Enviage Vaginal Biofeedback by David Bychkov, PhD, CEO of Exmovere Holdings

Enviage Marketing Strategy
Version 1.3
December 2010

Exmovere Enviage – Market Report
December 1, 2010 P a g e | 2
Enviage – Marketing Overview
Exmovere Holdings has developed a new proprietary service that combines state-of-the-art
hardware and software to deliver biofeedback-based pelvic floor and vaginal muscle
training to today’s women. Enviage by Exmovere provides a holistic combination of tools
women can use to address their vaginal and pelvic floor muscles imbalances. Women
experience improvements in urinary control, orgasmic sensations and vaginal conditioning
as a result. Enviage consists of a personal insert owned by each patient, other hardware
needed to gather biophysical data and feedback, and proprietary computer software
designed to report and track data when Enviage services are performed. Enviage provides
the training, and services needed by today’s women delivering the best possible continence,
vaginal rejuvenation, re-virgination, and sexercise to encourage natural healing and living.
To promote Enviage, the company will initially offer the products and services through
Clinica facilities, beginning with the clinic in Fairfax, Virginia. Medical staff and trained
assistants will be administering Enviage through nurse-assisted sessions that include:
 Biosensor monitoring and feedback during private one-on-one sessions
 Training female patients so they can exercise in the privacy of their own homes
 Monitoring and reporting of enhancements and improvements
 Evaluating patient symptoms related to pelvic floor conditioning
The basis for Enviage will be Exmovere’s licensed or patented technologies and intellectual
properties that incorporate biosensors, monitoring of patient vital signs, electrical
stimulation, vaginal inserts and meditative biofeedback. The hardware and software
needed to build Enviage exists today and is readily available. Combining these leading
edge tools into a product and service that helps women address their needs and desires
significantly improves options available to today’s woman. They no longer have to rely on
prescription medication with potentially harmful side effects, invasive or surgical procedures
with risk of infections, hearsay from their friends and social circles, or novelty items
intended only for play to receive effective treatment and conditioning for their well-being.
With Enviage by Exmovere, any woman can have and experience the positive intimacy she
wants.
The Setting
Women all over the world have need of rejuvenation and natural healing for the intimate
areas of their bodies. Many women also have to deal with cultural, medical and fitness
issues related to how they address their needs and secure a natural healing process. For
example, the number of American women with at least one pelvic floor disorder will
increase from 28.1 million in 2010 to 43.8 million in 2050 according to recent research.
The number of women around the world with one or more pelvic floor disorders is expected
to approach 250 million during that same period. Pelvic floor disorders and related
incontinence “represent a major public health issue in the U.S.” as cited by the National
Institutes of Health as recently as 2007.

To help address these issues, and related vaginal rejuvenation concerns which inevitably
arise from pelvic floor issues, Exmovere has created Enviage. Built to provide a natural and
holistic approach to women’s concerns, Enviage combines the best of Exmovere’s biosensor
technologies along with training and biofeedback meditation needed to promote continence
and muscle strength among women everywhere.
Recently, significant increases in vagina reconstruction, plastic surgery, and cosmetic
enhancement have occurred, especially in the United States. According to the American
Society for Aesthetic Plastic Surgery, there are over 4,000 cosmetic vaginal treatments –
known as vaginoplasty – each year with increases every year since 2000. Each customer
spends an average amount close to $3,000 per procedure. Customers for vaginal cosmetic
surgery come from all over the world. Thought still small as a proportion of all cosmetic
surgery in the U.S., more women are viewing vaginal rejuvenation and labia reconstruction
surgery as an option.
Part of the rationale women use to opt for this type of surgery comes from cultural and
relationship pressures. In many cultures, the condition of a woman’s intimate areas –
especially her hymen – is the subject of discussion prior to marriage. A virginal state prior
to marriage is important in attracting the right man and marriage proposal. After marriage,
pregnancy and childbirth, women and their husbands may desire improvements and
rejuvenation in order to recapture that virginal experience. Rejuvenating a woman’s vagina
can be done with plastic surgery but does include all the risks associated with surgery
including potential infections and lingering pain.
Enviage services provide an alternative to radical or cosmetic surgery. Intimate areas can
be reconditioned and rejuvenated with a series of exercises, biofeedback, electrical
stimulation and weight training. Muscles in the human body, including the most intimate
areas, respond to regular exercise and conditioning. The mind and the use of biofeedback
included with Enviage serve to reinforce exercise regimens to support natural and holistic
healing. Electrical stimulation may at times be needed to help the vaginal muscles respond.
And, weight training is a commonly used tool with Kegel exercises to strengthen the pelvic
floor muscles. With Enviage, any woman can rejuvenate, re-virginate or rehabilitate her
vagina.
Enviage – next generation intimate area conditioning for women everywhere.
It’s time for your sexual tune up.

Marketplace Summary
Incontinence
Within the next several years, there will be nearly 44 million women in the United States
who will suffer from at least one pelvic floor disorder, representing over 25% of all women
in the country. Applying this same proportion worldwide shows nearly 250 million women
across the world will have one or more pelvic floor disorders by 2050. Pelvic floor disorders
are classified as one of three types. Urinary incontinence or UI is one of the most prevalent
of the three. UI occurs due to weakness in a woman’s pelvic floor muscles which impacts
her ability to control urinary flow. A second type, fecal incontinence or FI can also occur
from weakened pelvic floor muscles. The third type – pelvic organ prolapsed or POP is
quite often caused from natural childbirth which weakens the pelvic floor.
As shown in the above diagram, when the pelvic floor weakens – and the causes of
weakening can be age, natural childbirth, obesity, smoking or other environmental factors -
- it has a connection to other body parts like the urethra, vagina and anus. The effect of
weakening muscles in the pelvic floor causes UI, FI, and POP due to the intricate
relationships between the pelvic floor and other parts of the body.
The direct and indirect costs of these issues to society and the effect on women’s quality of
life are well-documented. Incontinence results in both medical and psychological “costs” in
addition to adverse effects on quality of life. The most recent estimate of the annual direct
costs of incontinence in all ages was over $26 billion which is greater than the annual direct
costs for breast, ovarian, cervical, and uterine cancers combined. A majority (50-75%) of
the cost of incontinence is attributed to routine care, including absorbent pads, protection,
laundry and periodic medical exams.

