How Pessaries Can Help Prolapse Symptoms And Support

Pessaries for Prolapse Management – A Non-Surgical Alternative for Some Women

pessaries

Antique carved pessary

Are you seeking to avoid prolapse surgery?

Want to reduce bothersome prolapse symptoms?

Pessaries have been used for centuries by women seeking to manage pelvic prolapse. The hand carved antique bone pessary (shown right) dates back to the 1860’s and is not too different to the modern day pessaries available today.

Unfortunately many women don’t know about how a pessary may help them better manage their prolapse symptoms and help to avoid prolapse surgery.

Read on now to learn all about pessaries for prolapse with:

  • What is a pessary?
  • Why use a pessary?
  • How does a pessary work?
  • Potential benefits of using a pessary
  • How does a well fitting pessary feel?
  • How is a pessary fitted?
  • Vaginal oestrogen and pessary use
  • When is a pessary not suitable?
  • When is a pessary less effective?
  • Side effects of pessaries
  • Sex and pessary

What is a Pessary?

A pessary for prolapse is a support device that is inserted to sit high within the vagina.

Pessaries are designed to support the collapsed walls of the vagina, and the prolapsed organs pessaries(bladder, bowel and/or uterine prolapse). Modern day pessaries come in a wide range of shapes, sizes and different designs (shown right).

A support pessary is quite different from a pessary or tablet/capsule that is inserted into the vagina to delivery medication to the pelvic floor (e.g. vaginal oestrogen pessary).

Pessaries have been used by women for centuries manage pelvic organ prolapse. Reports of pessary use date back to ancient Egypt. Over the ages women have used a variety of materials for pessary support including fruit (pomegranates), stones, soaked cloth, cork,  brass and rubber. Today most pessaries are made from medical grade silicone or plastic which are readily cleaned, and non absorbent.

Why use a Pessary?

Women may use a support pessary to support their prolapse for a number of reasons including:

  • A desire to avoid or delay prolapse surgery
  • To allow exercise with a prolapse
  • Early stage prolapse
  • Desire for future pregnancy
  • During pregnancy or following childbirth
  • When unsuitable for pelvic prolapse surgery
  • Previous failed prolapse surgery
  • To manage stress incontinence and prolapse
  • During pelvic floor muscle rehabilitation for prolapse
  • With advanced age.

It may well be that by pessary devices can help women with pelvic floor exercises by lifting and supporting prolapsed tissues – this has not yet been confirmed (but is currently being investigated) by studies but this is a plausible theory.

It is a surprising that more pessaries are not fitted to help women to exercise with a prolapse and avoid prolapse symptoms with exercise.

Overweight women struggling to improve their pelvic floor strength and prolapse support are another group who might benefit from the added support of a pessary. This might be worth discussing with your medical specialist as a possible management option if this applies to you.

How Does a Pessary Work? Pessaries

A pessary provides a mechanical or physical support to hold up the prolapsed tissues within the vagina. It does this by occupying space high within the vagina. This can have the effect of lifting the walls of the vagina higher within the pelvis, and providing a support for the bladder, bowel or uterus.

The image (right) shows a fitted white ring pessary sitting at the top of the vagina.

Pessaries are designed in a variety of shape and sizes, and for different types and severity of prolapse. Some of the small flexible ring pessary designs can inserted on a daily basis or as required to support during exercise or activity. The less flexible space occupying pessaries are mostly designed to stay within the vagina for a designated period of time, before being changed over by the medical specialist.

Potential Benefits of Using a Pessary

There are a number of potential benefits that may be derived from pessary use. These potential benefits need to be weighed up against any possible side effects or risks, and in conjunction with the expert opinion of your medical specialist regarding your individual suitability.

Potential benefits of using a pessary for prolapse management may include:

  • Decreased prolapse symptoms
  • Delay or avoid pelvic prolapse surgery
  • Possible prevention of prolapse worsening
  • Allow for exercise with prolapse
  • Possible aid or adjunct to pelvic floor muscle rehabilitation.

How Does a Pessary Feel?

A well fitting pessary is comfortable and the wearer is usually unaware it is even there.

Discomfort wearing a pessary can be a sign that the pessary is not the right size or that it may have slipped out of position. If you feel discomfort when wearing a pessary you should consult your treating doctor.

How is a Pessary Fitted?

A pessary device is usually fitted by a gynaecologist or obstetrician. Your medical specialist will take some internal measurements of your vagina based upon an internal vaginal examination and will consider the nature and severity of your prolapse, whether you seek to be sexually active with the pessary fitted along with these measurements to fit the correct pessary for you. He or she will usually fit the largest size pessary possible that feels comfortable when fitted.

Successful fitting is usually indicated when the pessary: pessaries

  • Stays in place with walking, coughing and bending
  • Feels comfortable and pain free
  • Does not interfere with bladder or bowel emptying
  • Does not cause unwanted bladder leakage.

Sometimes it takes a couple of attempts with different styles or sizes of pessary to get the correct fit. It should be possible to fit a finger around the outside of a well fitted pessary. It is useful to know that you can empty your bladder normally with the pessary in place comfortably before leaving your pessary fitting so that it can be changed if necessary.

Some of the flexible pessary designs allow women to use and remove themselves as desired. Other pessaries are designed to stay in place once fitted for a specified time before being changed by the specialist. This may be something you wish to discuss with your specialist before fitting.

A woman needs to be willing to have regular medical follow-up, have intact cognition and adequate manual dexterity to be considered appropriate for fitting with a pessary.

Vaginal Oestrogen and Pessary Use

Vaginal oestrogen is commonly prescribed before or at the time of pessary fitting. Vaginal oestrogen is often prescribed for pessary use to improve the thickness and condition of vaginal tissues for prevention of infection or tissue erosion. This is a consideration for women with previous breast cancer, where consultation with their treating breast specialist is warranted for assessment regarding their individual suitability for vaginal oestrogen.

When is a Pessary Not Suitable?

