Understanding Pessaries: A Supportive Solution
As a pelvic floor physiotherapist, one of the most rewarding aspects of my work is helping women feel empowered in managing their pelvic health and getting back to the things they love- without pelvic floor symptoms. One tool that often comes up in conversation, yet may not be widely understood, is the pessary. This simple, often life-changing device can offer significant relief for many women, particularly those experiencing pelvic organ prolapse (POP) or other pelvic health issues.
Okay, But What is a Pessary?
A pessary is a small, flexible device that is inserted into the vagina to support the pelvic organs. It’s typically made of medical-grade silicone and comes in various shapes and sizes to suit individual needs. While the term “pessary” might sound unfamiliar to some, it’s been used for centuries as a non-surgical option for managing pelvic conditions.
A few examples of the different styles of pessaries
How Can a Pessary Help?
Pessaries are most commonly used to help women with pelvic organ prolapse (POP), a condition where the pelvic organs (such as the bladder, uterus, or rectum) descend or bulge into the vaginal canal due to weakened pelvic floor muscles. This can lead to symptoms like:
A feeling of heaviness or pressure in the pelvic area
Urinary incontinence
Difficulty with bowel movements
A noticeable bulge or sense of fullness in the vagina
For women experiencing POP, a pessary provides essential support to the pelvic organs, helping to reduce these symptoms. By holding the organs in place, a pessary can alleviate discomfort and improve overall quality of life.
In addition to POP, pessaries can also be used for other pelvic health concerns, such as stress urinary incontinence (leaking urine when coughing, sneezing, laughing, running, jumping etc.), and can sometimes be beneficial for postpartum women or those recovering from pelvic surgery.
Who Can Benefit from Using a Pessary?
Many people find that a pessary can provide a non-invasive, effective alternative to surgery. While not everyone will be a candidate, a pessary might be an ideal solution if you experience one or more of the following:
Symptoms of pelvic organ prolapse (POP)
Mild to moderate urinary incontinence
A desire to avoid surgery or delay more invasive treatments
Seeking an option that can be used temporarily while pursuing pelvic floor rehabilitation
It’s important to note that using a pessary is not a cure for pelvic organ prolapse, but it can significantly improve symptoms and quality of life. It’s often used in conjunction with pelvic floor physiotherapy, where we address the root cause of many pelvic health issues by strengthening and supporting your pelvic floor muscles, learning how to manage pressure, and more.
A Helpful Analogy: The Sports Bra of Pelvic Health
One of the best analogies I’ve heard, but won’t take credit for, is that a pessary is a bit like a sports bra in the way it provides support. Think of it this way: Just as a sports bra helps support the breasts during physical activity, a pessary provides support for the pelvic organs. And just like people vary in how they use a sports bra — some wear it just for exercise, some prefer to wear one most of the time, and others even sleep in one — the same goes for pessaries. Some women only need to wear their pessary when symptoms are most noticeable, while others may choose to wear it throughout the day or even overnight for extra support.
This analogy helps frame the pessary as a customizable solution, something that fits into your daily routine in a way that works best for you.
Types of Pessaries
Pessaries come in a variety of shapes and sizes, including:
Ring pessary: One of the most common types, shaped like a ring, it provides support for prolapsed organs.
Gellhorn pessary: Typically used for more advanced prolapse, with a disc shape and a stem that can be removed for cleaning.
Cube pessary: Smaller and compact, often used for mild prolapse cases.
Donut pessary: Provides a soft, supportive structure ideal for various prolapse degrees.
Choosing the right type of pessary is a personal decision that should be made with a healthcare professional’s guidance. A pelvic floor physiotherapist or gynecologist can help you determine the best option based on your symptoms, anatomy, and lifestyle.
How to Care for Your Pessary
Taking care of your pessary is essential to ensure it continues to work well and remains comfortable. Here are a few simple steps to follow:
Clean it regularly: A pessary should be cleaned thoroughly with mild soap and water at least once a week, or more frequently if needed.
Follow your healthcare provider’s guidance: They will show you how to insert and remove your pessary comfortably and safely.
Keep track of how it feels: Pay attention to any discomfort or changes in symptoms, and don’t hesitate to reach out to your healthcare provider if something feels off.
How to Get Started with a Pessary
If you think a pessary might be helpful for you, it’s important to first consult with a pelvic health professional, such as a physiotherapist or gynecologist. During a thorough assessment, we’ll discuss your symptoms, your medical history, and any goals you have for your pelvic health. If a pessary is recommended, we’ll work together to find the right type and size, and ensure that you’re comfortable using it.
It’s worth noting that not all pelvic health physiotherapists are trained to fit pessaries, so it’s important to find a physiotherapist who is familiar with them and has experience fitting and advising on their use. A trained pelvic health physiotherapist can guide you through the process and ensure that the pessary fits well and provides the support you need.
Final Thoughts
Pelvic health and dealing with pelvic organ prolapse can be frankly scary and embarrassing topic for many women, but it’s one that deserves attention and care, and does not need to be scary or embarrassing. A pessary can offer a non-invasive, effective way to manage symptoms of pelvic organ prolapse, urinary incontinence, and other common pelvic concerns. When combined with pelvic floor physiotherapy, it can be part of a comprehensive treatment plan that helps you regain comfort and confidence in your body.
If you have questions about pessaries or want to explore pelvic health treatments that might be right for you, feel free to reach out. I’m always here to help! I'm on instagram (nope, no medical advice there), or email works too!
