How To Properly Use A Pessary

It’s one thing to have a doctor tell you to use a pessary, and quite another to get used to the routine of inserting and removing one.

It might leave you puzzled and asking: How do I properly use a pessary?

Here’s what you need to know about a pessary, what it’s for, and how to properly use it.

Why Have I Been Given a Pessary?

If your doctor has suggested using a pessary, it’s likely for one of two reasons:¹

• to help manage the symptoms of pelvic organ prolapse, which is when a pelvic organ has slipped from its regular place in the pelvis. 
• to help manage the symptoms of stress urinary incontinence, which is when you leak urine when you laugh, cough, sneeze or exercise.

A pessary is one form of treatment for conditions that occur when your pelvic floor muscles weaken. Your pelvic floor is a hammock-like structure that holds your pelvic organs in place, including your uterus, bladder and urethra, vagina and rectum. The pelvic floor also supports pregnancy and the functions of peeing, pooping and having sex. 

If those muscles become injured or weak, the organs can slip out of place and cause pelvic organ prolapse, or lead to stress urinary incontinence.

What’s a pessary? It’s a removable device that goes inside your vagina, usually made of soft silicone, that supports your pelvic organs.¹ It is a firm ring that presses against the wall of the vagina and urethra.² People with POP and/or SUI have found a pessary use to be an effective treatment option to manage their symptoms.³

If you have stress urinary incontinence, other options to manage your symptoms include urethral inserts, seal pads and bladder neck support devices.

How Do I Properly Use A Pessary?

Your doctor will make sure that you receive the proper size and type of pessary, as it should be fitted to meet your anatomy and needs. You shouldn’t notice it once inserted. Your doctor will also give you advice on inserting, removing and other tips on using the pessary.

Here are the basics.²

1. Inserting the Pessary:

• Wash your hands.
• Grasp the device midway and fold it in half. The curved part should be facing the ceiling. 
• Put a small amount of water-soluble lubricant on the insertion edge.
• Hold the folded pessary in one hand and spread the lips of your vagina with the other hand. 
• Gently push the pessary as far back into the vagina as it will go, while squatting, standing with one foot propped on the tub or toilet, or sitting with your feet propped up.

2. Removing the Pessary:

• Wash your hands.
• Find the rim of the pessary just under the pubic bone at the front of your vagina. Hook your finger under or over the rim.
• Tilt the pessary slightly and gently pull down and out of the vagina. 

3. Caring for your pessary:

• Pessaries can be left in place for up to a week and removed for periodic easy cleaning. 
• Some women choose to remove the pessary nightly before bed and replace it in the morning. 
• It can be left in during intercourse if this is comfortable for you.
• Some women experience dryness, so be sure to use unperfumed soaps around your vagina.
• If you have sensations of pressure or rubbing, or if you notice any unusual vaginal bleeding or spotting, call your health care provider immediately. 

What Else Can I Do?

If you have been provided a pessary for your weakened pelvic floor muscles, you can also begin a regimen of pelvic floor muscle exercises, also known as “Kegels” after the doctor who invented them.

These exercises have been shown through research to be effective at keeping pelvic floor muscles “fit.” They can be used as an effective treatment for women suffering with stress urinary incontinence, prolapse and other pelvic issues. They can also be performed as a preventive measure before the muscles become too weak.
You should make sure you’re doing it correctly. One way is by using a tool like Gynesis. Gynesis FDA-cleared pelvic floor trainer shorts support women to take control of their pelvic health with a simple, effective, external, and accessible solution.  Using advanced Multipath Technology, Gynesis delivers targeted muscle stimulation with Kegel exercises that helps retrain and rebuild your pelvic floor—so you can achieve stronger bladder control and with confidence.

Check With Your Doctor 

Our Physician Finder will help you locate a doctor near you with expertise in women’s health. You can ask about using your pessary, and how you can start pelvic exercises to lessen the symptoms of weakened pelvic floor muscles.