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It can be used with 2 or 4 pads. It works very well to shut off menstrual pain without drugs with a large panel of intensity and different modes. It is delivered with a "container" that can holds on your clothes/belt if needed while avoiding to press the buttons.
The only downside is that it works with batteries instead of charging by plugging it in (because it's not the 90's, it never occurred to me to check this aspect) but at least the 1st 2 batteries are delivered with the device. I still highly recommend it, it's a great portable device to treat pain and except for the wires, the pads are very thin so it's easy to wear under your clothes.