A pessary is not appropriate for women with:

  • Active vaginal infection
  • Pelvic Inflammatory Disease
  • Ulceration of vaginal walls
  • Vaginal bleeding where the cause is unknown
  • Allergy to silicone and latex
  • Poor compliance with ongoing medical supervision and follow-up.

When is a Pessary Less Effective?

It is quite common to require a number of pessary fittings to achieve the correct size and design.

There are a number of recognized predictors of poor success when fitting a pessary.

Predictors of poor success1 may include:

  • Shortened vaginal length
  • Wide vaginal opening
  • Past pelvic surgery (including hysterectomy).

Side Effects of Pessaries

Pessary devices are generally considered to be a safe prolapse management option for women with few complications2. Possible complications or side effects can usually be avoided with ongoing medical monitoring have once been correctly fitted.

Some of the more commonly reported side effects of pessary devices include:

  • Vaginal bleeding , constipation2
  • Mild vaginal discharge, increased odour1

There have been some reported rare serious complications associated with pessary use, usually with devices that have not received regular ongoing medical supervision having once been fitted1.

Sex and Pessary pessaries

Your doctor will take into account your preference for sexual activity when fitting you with an appropriate pessary for your lifestyle.

Sexual intercourse can proceed with certain styles of support pessary not needing to be removed (e.g. ring, gehrung).

Some of the space occupying pessary designs do need to be removed before intercourse (e.g. cube).

Some pessaries, particularly those used for more severe prolapse cannot be removed by the user (e.g. gellhorn shown above right) and are therefore unsuitable for women seeking to remain sexually active with a pessary fitted.

Pessary Summary

A support pessary can provide a simple and effective prolapse management strategy and may be particularly for women seeking to avoid or delay prolapse surgery and minimize prolapse symptoms. Pessaries are not for everyone with a prolapse – some women choose to wear a pessary as an interim prolapse management measure while others find that a pessary helps them to manage symptoms as an alternative to prolapse surgery. The decision about whether or not to wear a pessary ultimately rests with you and your Obstetrician or Gynaecologist.

Next: How to Know if Your Support Pessary Fits You Well

Shah et al (2006) The history and evolution of pessaries for pelvic organ prolapse. International Urogynecology Journal of Pelvic Floor Dysfunction. Feb;17(2):170-5.
Guidelines for the Use of Support Pessaries in the Management of Pelvic Organ Prolapse. Continence Foundation of Australia and International Centre for Allied Health Evidence, 18th July 2012.

prolapse exercisesABOUT THE AUTHOR, Michelle Kenway

Michelle Kenway is a Pelvic Floor Physiotherapist and author of Prolapse Exercises Inside Out. Prolapse Exercises is a complete exercise guide for women with prolapse and after prolapse surgery seeking to exercise safely and protect their pelvic floor.

Comments

  1. This was very helpful and informative. I have a ring pessary with support that I wear when on my feet for long periods and remove when not. I have no desire for surgery at this time and do my exercises daily which normally keeps me symptom free. Thank you for all you do, when tis prolapse occurred I was caught unawares, good to know it is a common occurrence and can be lived with.

    • Jill Cooper says:

      What exercises are helping you? I have grade 2 cystocele. I Start pelvic floor therapy this week. pessary fitting is this week as well.

  2. Frances Everitt says:

    This is a really useful and informative article. I am very grateful for your regular newsletter and the valuable information it delivers. Thank you

  3. I was recently diagnosed with a Stage 2 cystocele, a Stage 2 rectocele and a Stage 1 uterus prolapse.
    I was fitted by a Urogynecologist with a ring pessary with support and only wore it about 4 times off and on because it would cause discomfort especially in my back area, like pressure.
    I don’t know if the pessary to too big or maybe I need a different shaped pessary but the bugling sensation that I felt at the entrance of the vaginal opening when I wore the pessary was gone. I didn’t feel the bulge, but the pressure and discomfort in my back area cause me not to want to wear it. I felt the pain and discomfort for 3 or 4 days after wearing the pessary. Any suggestions? I would appreciate it .

    • Michelle Kenway says:

      Hi Jo Ann

      Yes I understand this problem, unfortunately this type of thing happens quite often after initial fitting. Often it takes a number of fittings to get the right size and style of support pessary, so try not to be too disheartened by this one episode, it can be a little bit of trial and error. Return to your gynaecologist and explain what has happened after fitting – my guess is that he/she will try another size or style of pessary. The ring pessary isn’t the only style available either so the possibility of alternative styles may be worth discussing with your specialist too.

      Best of luck
      Michelle

      • Thank you so much Michelle for the reply. That’s good to know that happens often. I plan to return back the Urogynecologist that I saw and let her about the problem.
        Hopefully a different size or possibly even a different style will help me.
        Thank you again for your encouraging reply, that made me understand and feel better.
        Jo Ann

        • Michelle Kenway says:

          My pleasure Jo Ann, if you can get it sorted out it can help avoid/delay surgery so it’s definitely worth the effort, even though it’s a bit of a trial when this happens. Good luck!

          • Thank you again Michelle. I hope the pessary will help. I do not want to have the surgery, at least not anytime soon.

  4. i used a pessary successfully for about 20 years but my prolapse had recently become painful and had reconstruction w/hysterectomy and mesh. I’m 53 and play soccer frequently as well as ride and care for horses. I was wondering if I could prolong the stability of my reconstruction by wearing my pessary (gelhorn) during more strenuous activiites that would put more pressure on my pelvice floor??

    • Michelle Kenway says:

      Hi Allison
      It sounds as though you are very active, and I understand that caring for horses involves some heavy lifting. It may be possibility that a pessary might help in view of the poten tial for strain, particularly if your pelvic floor muscle support is weak or previously damaged. I think you need to be careful with your history of pelvic pain and reconstruction – this is something to discuss with the gynaecologist that did your reconstruction surgery.
      Best of luck
      Michelle

  5. marie mcneil says:

    I am looking for information on inflatible pessaries.

