If you’ve recently been told you have pelvic organ prolapse, you’re probably feeling overwhelmed with questions and concerns. The good news? You have more treatment options than you might think, and one of the most effective solutions might surprise you with its simplicity. Let’s talk about vaginal pessaries – a conservative treatment that’s helping women worldwide reclaim their comfort, confidence, and quality of life.
What exactly is pelvic organ prolapse?
Pelvic organ prolapse happens when the muscles and tissues that support your pelvic organs (bladder, uterus, and bowel) become weakened or stretched. This causes one or more of these organs to drop down into the vaginal space, creating that uncomfortable feeling of “something coming down.”
You might experience:
- A bulge or pressure in your vagina
- A dragging sensation in your pelvis
- Difficulty emptying your bladder completely
- Bowel movement challenges
- Lower back or pelvic pain
- Changes in sexual comfort
Here’s what’s important to know: you’re not alone. Research shows that up to 65% of women may experience some degree of prolapse during their lifetime, with symptoms becoming more noticeable as we age or after childbirth. While only about 21% find their symptoms truly bothersome, if you’re reading this, you’re likely in that group seeking solutions.
Enter the vaginal pessary: your conservative treatment champion
A vaginal pessary is a removable device made of medical-grade silicone or plastic that’s inserted into your vagina to support your prolapsed organs. Think of it as a personalized internal support system that holds everything in its proper place.
Why pessaries are such excellent news:
- Immediate relief: Unlike surgery, pessaries can provide symptom relief right away
- Reversible: You can try it without any permanent changes to your body
- Highly effective: Research shows that 70-90% of women experience significant symptom relief
- Long-term success: Most women who report successful pessary use at 4 weeks continue using them at 5 years
- May prevent progression: Some studies suggest pessaries might actually help prevent your prolapse from getting worse over time
Myth-busting: let’s set the record straight
Myth #1: “You have to be old to use a pessary”
Truth: Women of all ages successfully use pessaries! Whether you’re 35 or 75, if you have prolapse symptoms, a pessary could be right for you.
Myth #2: “Anyone with incontinence or prolapse can automatically use a pessary”
Truth: While most women can be successfully fitted with a pessary (up to 75% according to research), it does require proper assessment and fitting by a trained healthcare provider to ensure the right type and size for your specific anatomy.
Myth #3: “Pessaries are just a temporary fix while you wait for surgery”
Truth: Pessaries can absolutely be used as your primary, long-term treatment! Many women choose pessaries instead of surgery and use them successfully for years. Remember, surgery has a 30-50% failure rate, while pessaries offer immediate, reversible relief.
Myth #4: “You can’t manage a pessary yourself”
Truth: This is one of the biggest misconceptions! While some women prefer clinic-based care, many can learn to remove, clean, and reinsert their pessaries themselves. Self-management gives you complete control over your treatment and eliminates the need for frequent clinic visits.
Myth #5: “Pessaries will ruin your sex life”
Truth: Many women actually report improved sexual satisfaction after starting pessary use! Ring pessaries can often be left in place during intercourse, and research shows that 79% of sexually active women report improvement in sexual symptoms or enhanced relationships with their partners after using a pessary.
What to expect during your pessary fitting appointment
Knowledge is power, so here’s what typically happens during a pessary fitting:
Before your appointment:
- Your healthcare provider will assess your prolapse type and severity
- They’ll discuss your symptoms, lifestyle, and treatment goals
- A pelvic examination will determine the best pessary type for you
During the fitting:
- Your provider will try different pessary sizes and types to find your perfect fit
- You’ll learn how the pessary should feel when properly positioned
- Don’t worry if it takes more than one visit – getting the right fit is crucial!
- You’ll be taught how to check if the pessary is in the correct position
Testing your fit:
- You’ll be asked to walk around, cough, and bear down to ensure the pessary stays in place
- The pessary should feel comfortable and shouldn’t cause pain or significant pressure
- You should be able to urinate normally with it in place
Follow-up care:
- Initial follow-up appointments help ensure everything is working well
- You’ll learn about care and maintenance (and possibly self-management!)
- Regular check-ins help optimize your treatment
Types of pessaries: finding your perfect match
Ring Pessary: The most commonly used type, perfect for mild to moderate prolapse. It’s comfortable, easy to insert and remove, and can often be left in place during intercourse.
Cube Pessary: Excellent for women who have difficulty retaining other types of pessaries. It uses suction to stay in place and is particularly good for more advanced prolapse.
Gellhorn Pessary: The go-to choice for advanced uterine prolapse. It provides excellent support for more severe cases and has a high success rate.
Your healthcare provider will help determine which type is best based on your specific prolapse, anatomy, and lifestyle needs.
The life-changing benefits you can expect
Research consistently shows remarkable improvements in quality of life for pessary users:
- 90% of women experience relief from that uncomfortable bulging sensation
- 70% improvement in pressure symptoms
- Significant reduction in urinary difficulties (40-97% improvement in obstructive voiding)
- Better bowel function with 28% improvement in difficult evacuation
- Enhanced daily activities – you can exercise, work, and care for your family comfortably
- Improved sleep and energy when you’re not dealing with constant discomfort
Taking control: self-management is possible
One of the most empowering aspects of pessary treatment is that many women can learn to manage their pessary independently. Self-management means:
- Removing your pessary at home for cleaning
- Reinserting it yourself when ready
- Having complete control over your treatment schedule
- Reducing the need for frequent clinic visits
- Greater flexibility for travel, intimacy, and daily activities
Recent research shows that women who self-manage their pessaries report excellent outcomes with minimal complications – giving you the freedom to take charge of your own pelvic health.
Your next steps: taking action
If you’re intrigued by the possibility of pessary treatment, here’s how to move forward:
- Talk to your physician about pessary options during your next appointment
- Consult with a pelvic health physiotherapist who can assess your pelvic floor and discuss conservative treatment options
- Ask for a referral to a healthcare provider experienced in pessary fitting if your current provider doesn’t offer this service
- Don’t accept “surgery is your only option” – pessaries are a valid first-line treatment for pelvic organ prolapse
The bottom line: you have options
Pelvic organ prolapse doesn’t have to control your life. Vaginal pessaries offer an effective, conservative treatment that can provide immediate relief while giving you complete control over your care. With success rates of 70-90% for symptom relief and the possibility of preventing prolapse progression, pessaries represent hope, empowerment, and a return to the activities you love.
Remember, most women who find success with pessaries at 4 weeks are still happily using them 5 years later. That’s not just treatment – that’s transformation.
Ready to explore pessary treatment? Reach out to healthcare providers experienced in pelvic health, such as specialized pelvic health physiotherapists at clinics like Blueberry Therapy, who can guide you through your options and help you reclaim your pelvic health.
Want to learn even more?
Check out Episode 21 of The Hole Shebang podcast, which dives deep into everything about pessaries. It’s a fantastic resource to complement what you’ve learned here and can help you feel even more confident about discussing pessary options with your healthcare provider.
The evidence is clear: you don’t have to live with prolapse symptoms, and you don’t have to rush into surgery. Pessaries offer a proven, conservative path to relief – and your journey to feeling like yourself again could start with a simple conversation with your healthcare provider.