In addition to economic costs, incontinence substantially affects quality of life. Individuals
who are incontinent may have an emotional burden of shame and embarrassment as well
as the physical discomfort and disruption of their lives that occur with episodes of
incontinence. The impact of incontinence on individuals varies by age, sex, type of
incontinence, individual differences in coping skills, and the quality of social support. For
example, some persons may experience stresses in relationships, low productivity at work,
job difficulties, arranging daily activities by bathroom location, and avoiding activities that
provoke incontinence.
Individuals who are incontinent may experience anxiety about “accidents,” depression,
social isolation, and social exclusion. The management of incontinence itself is burdensome.
Quality of life and the effect of incontinence extend to sexual, parent–child, sibling, and
employer–employee relationships. Extra stress also results when these relationships involve
care giving for the incontinent individual as part of the family.
The above chart is based on analysis and research from the National Health and Nutrition
Survey administered by the US Department of Health and Human Services. Clearly, the
prevalence of incontinence and associated pelvic floor issues increases with age. For the
younger age groups, natural childbirth as well as other vaginal conditions helps explain the
presence of incontinence.
It is also true that the prevalence of incontinence stabilizes within broad age groups. As
shown in the chart below, groupings of 40-49 year olds, 50-64 year olds, and 70+ year old
age groups have about the same presence of incontinence within the group. The rates are
higher for the older age groups with the exception of the mid-60s group. This group may
be the most focused on treatments for incontinence and getting help to deal with related
issues.
7%
17%
23%
32%
0%
5%
10%
15%
20%
25%
30%
35%
Age 20 - 39 Age 40 - 59 Age 60 - 79 Age 80 and over
Incontinence in Women, by Age Group

Source: Centre for Epidemiology and Research, Population Health Division, NSW
Department of Health.
Treatment options for the 25-30% of women suffering from incontinence as a result of
pelvic floor disorders include exercises, biofeedback, electrical stimulation and rejuvenation
therapies. Most of these treatments require assistance from one or more medical providers
and experts. Self-administration of pelvic floor muscle or vaginal muscle exercises require
training first. Biofeedback used to effectively assist women with their training also needs a
clinician or certified biofeedback expert to help interpret and report results. Women can
exercise and train in the privacy of their own home as part of the therapy program if they
choose to do so. But, a key part of any treatment program includes advice, administration
and counsel from qualified medical practitioners – primarily doctors and nurses. Private
settings at a typical medical office or clinic make it easier for women to get the training and
counsel they need. Attempting rejuvenation and conditioning without the advice and
training of an expert would be similar to going to the gym alone without any knowledge of
how to use the weights or other fitness equipment. Outcomes will be much more
successful when using a personal trainer.

How effective have these treatments been? One of the earliest published studies shows
significant reduction in incontinence and related symptoms for nearly all the women
involved. One of the principles applied in this study was to provide the administered
therapies as long as necessary to cure the problem for the patient. There were no
predetermined limits on how many clinic visits each patient was allowed.
Source: John Perry, Ph.D., EMG Biofeedback Treatment of Incontinence, Biofeedback
Society of America.
Even though the sample of participants was relatively small – under 40 – it is significant
that nearly all patients achieved a near-total reduction in symptoms. And, for milder types
of incontinence – stress, urge, mixed – the number of clinic or office sessions ranged from
about 4 to 6. For the more challenging types of incontinence, more office visits were
needed to achieve reduction in symptoms with 8 visits for most types. These reductions
were also at 100%, meaning that every patient that participated left the study with their
incontinence problem fixed.
The protocol used in this research included:
 A personal vaginal and/or anal insert for each patient
 Computerized biofeedback software
 Clinical visits and private training
 Twice per day in-home exercises to complete
 Reporting forms and software for in-clinic use
On a broader scale, a recent summary of treatment results shows that almost three-fourths
(73%) of women using vaginal muscle therapies reported total reduction in incontinence
with about 97% showing significant improvement. The combination of biofeedback, vaginal
inserts and clinical training provide significantly better outcomes than unassisted exercises.

The following headlines and comments summarize recent research findings related to the
impact of vaginal conditioning through pelvic floor muscle exercises and strengthening.
Four weeks of both intensive group physical therapy or individual biofeedback training followed
by an unsupervised home exercise program for 2 months are effective therapies for female
urinary stress incontinence and result in a significantly reduced nocturnal urinary frequency and
improved subjective outcome. [..] Biofeedback therapy resulted in a better subjective outcome
and higher contraction pressures of the pelvic floor muscles. Am J Phys Med Rehabil. 2001
Jul;80(7):494-502. Comparative analysis of biofeedback and physical therapy for treatment
of urinary stress incontinence in women.Pages IH, Jahr S, Schaufele MK, Conradi E.
Biofeedback and pelvic muscle exercises are efficacious for sphincteric incompetence in older
women. Benefits are maintained and improvement continues for at least 6 months
postintervention. These therapies may be useful before considering invasive treatment. J
Gerontol. 1993 Jul;48(4):M167-74.A comparison of effectiveness of biofeedback and pelvic
muscle exercise treatment of stress incontinence in older community-dwelling
women.Burns PA, Pranikoff K, Nochajski TH, Hadley EC, Levy KJ, Ory MG.
Combining biofeedback therapy with a vaginal probe (perineometer) helps patients identify the
muscle, provides immediate feedback and assists the nurse and patient in assessing problem
resolution. This article describes an intervention program using biofeedback, and measured
Kegel's exercises on a small number of women with symptoms of stress incontinence. The
lessening of symptoms became a major factor in continued compliance with the exercise
program. Nurse Pract. 1985 Feb;10(2):28, 33-4, 46.Kegel's exercises with biofeedback
therapy for treatment of stress incontinence.Burns PA, Marecki MA, Dittmar SS, Bullough
B.
A relatively short-term intervention of PFME with sEMG-assisted biofeedback appeared to be
helpful in relieving symptoms of SUI in premenopausal women and represents a reasonable
conservative management option. Phys Ther. 2007 Feb;87(2):136-42. Epub 2007 Jan 9.
Management of stress urinary incontinence with surface electromyography-assisted
biofeedback in women of reproductive age.Rett MT, Simoes JA, Herrmann V, Pinto CL,
Marques AA, Morais SS.
An intensive and EMG-biofeedback assisted PFMT is very effective. Often, avoidance of
surgery is possible. Arch Gynecol Obstet. 2005 Dec;273(2):93-7. Epub 2005 Jul 6. EMG-
biofeedback assisted pelvic floor muscle training is an effective therapy of stress urinary or
mixed incontinence: a 7-year experience with 390 patients.Dannecker C, Wolf V, Raab R,
Hepp H, Anthuber C.