    • Michelle Kenway says:

      Hi Marie
      Sorry I do not know of these, maybe one of our readers can assist you?
      Michelle

  6. Hi , if you have a pessarie fitted can you do any physical activity you like ? High impact activity and not worry about making rectocele any worse ?
    Mandy

    • Michelle Kenway says:

      Hi Mandy
      A well fitting pessary will support the prolapsed tissues and does allow women to perform exercises they might not be able to. I am unable to comment on whether a woman with a pessary can stop worrying about worsening rectocoele, there really is no research that I know of that investigates whether pessary stops or delays prolapse worsening. I would think that it makes sense that if the internal tissues are being well supported, then prolapse progression would seem less likely.
      Michelle

  7. Hi
    I have been wearing a pessary for about 15 months now, and have had it changed every 4 to 6 months to date. On my initial visit, the gynaecologist said I had a moderate cystocele and mild rectocele.
    Have looked at your posts and other websites and am a little unsure whether I have right size or not. I do experience some discomfort at times – bulge in vaginal area when can’t go to toilet. I have, for example, had constipation on and off prior to being fitted, and still have diffculty with bowel movements at the moment, even though real attempts have been made to improve diet. Would like to know: is constipation a side effect of wearing a pessary, or am I experiencing more bouts of constipation because it is ill fitting. When I have a new pessary put it, my local GP seems to think pessary is in right position, but are they the experts in this field? He said that bulge is caused by rectum pushing into vagina and prescribed sennakot.
    My doctor has suggested going back to gynaecologist regarding having a hysterectomy as best surgical procedure to resolve problem. I am wanting to avoid this really. Would I be better going back to the hospital for an assessment? Going on holiday next month and feeling a bit fed up with situation.

    • Michelle Kenway says:

      Hi Pat

      Yes constipation can be a potential side effect of a pessary if it is pushing backwards into the rectum. It can in effect block the rectum a little bit decreasing the space for bowel movements to pass through, a bit like stepping on a hose. Then if the outflow is slowed, the whole system can back up – and this is the case with bowel movements. A well fitting pessary should allow for a finger to be placed under/outside the rim of the pessary around the circumference if this makes sense. If your doctor has cleared you of any other problems causing constipation, and if you think your pessary is slowing your bowel movements, phone your gynaecologist, explain to the recepetionist and they would be most likely to get you back in to check the sizing. I am not sure where you are writing from however in Australia the GP referral to the gynae remains valid for 12 months (usually).

      Incidentally Sennakot is a bowel irritant – works by irritating the bowel and so ultimately can lead to a sluggish bowel if used lont-term. There are excellent osmotic laxatives available these days that work simply by increasing the water content in the bowel and avoid that irritation, plus that horrible sensation of needing to empty urgently.

      Hope this gives you a little direction Pat
      Best of luck
      Michelle

  8. Hi
    I am coping with my bladder prolapse but feel that a pessary would be ideal for me for days of discomfort when looking after my one year old grandson. The lifting and bending is a real trial. My specialist has not suggested fitting me with one and suggested I use a tampon. This was extremely uncomfortable and dry even tho I used a lubricant.
    I have just read about sea sponges. Can you tell me is this something new ? Is it worth a try? I don’t go back to my specialist till October but feel as tho I should try a pessary idea. I awIt your comments. Thanks again for all your hard work on this website.
    Pamela

    • Michelle Kenway says:

      Hi Pamela

      Yes I think the tampon option is very short term trial and yes if you are post menopause you will need to use lubricant. The risk with prolonged tampon use is toxic shock and I think women need to be aware of this when using tampons for prolapse management. Many different objects have been used for pessary management – I have read that in ancient times pomegranite fruit was used with the aim of supporting the vaginal walls. Unfortunately I am unable to tell you about sea sponges and their efficacy or risks, I don’t believe their use for prolapse is widespread.

      Upon reading your comment my other thought is that if you are thinking along the lines of using a pessary, it could be wise to discuss this with your GP first if you have to wait for your Gynae appt. Ask him/her about your suitablity for use of vaginal oestrogen cream – this can assist with pessary tolerance as the oestrogen thickens the vaginal tissues. It could be worth commencing this before pessary fitting if you found that a tampon caused discomfort. This is just an idea and your suitability would need to be assessed by your doctor.

      Hope this helps you along Pamela
      Michelle

  9. Hi Michelle & everyone,
    I suffered a cystocele ( prolapsed bladder ) for quite a while..I was diagnosed 4 years ago with a stage 1 after feeling that terrible discomfort of a bulge.. Ive coped with the symptoms, and in April this year it got worse.. Im 65 years old, but very active, i go to dance classes regular, and used to be assistant aerobic coach for years.. My job over the years maybe didn’t help, ive been standing hairdressing since i was 15 and still do a bit even tho im retiring age.. I went to see a pelvic floor reconstruction consultant, who examined me and told me my cystocele was now a stage 3.. Ive never had children, but always suffered from constipation which also does’nt help.. My consultant decided i should try a ring pessary, which she fitted for me in August.. I was told to see her again in 3 months,, I must say ive had great relief, the bulge disapeared and ive felt so happy.. i do sometimes feel a little discomfort when bending for a while, maybe gardening etc… I had a hysterectomy in 1993 and so did’nt want to have another op.. I just hope i can keep manageing with the pessary without having to have surgery.. I do hope my info helps other ladies… Lets not suffer !!! – Good luck to all..

  10. Hi,
    I am so pleased to have found this web site, thank you for all of your information. Following the birth of my second child I have a stage 2 cystocele prolapse and are unsure if we would like a third child. I have a referral for a gynaecologist with a four month wait! Getting off track sorry. Being only 32 we would prefer to hold off surgery and feel that a pessery might be the best option? Could someone please advise if these items are possible with a pessery; playing tennis, going for runs, wearing a tampon?
    Thank-you

    • Michelle Kenway says:

      Hi Chelle
      A support pessary can be a great option for women seeking to hold off surgery, especially young women like yourself who have not completed their family. Your gynaecologist will assess your suitability for a pessary and then if appropriate work with you to select the best pessary for your needs.

