived with endometriosis for most of my life. Like most people with this condition, sex has often been synonymous with pain. For years, I’ve struggled with painful penetration, sharp, internal spasms after orgasm and deep abdominal cramping so intense that I almost went to the ER once.
Nearly every doctor and sex educator I consulted repeated the same thing: I had a weak pelvic floor, and the right device combined with Kegels would solve it.
And so the search began. I tried smart Kegel trainers, pelvic toners marketed as therapeutic, elegant vibrators that promised deeper orgasms and even clinical-looking internal tools so intimidating that some nights I’d wind up crying before I used them. My pelvic floor only clenched harder, the spasms worsened, and the pain kept growing.
Pleasure profit over pain solutions
Pelvic pain affects an estimated one in six women in the UK, yet it remains one of the least understood areas of sexual health. It can contribute to painful sex, reduced orgasmic capacity and musculoskeletal pain that radiates far beyond the pelvis.
Despite that, the mainstream sextech market still overlooks pelvic floor dynamics and instead chooses to centre on pleasure-first devices such as wider vibrators, stronger motors, bigger dildos, as if more intensity is the universal solution.
Most of these products assume the pelvic floor is simply weak and in need of boosting. For people like me living with pelvic pain, the issue is often the opposite. Being told to strengthen those muscles is akin to being told to do bicep curls with a shoulder that’s already in spasm.
“There are significantly more consumers for pleasure devices than people with pelvic pain,” explained Dr Alexandra Dubinskaya, a urogynecologist and sexual medicine specialist at Cedars Sinai Medical Centre in Los Angeles. “So it’s not surprising that companies market their devices as pleasure tools because that’s where the profit is.”
She goes on to say that “the moment a company wants to make a device into a medical tool, they have to deal with FDA clearance, which is time and resource-consuming. A device should offer pleasure while reducing pain, helping relax the pelvic floor, but that device has to be designed correctly.”
From pleasure-first to pain-aware
A new generation of devices is now emerging, designed to respond to pelvic pain as well as pleasure. Each takes a different approach, but together they point to where sextech could be heading.
MysteryVibe is one company trying to bridge that gap. CEO and co-founder Soumyadip Rakshit came to realise that many patients lived with chronic pelvic pain and sexual dysfunction, and yet had access to very few tools. So the company set out to create clinically validated, drug-free solutions that blended pleasure with therapeutic value.
MysteryVibe’s best-known device, the Crescendo, is designed to reach tender areas inside the vagina and support people dealing with pelvic pain. Rather than attempting to strengthen already overactive muscles, it works by promoting muscle relaxation. Its vibration therapy combines frequency, amplitude and flexibility to stimulate vasodilation, improve circulation and reduce inflammation. Preliminary results from a small clinical trial involving eleven women with genito-pelvic pain or penetration disorder suggested that using it three times a week for twelve weeks resulted in significant improvement, and a review led by Dr Alexandra concluded that vibrators may improve pelvic floor muscle function, support vulva pain treatment and enhance women’s sexual experiences. Larger randomised trials remain necessary.
Pelvic floor physical therapist Anna McMaster, who has worked with pelvic pain patients for ten years, said vibration therapy often complements the manual internal work clinicians do. “Vibration can reduce the painful sensations that come with stretching or insertion, which means the patient’s use of the tool becomes more effective,” she said.
Lioness sits in a different category. Its smart vibrator uses embedded force, motion and temperature sensors to track pelvic floor contractions during use, giving users a clearer picture of how stress, fatigue or alcohol shifts their arousal and orgasm patterns — something people with pelvic pain often struggle to sense on their own. A study published in The Journal of Sexual Medicine showed it can reliably measure pelvic floor activity at rest, during arousal, at orgasm and during recovery. Sensera works along similar lines, tracking pelvic floor tension, lubrication levels, friction and heart rate. When it detects rising tension or dryness, its Smart Release System can dispense lubricant to reduce discomfort. Both offer insight that most traditional pleasure products simply don’t provide, particularly for people whose pain fluctuates unpredictably.
Ohnut was designed directly from lived experience. Its creator, Emily Sauer, lived with deep pelvic pain and created the wearable ring system as a way to control penetration depth. The interlocking rings sit at the base of a penis or toy, limiting how deep anything can go without affecting intimacy. For people with endometriosis, hypertonic pelvic floors or postpartum pain, controlling depth can be enough on its own.
Several mainstream brands are also filling gaps through design practices that already align with trauma-sensitive care. Dame Products‘ research-first approach has made devices like the Eva, Fin, Pom and Aer popular among people who need gentle, predictable stimulation. App-connected vibrators from Vibely and Vibio let users customise patterns to relax or stimulate pelvic floor muscles, giving people more control when flare-ups make sex feel unpredictable. Even pleasure-first brands have seen internal devices like the Myth repurposed by users who rely on gentle warm-up and nerve desensitisation before penetration.
All of these show what sextech can offer when it moves beyond pleasure and starts prioritising people with pelvic pain. But none of them can fully replicate what a skilled pelvic floor physical therapist does in a session, and several important gaps remain.
