Prolapse Surgery Alternative: How to Use a Pessary

All of your intimate questions answered about pessaries! What they are, how to use a pessary, and how to know what types of pessaries are best. 

A pessary is often bypassed as a treatment option, leaving people to think that surgery is their only option. But if you're looking for a non-surgical option to manage your prolapse, then a pessary might be just what you are looking for!

This post is based on highlights from Episode 59 of my podcast, Dr. Bri Talks Lady Bits — an awesome interview with physiotherapist Michelle Lyons. If you have tried a pessary or are looking for a surgery alternative, then please listen to the full episode. To hear the entire interview, click to listen:

Or if you prefer to watch it on YouTube:

What is a pessary?

A pessary can be a plastic solid circle, a silicone ring, or a cube that goes internally into the vagina. It helps support the pelvic organs, keeping everything in place.

Pessaries are safe and effective devices that can help women with prolapse. They are ideal for stage 1 and 2 prolapse; however, certain types of pessaries may be helpful for more advanced stages of prolapse as well.

A pessary acts like “a sports bra for your vagina,” keeping everything in place!

It’s important to know that pessaries are NOT just for the elderly. In fact, pessaries can be an effective alternative to surgery for women of all ages. Pessaries are an under-pursued solution for prolapse issues. A pessary is a simple, low-cost, conservative option to try before surgery, and honestly, due to biases and assumptions, they are not tried often enough. 

Some women are fitted with a pessary and use one happily for many years. A pessary CAN be a long-term solution, bringing the wearer back to the active lifestyle she had before her pelvic organ shift. Women with a well-fitted pessary don’t feel discomfort, and due to the added support, they can return to exercise and heavy lifting with confidence. 

How to know if a pessary is right for you

...and how to use a pessary

“It is not a one size fits all…” -Michelle Lyons 

While there are “over-the-counter” options, it’s best to see an OB-GYN, nurse practitioner, or physiotherapist for a fitting. (Regulations vary by country when it comes to healthcare providers that can provide pessary fittings.)

It typically takes time and testing to find the right size and type of pessary that works for you. All bodies are different, and everybody’s history is different. Take time to learn how your body feels with the pessary. If you try a style that does not feel good, request to try a different size and/or type for comfort.

Tip: find a provider that will take the time to find the most helpful pessary for you. It could take several attempts to find the right one for your body!

How to use (and care for) your pessary

Topical estrogen cream can help with insertion and keeps the vaginal tissues healthy. Ask your doctor if topical estrogen is right for you, and work with your healthcare provider to help you learn to properly insert the pessary. Regular checkups are necessary for tissue evaluation.

You can use simple soap and water for cleaning your pessary.

Some pessaries can be left in for 3-6 months (you can even have sex with these types of pessaries), whereas others are removed every day. Some people only use their pessary during exercise. It depends on the type of pessary, and the needs of the client.

Even more about pessaries...

Learn more about this non-surgical alternative:

This is just the beginning of the information about pessaries as a conservative option to prolapse repair surgery! To learn more about daily life with a pessary, listen to the entire interview. You will learn: 

• Can pessaries be used during exercise?

• Can you have sex with a pessary?

• Are pessaries safe during pregnancy?

• Do they weaken or "overstretch" the tissues?

• Can products such as collagen supplementation, or red light therapy help with tissue health?

• Does nutrition help with tissue health? 

LASTLY... It's important to know that a pessary is just PART of a total-person treatment plan for pelvic wellness!

Pessaries are meant to be used in addition to conservative management. They don’t replace it.

If you have access to a pelvic floor physical therapist in your area, it's ideal to see someone in person for 1:1 evaluation and treatment. And for at-home prolapse support, CLICK HERE TO LEARN MORE ABOUT MY "LIFT" PROGRAM AND TO GET THE FIRST WEEK FOR FREE!

*NOTE: This website in general, and this article specifically, is for general information and educational purposes only. It is not intended to diagnose or treat any medical condition, but rather to understand what options are available. Please seek the advice of a physician to properly diagnose your symptoms.