      With the pessaries used for sexually active women, there is usually no problem wearing a tampon. Tennis is also often possible but will depend upon how well the pessary supports your prolapse. As far as running goes, this is a high impact exercise usually best avoided by women with prolapse in favour of other cardio exercises like cycling/spinning. You may like to read this article on running and prolapse

      Meanwhile there are benefits to be gained by doing your pelvic floor exercises daily and modifying exercise to low impact and appropriate strength training.

      Hope this answers your questions Chelle
      Cheers
      Michelle

    • I am 45 and was fitted back in August. It took 3 times to find the proper size. I run, box and lift weights. I am glad to know I’m not alone in this ordeal. I am very active and plan on staying that way. No surgery until absolutely necessary.

  11. joanne gorny says:

    i have a stage 4 cystocele and have had about 5 different fittings with pessaries. the one before the one I have now caused some erosion and bleeding in the vaginal walls. the one I have now is better, however I would like to try the inflatable one. I keep having bladder and urinary burning with relief from azo. my doctor keeps watching out for bladder infections as I use azo at least twice a week, especially when I am working and on my feet

  12. I am a mother of two and currently pregnant with my third. After my second baby was born I was diagnosed with a pelvic prolapse. My babies have all been over nine lbs so far, at birth. I recently feel like my prolapse is getting worse and try to do kegels and other exercises that my midwife has suggested. I’ve been watching your videos and reading the articles but they are still difficult to do and I find myself holding my breath and squeezing my abdominals, probably too much. Should I look into getting a pessary now or wait until after the pregnancy? Is it possible to still use an IUD for birth control with a pessary? I don’t want to have surgery and would still like to have another child after this, if possible. I will probably do physical therapy after this pregnancy, as well. Thanks.

    • Michelle Kenway says:

      Hi Marla
      Pregnancy and prolapse is a big challenge and really management comes down to daily pelvic floor exercises, resting the pelvic floor by placing the feet up where possible especially in the last trimester, managing bowels and avoiding straining and avoiding heavy lifting (easier said than done when you are looking after young children too).

      A pessary might be fitted after initial recovery from childbirth and it is usually possible to have an IUD with a pessary. The pessary supports the vaginal walls while the IUD is fitted within the cervix which may be elevated by the pessary. Pessary can be a great option for women like yourself seeking to manage their prolapse and have more children so this is an option well worth discussing with your gynaecologist after this pregnancy.

      Best of luck Marla
      Michelle

    • Suki Tutthill says:

      Before I was diagnosed with prolapse that required treatment my doctor referred me to a physical therapist who specialized in prolapse kegel therapy with biofeedback. I could actually see on a computer if I was doing the kegels correctly, the improvement, etc. It was well worth it. I was also experiencing the type of incontinence where I was talking myself into going to the bathroom every time I was near one, so therefore having to urinate all the time. With information and practice, I now only have to urinate every 3 to 4 hours and I drink about 2 quarts of water a day! I eventually was diagnosed with prolapse and just got a pessary as I didn’t want surgery before I tried something less invasive. I play lots of tennis and stand on my feet 4 days a week at work. So far, it’s working great and I put it in and out as I need it. I’m 66 and have also benefited from the Estrace I apply twice a week. I have also increased my water intake and bowel movements have become much easier, regular and NORMAL. As all of you, I’m grateful to find this website and thank you.

      • Michelle Kenway says:

        Hi Suki
        Great that the pessary is working so well for you! The combination of the pessary and vaginal oestrogn (Estrace) is important as you say to ensure the thickness of the internal vaginal tissues. Thanks so much for taking the time to share your experience and success story Suki!
        Best wishes
        Michelle

  13. Hi, I’m very interested to read all these stories. I am 48, had a hysterectomy in 2008 and during the last year have been investigating an enterocele and large rectocele. My gynae did ask ask me to have other bowel investigations as have ibs type symptoms and occasional incontinence (bladder & bowel) but nothing untoward was found apart form poor muscle strength due to very difficult labours and forceps deliveries of 2 children. Surgery is the next proposed option, however at no point have pessaries been discussed or offered. I’ve only recently understood more about them.
    I feel this option has been ignored in favour of surgery without giving me the chance, or is it a complete no no if a hysterectomy has already Taken place?

    • Michelle Kenway says:

      Hi Marian
      Pessary option for pelvic support is not exluded by a history of hysterectomy, so the anser to your question is that this may well be an option. One issue may be with the enterocoele (depending on the size) to ensure that the bowel is not at risk of obstruction simply due to the enterocoele itself – it would be worth asking why the surgery is necessary so that you are well informed to help you make the best decision for you. The pessary simply provides support to the lax pelvic floor tissues and for many women it is a viable option wirth discussing with the gynaecologist.
      Michelle

  14. Hi Michele,, its Suzie again.. I posted my comments in Sept about how happy I was with having the pessary fitted.. well im still happy not having the prolapse,, but I wonder if anyone has complained about soreness around the pubic bone, I wondered if this could be connected ?? My doctor doesn’t think it could be the pessary, but its strange that this tenderness has only appeared since it was fitted… please help if anyone has experienced this, i’d apprecitate your views ….

    Suzie..

  15. I recently got a gelhorn pessary and although I do like it and it seems to be working I don’t like that I have to take it out or plan to take it out when I want to get physical with my husband. My OBG told me this one was the best for me but after seeing this website I see there are other avail ones? I am only 36 yrs old and the reason why I got a pessary is because my OBG said that I am too young for surgery. I can’t exerise, sneeze, cough, laugh or pick anything up without urinating a bit. Can you advise if the gelhorn pessary is the correct one I should be using or can I get that ring kind where I don’t have to remove all the time.