Where sextech still falls short
According to Dr Veronika Matutyte, even though the intention behind consumer devices mimicking internal physiotherapy is good, rarely do they replicate the balanced, patient-specific manual pressure used by trained pelvic physiotherapists.
However, she believes that sextech companies could start by building small, flexible wands with a wide range of frequencies for gradual, gentle exploration. “The user needs absolute control over every millimetre and vibration setting; a simple button for low/medium/high is inadequate.”
Stigma and design of these sextech devices have also created additional barriers. Soumyadip said that while many customers with endometriosis, vaginismus or vulvodynia report that internal vibration warms tissues and calms nerves before penetration, others avoid vibration altogether because devices look too sexualised or intimidating.
Anna has also seen this in her clinical work. “People with chronic pelvic conditions are already in a highly reactive state, and if a tool looks sleek, rigid or overly futuristic, their nervous system guards before anything touches them,” she said. The problem is not just the technology but the design too. Patients with such conditions often want to go for neutral, non-vibrator-like tools, but much of the market still prioritises appearance rather than comfort.
Biofeedback remains another major gap. While companies promise real-time insights, the data usually prioritises strength-based metrics such as how hard someone can squeeze or how long they can hold a contraction. People with pelvic pain need the opposite. They need to know whether their muscles are relaxing.
Anna shared that many patients cannot sense relaxation on their own. Dr Matutyte added that the most valuable data would measure tension and release rather than contraction force. “A sensor that could confirm, for example, that a user is holding their pelvic floor muscles at fifty percent tension and guide them to a relaxed state of ten percent would be genuinely revolutionary for people with hypertonicity,” she said.
Part of the problem forms long before a device reaches consumers. Dr. Alexandra has noticed that companies tend to design the product first and only later do they look for medical advisors.
By that time, important features like the motor, materials and shape cannot be changed. “Vibration isn’t just vibration. Frequency matters; some frequencies cause numbing, some help with relaxation and vasodilation. Amplitude and pattern matter too. You want neuromodulation, not overstimulation. Motor placement and the number of motors change how vibration spreads. Materials play an important role in how vibration feels and can make it soft or harsh.”
There are risks when non-medical companies develop sextech devices with the intent of also addressing pelvic pain without consulting medical doctors. Materials may drag or cause microtears, which is especially dangerous for people with vulva skin conditions.
Deep ridges can trap fluids and increase infection risk. Certain vibration patterns can cause numbness, which interferes with both pain and pleasure. Without clinicians involved, some of these devices can actually worsen pelvic issues.
There are still significant research gaps. According to Dr Alexandra, we still do not fully understand how different vibratory characteristics affect tissue and different pelvic conditions. This remains an important area that undoubtedly needs more study.
What the future could bring for pelvic pain
Future sextech for pelvic pain is likely to be more adaptive, more clinically informed and far more personalised. Dr Alexandra hopes that AI-driven devices with high-quality sensors will be able to track pelvic floor muscle strength, lubrication, friction, and arousal responses, and adjust stimulation in real time.
This allows a device to create a personalized program that is both therapeutic and pleasurable. For people with chronic pelvic pain whose needs shift daily, this kind of responsive design could bridge the gap between pleasure, physiotherapy and pain management.
A major area of progress will come from understanding vibration more precisely. “We will also hopefully know more about vibration, which frequencies and patterns relax the pelvic floor and reduce pain, and which ones should be avoided,” she said.
One of the most promising areas, she added, is using pleasure as neuromodulation. Professor Barry Komisaruk’s research shows that pleasure-based stimulation can directly suppress pain signals. Devices that activate specific nerve pathways could have strong potential in treating endometriosis, vaginismus, vulvodynia and chronic pelvic pain. This approach could shift sextech away from treating pain and pleasure as separate categories and instead use one to modulate the other.
Wearable neuromodulation may also become more common. Dr Alexandra said that tools similar to those already used for bladder and bowel disorders could help people with vulvodynia and chronic pain manage flare-ups throughout the day or week. This type of continuous support could fill a major gap for patients who currently have to rely on infrequent physiotherapy appointments or rely solely on medication.
Soumyadip also sees the same trajectory from a product development standpoint. When asked about the diagnostic future of sextech. He shared that with the help of sensors to measure temperature, pressure, and wetness, future devices will be able to incorporate diagnostic capabilities alongside therapeutic functions, allowing for real-time biofeedback to track pelvic muscle tension, blood flow, and pain levels. Along with a clinician-supported app, devices could also provide personalized, adaptive treatment for pelvic pain.
Despite these possibilities, Dr Alexandra hopes companies still do not abandon simple solutions. At the end of the day, people living with pelvic pain simply want softer materials, smaller designs and low, steady vibration intensities. Yet these are still surprisingly hard to find.
Her guidance for founders is equally clear. Companies should involve clinicians early and consistently, not as a final sign-off when meaningful changes are no longer possible. She also emphasised that people living with pelvic pain must be part of the testing process rather than relying on healthy volunteers.
Without their direct input, devices risk repeating the same mistakes that already dominate pelvic healthcare. Sextech can’t fix what it doesn’t understand, and it won’t understand until it starts asking the people who actually live with the pain.
Leave a Reply