Treatment of SUI with pelvic floor exercises associated to biofeedback caused significant
changes in the parameters analyzed, with maintenance of good results 3 months after treatment.
Int Braz J Urol. 2006 Jul-Aug;32(4):462-8; discussion 469.Pelvic floor exercises with
biofeedback for stress urinary incontinence.Capelini MV, Riccetto CL, Dambros M,
Tamanini JT, Herrmann V, Muller V.
This randomized controlled trial suggests that the home biofeedback method in PFT has a good
success rate of 68.8%. The change achieved in leakage index after 12 weeks of training predicted
an effective outcome for conservative treatment. Acta Obstet Gynecol Scand. 2004 Oct;83(10):
973-7. The effect of home biofeedback training on stress incontinence.Aukee P, Immonen P,
Laaksonen DE, Laippala P, Penttinen J, Airaksinen O.
The findings of this study show that pelvic floor muscle activity is increased and the amount of
leaked urine is decreased after 3 months of PFMT. These preliminary results show a significant
improvement compared with the PFMT-alone group in PFMT outcome measures in patients
using electromyography-assisted biofeedback training. Urology. 2002 Dec;60(6):1020-3;
discussion 1023-4. Increase in pelvic floor muscle activity after 12 weeks' training: a
randomized prospective pilot study.Aukee P, Immonen P, Penttinen J, Laippala P,
Airaksinen O.
In our experience, patients with pelvic floor dyssynergia are likely to have continued benefit
from biofeedback training [at the] one-year control. Dis Colon Rectum. 2004 Jan;47(1): 90-5.
Epub 2004 Jan 2. Long-term study on the effects of visual biofeedback and muscle training
as a therapeutic modality in pelvic floor dyssynergia and slow-transit
constipation.Battaglia E, Serra AM, Buonafede G, Dughera L, Chistolini F, Morelli A,
Emanuelli G, Bassotti G.
Biofeedback to teach pelvic floor muscle control, verbal feedback based on vaginal palpation,
and a self-help booklet in a first-line behavioral training program all achieved comparable
improvements in urge incontinence in community-dwelling older women. Patients' perceptions
of treatment were significantly better for the 2 behavioral training interventions. JAMA. 2002
Nov 13;288(18):2293-9. Behavioral training with and without biofeedback in the treatment
of urge incontinence in older women: a randomized controlled trial.Burgio KL, Goode PS,
Locher JL, Umlauf MG, Roth DL, Richter HE, Varner RE, Lloyd LK
About half of the patients after PFR with biofeedback are still improved or cured after 26
months. Women should be counseled about the long-term efficacy and about the necessity of
maintaining training. Eur J Obstet Gynecol Reprod Biol. 2002 Nov 15;105(2):181-5. Long-
term efficacy of pelvic floor re-education with EMG-controlled biofeedback.Jundt K,
Peschers UM, Dimpfl T.

Stress urinary incontinence is a common problem among women of all ages but may resolve
with pelvic floor reeducation in many cases. Compliance to a regimen of pelvic floor muscle
exercises is poor and many devices have been produced to make exercising these muscles more
effective and interesting. This article describes a study in which two such devices -- vaginal
cones and pressure biofeedback -- were compared with pelvic floor exercises alone. The results
show that there is no statistically significant difference between the three modalities; all
treatments produced significant improvement in symptoms and quality of life scores. Br J
Community Nurs. 2001 May;6(5):230-7. Pelvic floor reeducation for stress incontinence:
comparing three methods.Laycock J, Brown J, Cusack C, Green S, Jerwood D, Mann K,
McLachlan Z, Schofield A.
These data suggest that self-selected healthy women with symptoms of urge, stress, and mixed
incontinence can improve their symptoms and lower their severity index with a minimal
intervention, comprehensive, self-directed home biofeedback continence system. J Wound
Ostomy Continence Nurs. 2000 Jul;27(4):240-6. A self-directed home biofeedback system
for women with symptoms of stress, urge, and mixed incontinence.Smith DB, Boileau MA,
Buan LD .
This randomized controlled trial suggests that the home biofeedback method in PFT has a good
success rate of 68.8%. The change achieved in leakage index after 12 weeks of training predicted
an effective outcome for conservative treatment. Acta Obstet Gynecol Scand. 2004 Oct;83(10):
973-7. The effect of home biofeedback training on stress incontinence.Aukee P, Immonen P,
Laaksonen DE, Laippala P, Penttinen J, Airaksinen O.
Home pelvic floor training with EMG-controlled biofeedback is efficient in 85% of patients in
alleviating the symptoms of genuine stress and mixed incontinence without causing side effects.
Int Urogynecol J Pelvic Floor Dysfunct. 1999; 10(1) :7-10. Treatment of female urinary
incontinence with EMG-controlled biofeedback home training.Hirsch A, Weirauch G,
Steimer B, Bihler K, Peschers U, Bergauer F, Leib B, Dimpfl T.
Thirty-seven women with stress incontinence were given biofeedback instruction on how to
perform pelvic floor exercises correctly. After 3 months with home exercises 31 patients
performed a new standardized pad-weighing test: 39% were objectively cured and 42%
improved. After a mean of 2 years 15 patients were evaluated with another pad-weighing test:
27% were now objectively cured and 47% improved. A questionnaire showed that 78% had an
exact knowledge about the location of the pelvic floor muscles and 47% were satisfied with their
present situation, but only 58% performed daily exercises . Int Urogynecol J Pelvic Floor
Dysfunct. 1998; 9(3):151-3. Efficacy of biofeedback in the treatment of urinary stress
incontinence.Glavind K, Laursen B, Jaquet A.
All round improvement in incontinence levels, sexual function and quality of life. J Sex Med
2010. Feb 2. Sexual function and quality of life in women with urinary incontinence treated
by a complete pelvic floor rehabilitation program (biofeedback, functional electrical
stimulation, pelvic floor exercises and vaginal cones) Rivalta M and others.