    Thank you

    • Michelle Kenway says:

      Hi Denise
      There are indeed a wide range of pessaries available, some are better suited to some types of prolapse more than others. The best option for you will be to discuss your alternatives with your OBG making sure that you descibe the issue you are having with stress urinary incontinence (SUI). Some of the ring pessaries are especially designed to help with prolapse and SUI. Did the SUI just start when you had the gellhorn inserted or did it exist beforehand?
      Michelle

    • Michelle Kenway says:

      Hi Denise
      The gellhorn pessary is usually fitted for more severe prolapse with the ring pessary often one of the first pessaries trialled for mild to moderate prolapse. The type of pessary fitted can also vary according to the type of prolapse.

      Your doctor will have fitted the pessary he/she has assessed for your particular prolapse. It may be worth returning to discuss the problems you are currently having – I am not sure if the stress incontinence you describe has started since being fitted with the gellhorn. This issue is outlined further in this article on correct fit for pessary.There are some pessary designs that do address both prolapse and stress urinary incontinence that you describe.

      All the best
      Michelle

  16. I have been wearing a ring pessarie for about six months and it has been so good until now.The last couple of weeks the symptoms of prolapse have returned and it feels like the pessarie is not working anymore . could it be I need a different pessarie or the prolapse is getting worse. can you buy them at a chemist as I am going overseas next week and my doctors surgery is closed for the holiday.

  17. denise mallis says:

    I would welcome supportive comments on my existing problems. Unfortunately, I am allergic to both the PVC and Silicone pessaries and am asking is anyone aware of
    hypoallergenic composed pessaries. I am fine with a pessary as per prolapse but can
    not find what I need. Also with fairly advanced prolapse, do exercises really help?
    My only alternative is surgery which I dread, as I cannot use web and understand the bladder will drop in time even after a hysterectomy. thanks for comments.

    • Michelle Kenway says:

      Hi Denise
      I am sending out some feelers to other physios on the question of non silicone/non PVC pessaries so I will get back to you soon. I recall reading that historically women used all kinds of materials for pessary support including pomegranites and even pessaries made of gold. It would be great to hear from anyone else wo has overcome this same issue.

      Pelvic floor exercises have the potential to improve mild – moderate prolapse. In the case of severe prolapse the alternatives are usually confined to surgery or space occupying pessary suport. It is in the interests of women undergoing prolapse surgery to maximise their pelvic floor support with regular pelvic floor exercises pre and post op.

      I will be back in contact with you Denise, thank you for yur comment.

      Michelle

  18. I have a very large prolapse( probably stage 10 if there is a stage 10 cystocele) started out small but got larger. will a pessary work for me?

    • Michelle Kenway says:

      Hi Irene
      There are different types of pessary for different types and grades of prolapse. Larger prolapse is often better suited to the space-occupying pessary types e.g. Gellhorn or Donut pessary. These pessaries fill the space in the uper vagina to support the prolapsed vaginal walls. They cannot be removed for intercourse which makes them different to some of the other forms of pessary such as the Ring pessary. This option may be worth discussing with your gynaecologist Irene, I do hope this information helps you.
      Michelle

    • Irene I am also an Irene, I have just recently been fitted for a pessary for a huge cystocele like you, I think it is a stage 10 if there is such a stage, and it was like sitting on a balloon. Mine is a ring type and so far so good. Had to get a couple of fittings and hope this one is okay, but so far seems to be.I am still sexually active and this one works. Do not have to take it out. The ob/gyn says this stays in place without being removed. Four days a week I use estrogen and three times a week use an antibiotic gel. Have been wearing it now for about a month, but sure is nice not to have that huge bulge.I’m just praying that it keeps working. Have noticed that I do have to make sure I don’t get constipated and have no straining. So if anyone has any information on this would like to know.

  19. Hi I would like to ask a question. .. I was fitted with a ring pessary for the first time today after I was diagnosed with stage 1 uterine prolapse almost a year ago. At the time of insertion this morning it felt fine, I managed to pass urine and open my bowels normally, but this evening each time I bend or lift something I feel like a pressure inside. Could this mean I need to be fitted with a different size? I’m a midwife so it’s no problem for me to contact a gynaecologist as I work with them! This happened after my first and only birth. Thanks for the info..it feels good knowing I’m not alone with this problem

    • Michelle Kenway says:

      Hi Samantha
      My guess is that your pessary may have slipped down and yes this does happen quite often. You may be able to push it back up into place and speak with your gynaecologist, you may need a larger size or a different design. Always check out any discomfort when wearing a pessary with your doctor.
      All the best
      Michelle

      • Thanks so much..I talked to my Gynae this morning and that’s what he said too…he said I could have tried to push it back up, but he also suggested fitting me with a slightly bigger size.
        Thanks for the support

        • Michelle Kenway says:

          My pleasure Samantha, glad things are on track for you!

          • Samantha says:

            Hi Michelle, so after 2 months of trying to figure out what size of pessary suits me best..and after basically having my gynae scare me into an operation (because he really wants me to avoid it for now since I’m only 28yrs and just had 1 baby!), we finally found a pessary that fits, and finally I can say YEAY! It’s been almost a week since it’s been fitted and I feel like a normal person again! I can almost do anything, and when I struggle a bit, I just lie down and if it feels out of place I push it back up…the doc says it’s normal until it finds its place sort of! I’m really happy I didn’t give up on the pessary! I haven’t had marital relations with my husband with it inside yet though, and I’m afraid we might move it, or it falls out, or he feels it! Any one can give me some advice about intercourse with a ring pessary? Thanks for the support, it feels good not to be alone in this

          • Michelle Kenway says:

            Hi Samantha

            Well that’s great news! I am so glad to hear you feel normal again.

            Regarding ring pessary and intercourse there should be no issue at all. Your partner shouldn’t be able to feel it at all (it sits at the top of your vagina) and no it won’t fall out or become moved either. Ring pessaries can be used during intercourse. Some women with the removable types might choose to take them out but with the more rigid ring pessary they are designed to stay in place for 6 months at a time until returning to your gynaecologist to be checked. If you are still worried having read this information, phone your doctor’s receptionist and she should be able to speak with your gynaecologist and let you know on is behalf.

