Pessaries 101: A Complete Guide to Non-Surgical POP Management

When you're diagnosed with pelvic organ prolapse, surgery isn't your only option. Many women successfully manage their prolapse with a pessary, a simple device that provides support without surgery, hormones, or medications.

What is a Pessary?

A pessary is a removable device that sits inside your vagina to support your pelvic organs. Think of it like a supportive bra for your pelvic floor. It holds things in place, preventing your organs from dropping down and causing discomfort.

Modern pessaries are made from medical-grade silicone, making them comfortable, safe, and easy to clean.

Who Can Use a Pessary?

Pessaries work for many women with pelvic organ prolapse. They're especially good for women who want to avoid surgery, are still planning pregnancies, have health conditions that make surgery risky, or simply prefer non-surgical options.

Common Types of Pessaries

Ring Pessary - The most popular. Easy to insert and remove yourself. Works well for mild to moderate prolapse.

Ring with Support - Similar to a regular ring but with extra support across the middle.

Gellhorn Pessary - Provides strong support for advanced prolapse. Usually requires a doctor to insert and remove.

Cube Pessary - Very effective but needs to be removed and cleaned daily.

Your doctor will help you find the right type and size for your body.

Getting Fitted

Finding the right pessary takes some trial and error. Your doctor will try different sizes and shapes until you find one that stays in place comfortably. You shouldn't feel it once it's properly fitted.

After your initial fitting, you'll return in a week or two for a check-up to make sure everything is working well.

Living with a Pessary

Most women adapt quickly. You shouldn't feel your pessary during daily activities. You can exercise, travel, and live normally. For intimacy, many women simply remove ring pessaries beforehand and reinsert them after.

Cleaning and Maintenance

Self-Managed Pessaries: Remove, wash with mild soap and water, and reinsert weekly or as recommended. Some women do this daily, others weekly.

Doctor-Managed Pessaries: Your doctor removes and cleans these every 3-6 months during regular appointments.

Potential Issues

Some vaginal discharge is normal. However, see your doctor if you experience excessive discharge, odor, irritation, or if your pessary keeps falling out. Regular check-ups help catch any problems early.

Pros and Cons

Advantages:

• Non-surgical and reversible

• Immediate relief

• Cost-effective

• Safe with proper maintenance

• Can be removed when not needed

Disadvantages:

• Requires ongoing maintenance

• May need to be removed for intimacy

• Doesn't cure prolapse, just manages symptoms

• Takes some getting used to

Success Rates

About 50-75% of women who try a pessary continue using it successfully. Many women use pessaries for years or even decades. Some use them temporarily while strengthening their pelvic floor, others use them long-term.

Questions to Ask Your Doctor

• Which type do you recommend for my situation?

• Will I be able to insert and remove it myself?

• How often will I need check-ups?

• Can I have sex with it in place?

• Can I exercise with a pessary?

• What happens if it doesn't work for me?

Is a Pessary Right for You?

A pessary might be a good choice if you want to avoid surgery, have health conditions that make surgery risky, are planning future pregnancies, or simply prefer a reversible option.

Trying a pessary doesn't mean you're committing forever. If it works, great! If not, you still have other options.

The Bottom Line

Pessaries offer a safe, effective, non-surgical option for managing prolapse symptoms. While they require maintenance, thousands of women successfully use pessaries to stay active, comfortable, and in control of their lives.

You don't have to choose between living with uncomfortable symptoms and undergoing surgery. A pessary might be the solution you're looking for.

Living with Prolapse?

Join the APOPS community forum to connect with other women who use pessaries. Share experiences, ask questions, and get support from thousands of women who understand what you're going through.

You're not alone. We're here to help.