Biofeedback provides better outcomes than unassisted pf exercises for patients with fecal
incontinence. Dis Colon Rectum. 2009 Oct;52(10):1730-7. Randomized controlled trial
shows biofeedback to be superior to pelvic floor exercises for fecal incontinence. Heymen S
and others.
Given these success rates and the near total reduction in incontinence that women
experience through a combination of biofeedback and pelvic floor muscle exercises, women
around the world have hope. Taking care of the most intimate areas of their bodies and
experiencing the healing and rejuvenation potential from these therapies is possible for
every woman. They should not feel like they have to try to deal with these problems on
their own, even though most women do. Once incontinence symptoms appear, a recent
report indicated that a woman will suffer with incontinence on average for a period of 6
years before seeking treatment. That’s a long time to struggle with an issue that can be
effectively eliminated with 4 to 8 clinic visits.
Case Study
Judy is a 50-year old woman living in the North Eastern United States. She and her
husband have 3 children, grown and on their own. Judy has noticed an increasing
tendency to have to get up in the middle of the night several times to urinate and is getting
frustrated by a lack of good quality sleep.
Judy decides to see her doctor who performs a standard pelvic exam. He notes weakness
in pelvic floor muscle tone and lack of squeeze pressure during the exam. Based on these
preliminary results, Judy’s doctor suggests surgery may not be too far off. Her doctor also
refers Judy to an intimate rejuvenation facility to see if a regimen of conditioning and
biofeedback can either slow the muscle deterioration or provide significant relief for Judy’s
nighttime incontinence.
Judy makes an appointment with the clinic and goes to her first appointment. During the
first visit, the nurse practitioner at the facility explains the doctor’s referral and method of
treatment. Judy is asked to purchase her personal equipment and is then shown an
example of how the therapy works.
In a private, screened room Judy gets comfortable then lets the nurse know she is ready to
begin her first session. As part of the session, Judy wears a wristwatch that reads her vital
signs and wears a pulse meter on her index finger. This equipment communicates
wirelessly with the laptop computer on the other side of the privacy screen.
The nurse asks Judy to begin the procedure and connect the USB cable as instructed
earlier. The cable is connected to a laptop computer on the other side of the private area.
On the laptop, the nurse engages software that reads signals from the personal equipment
and records metrics like muscle tone and squeeze strength.

In the next 30 minutes, the nurse coaches Judy through a series of exercises that help tone
and strengthen the pelvic floor. And, Judy uses a biofeedback visor that shows her the
results of her muscle exercises through her choice of visuals. Judy likes the ocean so she
chooses to watch ocean waves rise and fall as she exercises. Based on her progress, Judy
“sees” the immediate feedback and results. The biofeedback portion of the treatment
provides immediate feedback on the effectiveness of Judy’s ability to contract and relax her
muscles.
At the end of this first session, the nurse shows Judy her results on the laptop computer
and says that a printed report will be available after 6 visits so Judy can see her progress.
The nurse also asks Judy if she would like to exercise at home as part of the treatment.
When she agrees, the nurse asks Judy to exercise twice a day for 30 minutes each time.
These additional exercises are intended to support faster progress in Judy’s rejuvenation
and healing.
Over the next month, Judy visits the rehab clinic weekly going through the same exercises
and biofeedback session each time. With her regular exercise at home, both Judy and the
nurse can see progress. For the second and third months, Judy schedules sessions at the
clinic for every other week rather than every week.
By the end of 3 months, Judy has been through 8 therapy sessions and has continued her
at-home exercise routine. After 8 sessions, Judy’s nighttime incontinence has virtually
disappeared. She is confident that she can maintain her exercise routine and agrees with
the nurse to report any resurgence of incontinence problems. The nurse agrees to call in
30 days to make certain that Judy is still “dry” at night and is getting a good night’s rest.
Enviage by Exmovere intends to help as many women as possible address
incontinence issues with state-of-the-art technology, biofeedback, and intimate
exercise routines that solve the problem.
Intimate muscle fitness
One way to evaluate the impact of the exercises, biofeedback and training programs on a
woman’s intimate area is through a measure of pelvic muscle strength. Known as “net
contraction” – which shows the difference between her “resting” squeeze pressure and her
pressure at maximum squeeze -- this measure can be taken each time a woman exercises
the muscles in her intimate areas. Also known as squeeze pressure, this number shows
how tight the muscles fit around the personal insert. A woman’s training and exercise
increase her squeeze pressure or net contraction over time as she improves and
rejuvenates her intimate condition and fitness.