            I am so glad to hear that your pesary is working out so well for you.

            Best wishes
            Michelle

        • Hi Sam, your story sounds so much like mine only mines a grade 2. I was fitted yesterday with a pessary but it’s too small, keeps slipping down.

          So glad you got one that fits you, I’m going for a re fit Monday.

          How are you feeling now whilst using the pessary, it was great to hear you felt normal again

          Hope your well
          Kim

  20. Jacqueline says:

    Can you use a pessary with a iUD?

    • Michelle Kenway says:

      Hi Jacqueline
      Pessary can usually be used with an IUD – speak with your gynaecologist about the most appropriate design which will probably be a ring design (rather than the space occupying cube or gellhorn designs that cover the cervix). The reasons for not using a pessary are: the presence of active vaginal infection or pelvic inflammatory disease, vaginal bleeding where the cause is unknown or where follow up cannot be assured. Caution is advised for women on Warfarin (blood thinning medication) and for those women with mesh prolapse repairs.
      Michelle

  21. denise mallis says:

    Hi Michelle, great to receive such a professional response. Yes I have read tomes of info. about ancient and modern pessaries. What is needed is a material which does
    not oxidise and all I can think of is glass hardly practicle. May be this is why gold was chosen as it hardly gives off any material. A chemical engineering friend said that e.g. pvc gives off a gas similar to chlorine. I am sure the manufacturer has modified their material in the use of pessaries. I notice the older the item the lessit bothers me so would rather have less support than the awful rash it produces initially.
    The only

  22. Thank you for the response to my last question. Now I am wondering if a person with a severe cystocele can have a colonoscopy without any problems? this cystocele protrudes from the vagina like a balloon, unless I am sitting down.

    • Michelle Kenway says:

      Hi Irene
      I believe there is no issue for colonoscopy with a severe cystocele. For the procedure you are lying down and the scope is used in the bowel – I can’t see that it would obstruct the scope in any way. Confirm this with your gastroenterologist prior to your procedure.
      All the best
      Michelle

  23. Am 68, physically active, fitted with a pessary for a uterine prolapse. I have such a difficult time with insertion. With insertion at MD’s office, comfortable for 3 days. Removed for cleansing, Practice frequently and never achieve the same support. Seriously considering having uterus removed, Is there a secret for attaining the same support as the physician? thanks.

    • Michelle Kenway says:

      Hi Pat

      Do you mean that when you remove your pessary for cleaning you don’t achieve the same support when you replace it?

      It may be that the pessary is not corectly in place if the same level of support isn’t achieved. The success of your pessary will depend on the size and the style chosen by your gynaecologist. Some of the support pessaries for more severe prolapse are fitted and stay in place for a period of time (up to 6 mths) before removal for cleaning by the gynaecologist. It may well be that the size or style is not quite correct – I understand you may feel hesitant to be refitted following your first experience. The regular use of vaginal oestrogen when appropriate can also help thicken the vaginal tissues for comfort with a pessary.

      This article on how to know if your pessary fits well may also assist you Pat, I hope this information gives you some more direction – essentially return to discuss this further with your doctor.

      Kindest regards
      Michelle

  24. Christine says:

    I have been diagnosed with a severe prolapse and need to see a specialist in this feild next week, meanwhile my consultant fitted a pessary (ring) for me this morning which was fine i just felt a little bit of pressure. I went to work and for the rest of the day i have been experiencing a lot of pain which is just like contractions coming and going, is this normal?

    • Michelle Kenway says:

      Hi Christine
      No this is not normal, I suggest you return to your specialist for assessment and possible refitting of your pessary. The pessary should be retained in position without any discomfort having once been fitted. This article on how to know if your pessary fits you well should assist you too
      All the best
      Michelle

  25. I had a pessary fitted two weeks ago and it has been fantastic I am an active 65year old and of normal weight. My concern is exercise can I still attend my yoga class with no worries, I am on a waiting list for pelvic floor exercise at the hospital but it will be at least 13 weeks before I get an appointment so is it safe to just carry on as per normal. Thank you.

    • Michelle Kenway says:

      Hi Sue

      If your pessary has been correctly fitted there should be no reason why you can’t perform your normal activities without issue. You may wish to refer to these articles on how to know if your pessary fits well and also pelvic floor safe Yoga exercises to choose and avoid that are well worth knowing with prolapse issues.

      All the best
      Michelle

  26. I went to have a pessary fitted and I gave up because we could not find one that fitted. I did not want a pessary that I cannot remove myself. I cannot stop crying for the big disappointment and now I do not know what decision to make. I do not want surgery. I am 75 and love to walk. I walk every morning for an hour and half hour in the evening. I have a bladder prolapse, what should I do? I have an appointment with urologist in a month. She is the one that told me about the pessary

    • Michelle Kenway says:

      Hi Maria

      This must be a disappointment for you, I understand how you must feel. Maria why do you only want a removable pessary? If the prolapse is large, a more rigid pessary that stays in place for 6 months might assist you to stay confortable with your walking. The other option aside from pelvic flor exercises (Kegels) if your prolapse is moderate to severe would be to consider surgery so there are some decisions to be made.

      Finally you mention that you are seeing a Urologist – is this because you have a bladder prolapse or do you know what type of prolapse you have and its severity?

      Kindest regards
      Michelle

      • A week ago I went to a doctor for a second opinion about a pessary fitting.
        I was so surprised when the doctor examine me and fit me a pessary at her first try. It is a pessary that I can learn to take care and remove when needed.
        A week has passed and I so happy I cannot explain the turn around. No pains, no trying so many pessary without results, one try and I was on my way home.
        I will see her next week, to learn how to take care of it, and take it out and put it back in.
        I want to make sure that if someone had a bad experience like me, do not give up and seek a second opinion.
        Thank you Michelle

  27. hi, I am currently trying out a cube pessary for moderate prolapse. I am a 51 year old physio, active, love running (not long distances), gym work outs, walking, cycling.
    I am comfortable with the inserting and taking out of the cube and have been using some Pjur lubricant to help with this. I understand that overseas Trimosan is used. In your opinion, is Trimosan necessary? Btw- I do not and don’t particularly want to use Ovestin cream.
    thanks for your advice.

