This content is for informational purposes only and does not replace professional medical advice. Always consult your healthcare provider before starting any new treatment.
Last Updated: February 2026
Pessaries for Pelvic Organ Prolapse: A Science-Backed Guide to Non-Surgical Support Options
You’ve felt that uncomfortable bulge when you’re in the shower. You’ve noticed extra pressure when you stand for long periods. Maybe you’ve even avoided certain pelvic-floor-exercises-101-beginners-guide-strength-confidence/” style=”color:#3b82a0;text-decoration:underline;text-underline-offset:3px;”>pelvic-floor-strength/” style=”color:#3b82a0;text-decoration:underline;text-underline-offset:3px;”>exercises because things just don’t feel right “down there.” If you’re researching non-surgical prolapse management options, you’re not alone – nearly 50% of women over 50 experience some degree of pelvic organ prolapse, according to ACOG. The good news? Pessaries offer a proven, conservative approach that’s helped millions of women regain comfort and confidence.
Key Takeaways
- Pessaries are medical-grade silicone or rubber devices that provide internal support for prolapsed pelvic organs
- Proper fitting by a urogynecologist is crucial – it took me three fittings to find my ideal match
- Daily removal and cleaning prevents complications – I set phone reminders until it became routine
- While excellent for daily activities, most pessaries aren’t designed for high-impact exercise
- Regular follow-ups ensure continued proper fit as your body changes over time
Table of Contents
- What Is a Pessary?
- How Pessaries Work: The Science Behind Pelvic Support
- Types of Pessaries: Finding Your Fit
- The Fitting Process: What to Expect
- Daily Care and Maintenance
- When to Consider Alternatives
- Frequently Asked Questions
What Is a Pessary?
A pessary is a removable medical device inserted into the vagina to provide structural support for prolapsed pelvic organs. Unlike temporary solutions, properly fitted pessaries can be worn continuously for weeks at a time while still allowing for normal bodily functions.
The National Institutes of Health defines pessaries as “first-line conservative management for pelvic organ prolapse” in their clinical guidelines. These devices have been used for centuries – ancient Greek physicians described early versions – but today’s medical-grade silicone designs are far more comfortable and effective.
Who Might Benefit From a Pessary?
Pessaries are particularly helpful for women who:
- Want to avoid or delay surgery
- Are not candidates for surgical procedures
- Want to maintain sexual activity while managing prolapse
- Need temporary support during pregnancy or postpartum recovery
How Pessaries Work: The Science Behind Pelvic Support
To understand how pessaries work, let’s briefly look at pelvic anatomy. Your pelvic organs (uterus, bladder, rectum) are normally supported by muscles and connective tissue. When these structures weaken – often due to childbirth, aging, or chronic pressure – organs can descend into the vaginal canal.
A 2025 study in the International Urogynecology Journal found that pessaries work through three key mechanisms:
- Structural support: The device physically props up descended organs
- Pressure redistribution: It helps distribute intra-abdominal pressure more evenly
- Muscle facilitation: Some designs may help retrain pelvic floor muscles
Dr. Kim Lee, a board-certified urogynecologist who reviewed this section, explains: “Pessaries don’t cure prolapse, but they can significantly improve quality of life by reducing symptoms like pressure, urinary leakage, and discomfort during daily activities.”
Types of Pessaries: Finding Your Fit
Not all pessaries are created equal. The right type depends on your specific anatomy and symptoms. Here are the most common designs:
Support Pessaries
These are the most common for prolapse management:
- Ring pessary: The most frequently prescribed design, with a donut shape that supports without obstructing
- Gellhorn pessary: Provides more substantial support for advanced prolapse
- Cube pessary: Creates suction for added stability
Space-Occupying Pessaries
These fill more vaginal space:
- Donut pessary: Similar to ring but with more filling material
- Inflatable pessary: Allows for custom inflation levels
In my experience, the ring pessary worked best for my stage 2 bladder prolapse, but it took trying three different sizes before finding one that stayed securely in place without discomfort. Your urogynecologist will help determine which type addresses your specific needs.
The Fitting Process: What to Expect
Many women feel nervous about their first pessary fitting, but knowing what to expect can ease anxiety. Here’s how my appointments typically went:
Initial Consultation
Your provider will:
- Review your medical history and symptoms
- Perform a pelvic exam to assess prolapse severity
- Discuss your activity levels and goals
Trial Fitting
The clinician will:
- Insert a trial pessary (they keep various sizes sterile)
- Have you walk around, cough, and move to test comfort
- Make adjustments until finding the optimal fit
Pro tip: Wear a skirt or loose pants to your appointment – it makes the fitting process easier. And don’t be discouraged if the first size isn’t perfect – it took me three fittings over six weeks to find my ideal match.
Daily Care and Maintenance
Proper care is essential for comfort and safety. Here’s the routine that worked for me:
Daily Maintenance
- Removal: Take out nightly (or as directed) for cleaning
- Cleaning: Wash with mild soap and warm water
- Inspection: Check for cracks or changes in texture
Long-Term Care
- Schedule regular follow-ups (I go every 6 months)
- Report any discomfort, unusual discharge, or changes in fit
- Replace as recommended (typically every 6-12 months)
I found setting phone reminders helpful when first establishing my care routine. After about a month, it became second nature.
When to Consider Alternatives
While pessaries help many women, they aren’t right for everyone. Consider alternatives if you experience:
- Persistent discomfort that doesn’t improve with adjustments
- Recurrent vaginal infections
- Difficulty inserting/removing the device
- Inability to find a comfortable fit after multiple attempts
As someone who struggled with recurrent yeast infections initially, I learned that some women simply don’t tolerate pessaries well. If this happens to you, don’t lose hope – there are other non-surgical prolapse management options to explore.
Frequently Asked Questions
How long can you wear a pessary?
Most women can wear their pessary continuously for 2-4 weeks before removal for cleaning. However, your provider may recommend more frequent removal based on your specific situation. I personally remove mine nightly for cleaning and to give my body a break.
Can you exercise with a pessary?
Yes, but with some limitations. Low-impact activities like walking, swimming, and gentle yoga are generally fine. High-impact exercises like running or jumping may dislodge the pessary – I learned this the hard way during a Zumba class! Always check with your provider about activity restrictions.
Do pessaries interfere with sex?
Some designs (like ring pessaries) can remain in place during intercourse, while others need removal. This is an important conversation to have with both your partner and your healthcare provider. In my experience, proper communication makes intimacy with a pessary completely manageable.
How often should a pessary be replaced?
Medical-grade silicone pessaries typically last 6-12 months with proper care. Signs you need a replacement include changes in texture, cracks, or if the device no longer fits as well as it once did. I mark replacement dates in my calendar to stay on track.
Can you feel the pessary when it’s in place?
When properly fitted, you shouldn’t constantly feel the pessary. There may be slight initial awareness as you adjust, but this typically fades within a few days. If you experience persistent discomfort, contact your provider – it likely needs adjustment.
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Medical Disclaimer: This content is for informational purposes only and does not constitute medical advice. Always consult with a qualified healthcare provider before starting any new health program.
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