Muscle strength can be defined as the maximal force that a muscle can generate and is
often referred to as the weight the muscle can lift once, or the one repetition maximum
(1RM). When assessing muscle strength, the person being tested is asked to attempt to
perform a maximum voluntary contraction of the specific muscle. This force can be
measured by different instruments, each with its own qualities. For example, a Russian
woman recently claimed the Guinness Book title of “strongest vagina in the world” by
demonstrating an ability to lift just over 30 pounds (about 14 kilos) while standing. Not
every woman aspires to develop this level of fitness, but with regular exercise and
appropriate biofeedback it is possible.
At least part of the reduction in incontinence is believed to be a result of increasing pelvic
muscle strength. A relatively weak or “resting” reading ranges from 2.0 to 3.0. Improving
muscle strength is a natural outcome of pelvic floor exercises and the therapies
administered to treat incontinence. For example, the Perry study quoted earlier also shows
the following improvements in vaginal muscle strength and conditioning.
Notably, most participants in this research experienced very significant improvements in
their “net contraction” as a result of the exercise and treatment regimens. These outcomes
resulted from a combination of increasing the squeeze but also from reducing the resting
level. As part of any exercise or fitness program, one of the well-known outcomes is a
reduction in resting muscle tension or pressure. For example, from a regular weight lifting
or resistance training program, we know that arm and leg muscles become much more
efficient. Based on these reports and findings, this same outcome appears to be true for
intimate muscle conditioning as well.
Enviage from Exmovere provides the tools and training needed for any woman
to increase her intimate muscle strength through exercise and biofeedback.

Vaginal Sexercise
The clinical and research evidence from rejuvenation and intimate area treatment regimens
also suggest that women who regularly exercise their intimate muscles experience better
sex. They feel more pleasure and experience more orgasms.
The pelvic floor is a large hammock of muscles stretching from side to side across the floor
of the pelvis in both women and men. It is attached to the pubic bone in front, and to the
tail end of the spine behind. The openings from the bladder, the bowels and, for women,
the vagina, all pass through the pelvic floor. The correct anatomical name for these
muscles are the pubococcygeus muscles, but nowadays they are more commonly called the
pc muscle or love muscles, or even more commonly, the pelvic floor muscles. It is actually
more accurate to talk of these muscles in the plural, as there are a number of muscle
groups that together make up this pelvic floor sling.
Many women are aware that they should exercise these pelvic floor muscles but very few
do it regularly and successfully. Most women who have had children will have been advised
on the importance of pelvic floor exercise to restore muscle tone after childbirth, and
muscle strengthening was identified as an appropriate treatment for stress urinary
incontinence in the U.S. in the 1950s. Medical professionals continue to make these
recommendations but they do so without proper education and coaching. As a result of
improper training and attempts to improve, most women that try on their own fail to
achieve the unique healing and rejuvenation available to them. Desirable, holistic
outcomes and effective natural healing require training and guidance, like any other valid
exercise routine or therapy.
To understand why the routines for love muscle strengthening have an impact on sexual
performance, consider what happens in your body when you experience an orgasm:
 Your heart pumps faster and your breathing gets heavier to fuel those tensing
muscles.
 Hormones are pumped round your brain and body, telling you this is fun.
 Blood is pumped to your genitals to create the tension that will ultimately trigger a
pudendal reflex (muscular spasm of the genitals).
 That reflex will result in your pelvic-floor muscles contracting between five and 15
times at 0.8-second intervals. Clinically, this is an orgasm as we know it.
So when you consider that the synergistic array of modalities needed to experience orgasm
is focused on the love muscles and their ability to contract or squeeze, it should not be
surprising that exercising and strengthening those muscles makes for more and better
orgasms.

The association between a strong pelvic floor and improved sexual response and pleasure
led sex therapists to recommend pelvic floor exercises (or kegel exercises as they are
known in the US) to clients, and earned the pelvic floor yet another name: "the love
muscle".
So why are pelvic floor exercises helpful in increasing sexual pleasure?
 The pelvic floor muscles are directly responsible for the amount of sensation you feel
during intercourse, and for the amount of grip felt by your partner. So although an
exercise regime for the pelvic floor muscle has the same physiological benefits as
exercising any other muscle, the spin-offs are much better.
 Exercise improves muscle tone which means that the muscle is tighter, so is
stretched more by an erect penis.
 Strong, firm muscles have more nerve endings, and more nerve endings mean more
sensations for you during sex. Firmer muscles also help create more friction during
intercourse. With more nerve endings and more friction, you get a double benefit.
 Exercise improves circulation, and this is particularly important for the smaller
muscles of the pelvic floor, which are responsible for pumping blood to and
engorging the most intimate areas for women when they are aroused.
 Rhythmic contractions of the pelvic floor contribute to arousal and to many women's
ability to achieve orgasm. Many women report they are able to reach orgasm more
easily, and that their orgasms are more powerful, after a pelvic floor exercise
program.
Most experts agree that it takes approximately 12 weeks or about 3 months of consistent,
proper exercising to make a real difference.
Specialists strongly believe that a regular program of pelvic floor exercise will enhance a
woman's sex life.
Through working with many thousands of women over the last 30 years, it has become
abundantly clear to me that a strong pelvic floor muscle enhances orgasm with oneself and
during partner sex. Betty Dodson- US sex eduator and expert
These exercises, when performed correctly, can increase orgasmic intensity as well as prevent
pelvic organ prolapse and incontinence. Stanford University School of Medicine
The pelvic floor has an important sexual function, helping to increase sexual awareness both for
yourself and your partner during sexual intercourse. Continence Foundation, UK