    • Michelle Kenway says:

      Hi Erica

      Thanks for you question – I haven’t used Trimosan and as I understand it, it’s used in some women to maintain the normal acidity/PH of the vagina and prevent bacteria from flourishing. This is different to the rationale for using Ovestin with a pessary which thickens the vaginal tissues to minimise the risk of vaginal wall erosion. If you are comfortable taking the cube out regularly and using Pjur and not having issues do you need to do anything further – I just wonder if the Hydroxyquinoline Sulfate in the Trimosan could erode the cube, just thinking outside the square? Is your gynae happy with you following your current regime?

      Cheers
      Michelle

  28. I’ve just had a ring pessary fitted as i was left with a bladder and rectal prolapse after the births of my two gigantic children. I do not have any discomfort but the pessary is sitting about 2 cm away from the entrance to my vagina. Although i have nothing bulging out anymore the prolapse isn’t really being held up. Not too sure how the pessary should fit! Does that sound normal for it to be where it is?

    • Michelle Kenway says:

      Hi Sarah
      A well fitting pessary should feel comfotable and pain free.
      This article explains how to know if your pessary fits well will answer your questions on this issue – please don’t hesitate to reply if you need any further clarification having read this information.
      Cheers
      Michelle

  29. Jill Cooper says:

    I wondering if recumbent bike at gym is okay for cystocele grade 2. I’m
    54 and use estrogen cream and have had huge rectocele repair four years ago.

    • Michelle Kenway says:

      Hi Jill
      I really like recumbent cycle for cardio exercise and pelvic floor protection. It is low impact and the recombent position can alleviate pelvic floor pressure for some women when compared with upright cycling. Keep the resistance low through your legs and rest your head back during cycling to protect the neck and avlid using your strong upper abs.

      All the best
      Michelle

  30. Hi,
    I have just had a ring pessary fitted and all my symptoms have cleared, have a mild bladder prolapse and stress incontinence, I feel much more confident now. I was wondering if I should do pelvic floor excersise while having a ring fitted and if this would help or hinder the ring. I don’t want to push it out with any pressure of the pelvic exercise.

    • Michelle Kenway says:

      Hi Susan

      Absolutely yes to pelvic floor exercises with a fitted support pessary! There is even some speculation that having a pessary fitted may improve the success of pelvic floor exercises. If you are confident that your pelvic floor exercise technique is correct ie lift up rather than push downwards then there should be no issue at all. This would seem to be an ideal time for strengthening.

      Best of luck
      Michelle

  31. Hi, I had a pessary ring fitted about three weeks ago and today I got my period. When I tried to insert the tampon I could feel the rubber ring like it has fallen out side ways, if that makes sense. Should I pull it out? Thanks

    • Michelle Kenway says:

      Hi Sandra
      Yes this can happen when the pessary moves out of position. Some women are able to push the pessary back into position while others choose to pull it out (squeeze the sides together as much as possible in doing so). You will probably need to return to your gynaecologist for refitting – sometimes it can take a number of attempts to get the right size so try not to feel too disheartened.
      All the best
      Michelle

    • Hi Michelle

      Thank you for your advice. I have had a bigger pessary fitted two days ago. I have since then experienced a dull ache similar to period pain. Is that normal and will it cease over time?

      Thanks Sandra

      • Michelle Kenway says:

        Hi Sandra

        This article on how to know whether your pessary fits should give you more information. The pessary should really feel comfortable and pain free when it is the correct size so that I would think that if the dull ache continues you will need to return to your specialist. Sometimes a different style of pessary can help with this issue too Sandra, this process does sometimes take perseverance.

        All the best
        Michelle

  32. Hi Michelle,
    I was wondering what you think of the Cross Trainer and also the Rowing Machine for someone with a stage 2 Uterine Prolapse.
    Also, I have tried a ring pessarie which felt supportive, but didn’t improve stress incontinence whilst exercising (I have used a contiform which is excellent for stress incontinence control, but does nothing to support my prolapse)
    I then tried a pessary which looked like a door knocker….a ring with a ‘knob’ on it which was supposed to support my prolapse and help with the stress incontinence. Due to its structure it needed to be removed as too much pressure on the urethra can be harmful long term (as I’m sure you are aware). Anyway…. I found it really hard to remove…its like my longest finger isn’t long enough to loop through it to pull it down and I have to ‘bear down’ to push it out…..the opposite of what I try to do the rest of the time!!
    I only really want to wear it when I exercise….can you recommend another device with a ‘handle’ maybe to help with removal.
    I have already spent a lot of $$ and have 2 pessaries in my bathroom which are of no use to me….I too am feeling disheartened…
    Thanking you in advance, Kate.

    • Michelle Kenway says:

      Hi Kate

      Yes good questions, thank you.

      Rowing machine needs to be used with caution with pelvic floor dysfunction and there are some rowing machine modifications that can be made to reduce the pressure on the pelvic floor as you will see in this previous comment. The Cross Trainer is appropriate low impact exercise however the resistance thought the legs should be kept light and the steps small rather than large.

      Regarding your questions on ring pessary for prolapse and SUI …I ran a search on the research into the efficacy of ring pessary for prolapse and there seems to be limited evidence supporting their use in the treatment of urinary incontinence. It sounds as though you have tried the ring with support and knob, unfortunately I don’t know of any product to help with removal (this isn’t to say there isn’t such a product available). I understand you must be feeling disheartened and I wish I could suggest another option in terms of pessary support. I am not sure which country you are writing from however in some countries there are urthethral inserts or urethral patches that may be worn with a ring pessary. The urethral inserts are reported to be safe however there may be some risk of mucosal irritation. Might be worth investigating to allow you to exercise with your ring pessary?

