• Emily Reul, PT, DPT

Pessaries

Updated: Nov 24, 2020

Hello friends! Have you ever heard of a pessary? Today we’re going to discuss what a pessary is and why you might benefit from one.


WHAT IS A PESSARY?

Pessaries are used to help with pelvic organ prolapse symptoms. They can be used to help prolapse from progressing to a more severe stage or may even be able to prevent prolapse for those at high risk of developing it. (Bo, 2015) It is a device (typically made of silicone) that is inserted into the vaginal canal to provide internal support to the walls of the vagina. (Bo, 2015) Pessaries have been used since ancient times, and they used to be made of materials like pomegranates or wool—thankfully technology has advanced since then! (Bo, 2015)


WHAT IS PELVIC ORGAN PROLAPSE?


Pelvic Organ prolapse is the descent of the bladder, cervix, or rectum into the vaginal canal due to insufficient support. To learn more about pelvic organ prolapse, visit our full blog post.




HOW DO I KNOW IF I HAVE PELVIC ORGAN PROLAPSE?

Your provider may have diagnosed you with pelvic organ prolapse after an internal examination. Symptoms of pelvic organ prolapse are often heaviness “down there” or you may even feel a bulge in the vagina. Watch this video from Jeanice to learn how to check for pelvic organ prolapse. If you think you may have it, talk with your provider.


HOW DOES A PESSARY WORK?

Once the pessary is inserted into the vagina, it can alleviate those symptoms like heaviness and vaginal bulging by providing physical support to the vaginal walls to stop the pelvic organs from falling. Pessaries are an alternative option for women who cannot or do not want to have surgery for pelvic organ prolapse. (Bo, 2015) Pessaries are designed to be lightweight to avoid straining the pelvic floor muscles with frequent use. Some objects like “jade eggs” or “yoni eggs” are similar to a pessary but they are weighted and can cause pelvic pain and spasm in the pelvic floor muscles if worn for long periods of time.


WHAT ARE THE BENEFITS OF USING A PESSARY?

One study found 60% of women after 3 months of pessary use reported improvements in bowel, bladder, and prolapse symptoms. (Cundiff, 2007) A pessary may help to prevent further progression of prolapse . They can be used as a preventative measure in high risk women such as those with chronic lung disease or with jobs that require heavy, repetitive lifting to prevent them from developing pelvic organ prolapse. (Bo, 2015) A pessary may even help to change structure of the vagina by slightly decreasing the size of the vaginal canal. (Bo, 2015)


WHAT ARE THE DRAWBACKS TO USIGN A PESSARY?

Pessaries require regular check-up visits with your provider. If not properly cared for, pessaries can cause infection, vaginal bleeding, cervical incarceration, or become embedded in the vaginal canal. (Bo, 2015) These side effects are most likely to occur in pessaries that are neglected and not changed regularly. (Bo, 2015)

You may also be uncomfortable with using internal support or using a pessary just may not be the right solution for you. That’s okay, but there are other ways to address pelvic organ prolapse symptoms.


WHERE CAN I GET A PESSARY?

Pessaries come in many shapes and sizes and you will need to find a pessary that’s the best fit for you and your needs. In the United States, you get be fitted for a pessary during an appointment with your nurse of physician. In some other countries your pelvic PT can fit you with a pessary.


ARE THERE ANY ALTERNATIVE NON-SURGICAL OPTIONS?

In addition to pessaries, you can use other internal support options like, a sea sponge, tampons, Poise Impressa, or a menstrual cup. To learn more about internal support options, check out our YouTube video here.


If using an internal support option isn’t right for you, there are also external support options that can help to alleviate the heaviness and vaginal bulging symptoms. You can find some examples here in our Amazon Store. If you want to learn more about external support options, watch our YouTube Video here.


You may get the best results when using a pessary, or external support, in addition to pelvic floor muscle training and lifestyle modifications like good bowel habits to prevent constipation and bladder training.


Are you ready to manage your prolapse? Here are some steps you can take now:


What experiences or tips do you have that can help others? We’d love to hear them. Please join the conversation in the comments section below.  


Written by Emily Reul, PT, DPT


References

1. Cundiff GW, Amundsen CL, Bent AE, et al. The PESSRI study: symptom relief outcome of a randomized crossover trial of the ring and Gellhorn pessaries. Am J Obstet Gynecol. 007 Apr;196(4):405.e1-8. doi: 10.1016/j.ajog.2007.02.018.

2. Bo K, Berghmans B, Morkved S, Van Kampen M. Evidence-based physical therapy for the pelvic floor bridging science and clinical practice: 2nd edition. 2015. 230-233.

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This information is for awareness purposes and not individual medical advice. You should seek your own professional counsel for any medical condition or before starting or altering any exercise or fitness program.

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