Strengthening all the muscles in the pelvic floor, identifying them, learning to use them and
keeping them strong, will not only help prevent reproductive organs from falling later in life, but
will be key in enhancing sexual response today. Focusing part of your exercise regime on this
muscle group can really pay off later in the bedroom. Laura Berman, US sex therapist
However, despite these benefits, without proper instruction many women are unable to
contract these muscles on demand because the muscles are situated at the floor of the
pelvis and are seldom used consciously. Several studies have recently shown that more
than 30% of women do not contract their vaginal or pelvic floor muscles correctly. In order
to achieve the best possible outcomes women need training and biofeedback to learn how
to exercise their intimate muscles properly.
Case Study
Mary is a 25 year old woman living in the South Western United States. For the last two
years, Mary has noticed deterioration in her ability to achieve multiple orgasms during
sexual intercourse. She has always been multi-orgasmic and recognizes that part of the
pleasure she gets from sex is her ability to climax multiple times, along with the human
intimacy and contact with her partner.
Mary decides to consult her chiropractor to see if he can help with adjustments, muscle
toning or something that can help her understand the issue and solve whatever the
problem might be. Under consultation, the doctor discusses Mary’s recent car accident
which resulted in lower back stress and pain. The disks in her lower back were bulging but
the doctor made spinal adjustments and now the disks are back in place.
However, upon further examination, the chiropractor discovers that potential nerve damage
in the lower back due to the car accident could be impeding Mary’s ability to achieve
regular orgasms. The nerve areas in the lower back are connected to and control muscle
tone and sensations, especially in the genital and vaginal areas. Her chiropractor
recommends a course of treatments for Mary that include intimate muscle toning, electrical
stimulation and biofeedback.
Mary contacts the rehab center and schedules her doctor’s recommended rejuvenation and
exercise treatments. At her first visit, Mary talks with the Nurse Practitioner who explains
the processes and procedures. Mary purchases her own personal equipment and learns
about the biofeedback equipment used during treatments. The version she purchases also
includes electrodes that will be used for vaginal muscle stimulation as part of her course of
therapy. To set the proper expectations, Mary and the nurse walk through the private,
screened area of the clinic where each session will be held. Mary is encouraged to ask
questions and get comfortable with the process.

During each session, Mary performs muscle strengthening exercises – assisted by the
electrical stimulation at the beginning of her therapy regimen – and uses the biofeedback
tools when she is treated at the clinic. Mary is encouraged to exercise at home between
clinic visits and learns more about herself, her intimate areas, and the level of control she
has with her love muscles. As a result, after 3 months, Mary is more comfortable with the
frequency and intensity of her orgasms.
Enviage by Exmovere provides the tools and training needed for any woman to
properly exercise and tune up her intimate muscles and reap the benefits.
Vaginal Sexercise – Science and Surveys
(Content and survey results courtesy of The National Orgasm Survey, United Kingdom)
Researchers have known for over 60 years that you need a strong pelvic floor muscle to
enjoy better sex and great orgasms. But few women exercise their pelvic floor on a regular
basis. And even fewer exercise effectively or have been taught to exercise correctly.
What's the science? It's been over 60 years since Arnold Kegel first identified the link
between pelvic floor muscle tone and the ability to achieve vaginal (coital) orgasm during
intercourse. His contraption allowed him to actually measure the strength of the pelvic
floor muscle, and he found that women with slack pelvic floor muscles and poor muscle
tone often regarded themselves as sexually dysfunctional because they could not achieve
orgasm. Kegel devised exercises that enabled these women to develop their pelvic floor
muscle tone - and in no time at all their sex lives were revolutionized! The most important
aspect of Kegel's research was that there has to be a resistance to squeeze against.
The three things that you have to know about Kegel pelvic floor exercises
1. You have to squeeze the correct muscle and get the feedback that you are doing so.
Your buttocks, thighs, abdominal muscles and eyebrows do not move!
2. You have to squeeze against a resistance - it's no use doing the odd squeeze against thin
air while you're vacuuming or waiting for the bus!
3. You have to work at it - Kegel recommended 300 squeezes a day - against resistance!
The G-spot was discovered at the same time as Kegel's research, by a German called
Grafenberg. But someone lost it and millions of men around the world have spent years
looking for it. Then, in 2008, an Italian scientist names Jannini claimed to have found it
again.
Unfortunately, according to Jannini, most women didn't have one! Only those who could
achieve a vaginal orgasm! Using ultrasound Jannini found that women who could achieve
vaginal orgasm had thicker muscle tissue between the vagina and urethra. This comes as

no surprise to those who have developed this area of muscle tissue using effective pelvic
floor exercises. The same exercises that strengthen the vaginal muscles also build up the
muscle tissue between the vagina and the urethra, actually creating a G-spot.
“Observations in [more than 3,000 women,] ranging in age from 16 to 74 years, have led
to the conclusion that sexual feeling within the vagina is closely related to muscle tone, and
can be improved through muscle education and resistive exercise." Kegel 1952
"78 of 123 women complaining explicitly of sexual deficits achieved orgasm following the
training" Kegel 1952
The pelvic floor is like any other muscle - use it or lose it! The confirmation of the link
between the pelvic floor, the G-spot and the ability to achieve a vaginal orgasm should
provide all the motivation necessary to encourage women to exercise their pelvic floor
effectively and regularly. Daily 'sexercises' will help you strengthen your pelvic floor and
develop a much greater awareness of your vaginal muscles. But, as with all exercises, you
must do them correctly. At best, exercising incorrectly will achieve nothing. At worse, it
could cause real harm.
Three reasons why your pelvic floor affects your sex life
1. The pelvic floor is one of the most under-exercised muscles in the body. Lack of effective
exercise, childbirth and menopause mean that there is often a lack of sufficient contact
between the vaginal wall and the penis. So your G-spot doesn't get the stimulation it needs!
2. Exercising the pelvic floor develops a much greater awareness of the pelvic floor, the
vaginal walls and the G spot and builds the neural pathways between the brain and the
vagina that lead to more frequent orgasms of greater intensity.
3. Improving the pelvic floor muscle tone means you become more aware of your muscles
and can contract your vagina at will to squeeze your partner during intercourse - this
benefits both of you.
The pelvic floor muscles begin to weaken from the mid-20s onwards, then further with
every child you give birth to and again after the menopause. This dulls sexual sensation for
both partners. The benefits of exercises are "better circulation, increased sensitivity and
improved orgasmic potential.
“My pelvic floor muscles were shot - I couldn't laugh without feeling as if I was going to
leak. I found the [sexercises] and started to feel the benefits in about a week. I soon had
enough stamina in the muscles to use them during lovemaking to achieve orgasm - which
I'd never been able to do previously. It made me feel like a strong woman again."
Allie Crowley quoted in 'I thought I'd never enjoy sex again';
Good Housekeeping article May 2007

