What is a Pessary?
A Pessary is one of the tools that can be used to help manage symptoms of prolapse and incontinence. It’s used to provide structural support of the vagina and to reposition the organs into a better position. This can help manage the symptoms of prolapse and prevent the prolapse from worsening. It can be used to provide occasional support from symptoms during certain activities or more often to prevent or prolong the need for surgery. So you can use the pessary to help you return to activities you previously enjoyed prior to your prolapse diagnosis!
Pessary: How to get one
Pessaries come in many shapes and sizes and each type has its own purpose. Some are better at managing symptoms of particular prolapses than others. A pessary is something that you will usually need to see a Urogynecologist to be fitted for. Everyone’s body and vagina are different so it’s important to be wearing the appropriate pessary for you to avoid any issues.
Most commonly I have seen pessary use being brought up by Pelvic Floor PTs than OB Providers referring you but can make the recommendation.
Usually, you will need a referral put in by a doctor, so bring it up to your OB or Primary Care Provider to get that.
At the appointment, they will ensure the pessary fits well and that you know how to place and remove it yourself. Once it’s in place you should not feel or notice it, and symptoms should be improved while in place!
Side Effects & Complications
There are some possible side effects and complications with pessary use since it is a foreign device being placed in your body. Most common is an increase in vaginal odor and discharge. This could be associated with a vaginal infection like bacterial vaginosis or a yeast infection. It could also just be from the position of the pessary in the vagina. I found that I had an increase in vaginal discharge with my pessary because the pessary would hold the discharge in until I would be in a certain position and it would all come out at once. So, I found wearing a panty liner when I wore my pessary to be useful.
This is not something you have to wear every day, especially if it is only for symptoms management. You may only need to wear it on days you have increased symptoms or doing an activity you need some extra support like running, jumping, or heavy lifting.
My Personal Experience
My experience with a pessary is I had a goal to return to running and due to my symptoms, I was not able to run without symptoms, so it was suggested by my pelvic floor PT to try out a pessary. She was able to put the consult in and I was fitted with a ring pessary (see picture below). I would at first only wear the pessary when working on Labor and Delivery and when I would work out.
Then over time as my pelvic floor healed more I needed to wear it less and less till the point I no longer needed it…then I got pregnant. I found it to be a great tool to use till my body and pelvic floor built up the strength to be able to support my pelvic organs on their own, without me having to worry about worsening my prolapse. It did take time to master being able to place it and take it out. At first, I would feel some heaviness after taking it out, but that was more due to getting used to not having ANY heaviness with it in and then having my usual amount when it was taken out. Over time, as I got more comfortable with it I didn’t experience that heaviness after its removal anymore.
I would recommend anyone interesting to ask their provider or Pelvic floor PT if a pessary would be beneficial to your recovery!