Results from the 2008 Orgasm Survey:
Interim results were published to coincide with National Orgasm Day, July 31 of each year.
One thing was very clear from the Survey (results from over 5,000 respondents) - a good
pelvic floor means a great sex life. Key findings include:
• Nearly half of all women are not getting their share of orgasms!
• The G-spot is not a myth – 75% of women claim to have one. And women who don’t think they have a
G-spot rarely orgasm
• Women who claim to have a good pelvic floor have twice as many orgasms as those who don’t
• Women who undertake regular pelvic floor exercises using a resistance device reported a much
improved sex life within 4 weeks
Survey results
• 72% of women say they are aware of their G-spot but its location varies significantly!
• 50% place the G-spot just inside their vagina while 35% say it’s deep inside. The remaining 15% locate
it elsewhere
• 70% never or rarely achieve vaginal orgasm during penetrative sex
• Only 31% claim to do so often or always
• 36% never or rarely achieve clitoral orgasm during penetrative sex, but 80% often or always achieve
clitoral orgasm by self-stimulation
• 69% are aware that pelvic floor muscle tone is implicated in the ability to achieve orgasm, but 12% rate
their pelvic floor as poor or very poor
• 70% of women claim to exercise their pelvic muscles sometimes or often, but 92% would like to be
shown how to exercise properly
• Those women who rate their pelvic floor as good or very good, or who exercise regularly, are twice as
likely to achieve vaginal orgasms as those that rate their pelvic floor as poor or very poor (42% versus
22%)
• There’s a similar pattern with clitoral orgasms but it’s slightly less marked
• Two thirds of women who rate their pelvic floor as poor or very poor never or rarely have vaginal
orgasms
• 62% said that their partner noticed the improvement in muscle tone and tightness

We believe that you can develop your vaginal muscles and your G-spot by regularly using
vaginal sexercises and Enviage by Exmovere. You will be able to identify, isolate and
exercise the right muscles correctly.
And this will make sex much more enjoyable - for both of you.
How our view of orgasms has changed over the years
"The female orgasm is located in the clitoris and this will take precedence over the vaginal orgasm in the
early years of marriage" Dr Helena Wright, The Sex Factor in Marriage, 1931
"Sexual passion is the driving force in life in a partnership of equals. Men desire physical gratification;
female fulfillment is enhanced by home and children. Out of that mix comes orgasm." Rev Herbert Gray, a
founder of the Marriage Guidance Council, 1938
"Sexual feeling within the vagina is closely related to muscle tone, and can be improved through muscle
education and resistive exercise. 78 of 123 women complaining explicitly of sexual deficits achieved
orgasm following the training.” Arnold H. Kegel. Western Journal of Surgery, Obstetrics & Gynecology, 1952
"The vagina is not designed as a pleasure centre and therefore attributions of frigidity based on not
reaching vaginal climax (as opposed to clitoral climax) are a construction of patriarchal masculinity. Some
would say the natural sexual act is irrelevant to women's pleasure, but instrumental in women's
subordination. The location of women's pleasure in the vagina, rather than the clitoris, is an expression of
the way in which sex has been organised solely in the interests of men." Anna Koedt, The Myth of the Vaginal
Orgasm, 1970
"Research indicates that perhaps only 10% of women can achieve coital orgasm." Female Orgasm: Role of
Pubococcygeus Muscles" Journal of Clinical Psychiatry, 1979
"Satisfaction was directly connected to sexual assertiveness, frequent sex, using many techniques, and
orgasm. A woman was significantly less likely to have had an orgasm if she was 16-19 or 50-59. She was
significantly more likely to have had an orgasm if she spoke English at home, had completed post-
secondary education, had a higher household income and had a managerial/professional occupation.
Orgasm was least likely if the only reported practice was vaginal intercourse." Sexual practices at last heterosexual
encounter. Richters, Journal of Sex Research 2006
"Women without any visible evidence of a G spot cannot have a vaginal orgasm".Conclusion of research with
Ultrasound. Jannini, Journal of Sexual Medicine, 2007
A better understanding of the female orgasm, and helping women become more aware of
how they can improve their ability to orgasm, should have a major impact on the sex lives
of millions of couples.
There is strong evidence that the sexual satisfaction of both partners seems to be reduced
when a woman's pelvic floor muscles are weakened as a result of childbirth, menopause or
the lack of effective exercise. This leads directly to a lack of physical contact and
stimulation during intercourse which means that in many cases neither partner can reach
orgasm through intercourse alone.

The female orgasm has always been a matter of intense interest and the subject of
incredible media hype. There is plenty of advice about how to have 'better sex'.
But the reality of what women actually experience is shrouded in mystery.
Some 'experts' dismiss the idea that vaginal and clitoral orgasms are even distinguishable;
for others the subject is at the root of the feminist debate. For many women that centre of
intense ecstasy - the G-spot - is a myth and for most the vaginal orgasm seems to an
unattainable dream. Recent scientific discoveries would appear to substantiate this view.
There are many women who would just like to experience any orgasm of any kind!
That’s why we invented Enviage.
Enviage by Exmovere provides a next generation combination of technology,
training and biofeedback women everywhere need in order to have more, better
orgasms.
What is Enviage?
Enviage will present a combination of technology-based tools that deliver intimate area
wellness through a harmonious relationship between mind, body and spirit. Biofeedback,
intimate muscle conditioning and more sexual satisfaction combine to deliver holistic
rejuvenation and healing. Enviage includes administration of exercise and biofeedback
routines specifically designed for women, including:
 A personal insert for each patient
 USB-based connector cables so that the insert and its sensors can be directly
connected to any personal computer
 Computer software to record squeeze pressure and contraction strength
 Nurse-assisted exercise routines and descriptions of the right ways to exercise
 Biofeedback sensors to measure pulse rate and blood oxygen level
 Biofeedback programs and visualization graphics to reinforce proper training
 Private training sessions in-clinic
 Recommended training routines for in-home exercise
 Monitoring and reporting of results and outcomes

Depending on desired outcomes, each patient will receive consulting and recommendations
on how many clinic visits to expect and how much exercise to perform at home. For
example, using Enviage to revirginate a vagina may be a longer process than treating
incontinence. Strengthening the vaginal muscles to improve sexual performance can be a
side benefit, but can also be a primary objective of the program. Each patient will receive a
customized exercise and intimate fitness program designed to help them achieve their
objectives.
Enviage Marketing
Due to the lack of understanding among most women about how to exercise their intimate
muscles properly, Enviage will only be offered through Exmovere’s Clinica facilities. A
medical professional will be a primary consultant for each patient, the facility computers will
have the necessary software installed to capture biofeedback, and private exercise rooms
will be available for use during treatment.
Each patient will purchase their own insert and it will be theirs alone. They will be
responsible for use of the personal equipment during treatment at the clinic and will also be
asked to connect the insert to the facility’s USB cable. This will be done in private,
screened treatment rooms. All treatment rooms will be private and patients will remain
behind curtains, screens or doors to protect their privacy during exercise. No clinic staff
other than qualified medical doctors or nurse practitioners will be permitted in the rooms
while patients are exercising.
The first Clinica facility is in operations in the Fairfax, Virginia area. Within the facility’s
range, the population is about 50/50 split between males and females, like the rest of the
country. Within the women’s group, the following age segments are estimated.

The proportion of women in the 35 to 54 year age group – representing about 80,000
women is a logical target for the introduction of Enviage services and its benefits. As noted
earlier, the prevalence of incontinence in this group is expected to be from 15% to 20%.
In addition, this group along with its younger counterparts are the most likely to be sexually
active and looking for ways to improve their experiences. Intimate area rejuvenation and
transformation is likely to have the highest appeal to these groups.
In addition, Enviage will be targeted at ethnic groups. The latest information suggests that
Asian, Hispanic, and African-American groups are large enough to represent a substantial
market for these services, representing 17%, 15%, and 9% of the area’s population.
Marketing to women presents special opportunities to develop Clinica’s name recognition
and brand awareness. The programs for marketing Enviage will be based upon the
following principles.
Women are busy and we must grab their attention quickly. Any connections that can be
made with the area’s gynecologists, women’s health specialists, and urinary specialists for
women will be used. These offices can be a source of recommendations and patients for
Enviage and its exclusive offering at Clinica, Fairfax.
Social networking and promotions will be used to encourage women patients to help
recommend Enviage. Word of mouth is often the best way to promote a product or service
to women. We know that women enjoying telling other women about their latest discovery
and how it has made their life better or easier. By highlighting benefits and providing
incentive referrals women can get the word out to their friends and neighbors through viral
marketing.

Communication pieces must be well-developed and to the point. Women are practical but
with flair. We will need to communicate clearly about benefits, but at the same time be
interesting and stylish. Great design will be an integral part of ads, mail pieces and
Internet promotions for Enviage.
Women focus on their family. Tell the story, but quickly. Use headlines and copy that hits
"home", literally. We need to speak to women about how our product or service is going to
appeal to them as a mom, a wife, a daughter, or a partner. Women are driven to make
their own lives and the lives of those they care about better. The quality of life outcomes
from Enviage will be emphasized in the marketing.
A special atmosphere or special treatment service appeals to women of all ages.
Introducing Enviage as a spa-like regimen for intimate area rejuvenation can enhance the
opportunity to recruit new patients. Specifically, spa marketing as part of the Clinica
offering will appeal to women throughout the United States, Europe and the Asia-Pacific
region. Luxury treatments need to be part of the program and service offering, but may
require additional investigation and research to properly position and advertise the offering.
Multiple tools and tactics will be used. Opportunities to advertise on radio and billboards, in-
facility at referral offices and clinics, through print, on-line and direct mail will all be
explored for effectiveness.
New Service Introduction Plan
Strategy 1 Strategy 2 Strategy 3
Plan Enviage offering around
Fairfax Clinica marketing and
service area
Create broader, regional
marketing campaign
Capitalize on national trends and
spa-like approach
Marketing area is 50% female;
over 40% minority-specific
targets. Program to include:
1. Referrals from area ob/gyn
and uro-gyn offices
2. Fairfax area social and word of
mouth marketing
3. Well-designed creative pieces
for mail and direct marketing
4. Multiple tactics to reach target
market on radio, billboards and
local television
5. PR and news releases at local
level
6. Online marketing with Fairfax
and D.C. websites
1. Use existing creative and copy
from Fairfax program to cover
region
2. Larger online viral campaign
3. Relationships with ob/gyn and
uro-gyn regional trade
associations and individuals
4. Regional radio and billboard
ads
5. Broader use of PR and news
release tools
6.Gather customer testimonials
and feedback from test marketing
7. Evaluate use of referral
program
1. Use existing copy and creative
2. National social and viral
campaigns online (Facebook,
Twitter, YouTube)
3. National trade association
marketing
4. Optimize online buzz and viral
campaigns to gain maximum
exposure to worldwide audiences
5. Enlist support from nationally
known personalities and facilities
(e.g. Joan Rivers,
LiveStrong.com, etc.)
6. Testimonials and PR used
extensively

Enviage Vaginal Biofeedback by David Bychkov, PhD, CEO of Exmovere Holdings

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