      Let me know if I can assist you further Kate
      Michelle

  33. Hello my 83 year old mom has a pessary which she has had changed every 6 months for the last 5 years. She has been experiencing bladder problems,increased frequency more noticeable in the morning and an uncomfortable feeling.Her gp has given her antibiotics but this does not help,all her recent urine tests are negative,Her gp has mentioned bladder investigations which she does not want,My question is that could this be an issue with her pessary? She had it changed a few months back and it made little difference.Is it possible that she may need a new size one? Is it unusual to need a different size after all these years in your experience? She has a large hiatus hernia also which I am not sure whether may affect her bladder positioning.Thank you

    • Michelle Kenway says:

      Hi Sheila
      It’s probably worth mentioning this to your mum’s GP – do you know if the gynaecologist fitted the same style and size of pessary she is accustomed to? I think this would be worth following up as a useful line of enquiry.

      Cheers
      Michelle

  34. Is it best to do kegal exercises with or without wearing a pessary? (Ring style). Also,
    is it right to be leaving a ring pessary in all night. Out just for once per month cleaning?

    • Michelle Kenway says:

      Hi Grace

      There is some thought that doing Kegel exercises while wearing the pessary may assist in cases where the pelvic floor muscles are weighed down by the prolapsed tissues. This may even be more relevant towards the end of the day if you notice your prolapse dragging and find it difficult to do your exercises. To date there is no hard and fast rule on this – use the pessary to assist your pelvic floor activation as needed. There is no issue at all leaving the pessary out for cleaning.

      Michelle

  35. Elizabeth says:

    Hi Michelle, I hope you can help me, I had surgery for a bladder prolapse in January this year, it lasted for 12weeks then came back but not as bad.I was recently fitted with a ring pessary but due to me having a hysterectomy years ago it wouldn’t stay in. I have also been diagnosed with osteoarthritis of the hip and lower spine,I am 62yrs old and have always been fit till now and I’m at a loss as where to go now, I will not have surgery again as it doesn’t seem to last.thanks Liz.

    • Michelle Kenway says:

      Hi Liz

      This is tricky isn’t it – you’ve had a tough time indeed.

      I hope you don’t mind me asking but was the pessary problem caused by vaginal shortening due to the hysterectomy surgery?

      Did your specialist offer you a range of pessaries to trial? Was it a ring pessary? It may well be that a different style of pessary might stay in place.

      I believe you do have management options Liz, I will wait to hear from you further.

      Best wishes
      Michelle

      • Elizabeth says:

        Hi Michelle, I have no cervix so the ring pessary had nothing to attach to,I was offered more surgery but am not going through that again, I’m not convinced it works one hundred percent,I’ve been using a kegel.8 since April and I’m taking vitamin d 3, I have just ordered some sea pearl sponges so will give them a try,the prolapse is not as bad as before the operation so it did help a bit I suppose, plus I don’t do any heavy lifting etc anymore.thanks Liz.

        • Michelle Kenway says:

          Hi Liz

          Interesting, the ring pessary doesn’t need to attach to a cervix, it really just sits in behind the pubic bone and the back wall of the vagina. Maybe it could be worth keeping in mind the potential for a different style of pessary as a possible option in the future? Just a thought …

          I’d really be interested to hear how you go with the sea sponges if you have time to send me a message as many ladies seek alternatives to support pessary.

          All the best to you Liz
          Michelle

          • Elizabeth says:

            Hi Michelle,tried the sponges and I’m afraid I couldn’t get away with them,they were uncomfortable,I used to have that problem whenever I tried tampons so I should have known really.i may give them another go,I’m also scared in case I can’t get them back out lol.at the moment I am using the kegel machine and doing pelvic floor exercises and I think I will just try and live with it as long as it doesn’t get any worse. i wish that I had known about pro lapses being so common but nobody talks about it,Liz. thanks.

          • Hi Michelle, I tried the sea sponges but wasn’t comfortable, am not surprised really as I used to have problems with tampons years ago,plus im scared I can’t get it back out lol.so I’m going to continue with the kegel machine and pelvic floor exercises and your advice from your website plus vitamin d3 and take it from there.liz.

          • Michelle Kenway says:

            Hi Elizabeth
            Thanks so much for letting me know about this! Was is just the fact that you were concerned about getting it back out? Was the sponge uncomfortable when in position? Did it relieve any prolapse symptoms?

            Thanks so much for your insights to help other ladies too

            Best wishes
            Michelle

  36. I tried using vaginal estrace. had very bad cramps, and headache. is there another cream to use in place of a hormone cream. Dr. did not suggest anything else. He wanted me to use this cream to strengthen the vaginal wall, before using pessary. Thanks for your input

    • Michelle Kenway says:

      Hi Dorothy

      Great question, unfortunately this is not my realm – I am aware of natural HRT alternatives to oral medication in Australia but I would love to hear about any natural HRT vaginal pessary alternatives, maybe one of our readers might be able to provide some information on this if in fact it does exist.

      Kindest regards
      Michelle

  37. Was fitted for pessary last week the huge bulg is gone but cannot hold my urine in have to wear a hug pad called the doctor she said that’s normal until my body adjuste to it.Does that seem right?

    • Michelle Kenway says:

      Hi Linda

      Thanks for your comment. If you checked with your specialist and she is happy then you have done the right thing. Did she check that you don’t have a bladder infection as a precaution?

      It may well be that you have some urinary urgency because the bladder has reduced space to fill if it was previously bulging into the vagina or perhaps the pessary is providing a little pressure into the bladder.

      Bladder urgency can be managed with bladder control training to increase the capacity of the bladder in some cases. If the problem continues and you feel uncomfortable it will be prudent to return for a medical review.

      All the best
      Michelle

  38. Hi there, what an awesome site! so glad I’ve found it. Im 47 & had a pessary ring inserted last week. Was diagnosed with a vaginal prolapse, grade 4 back wall, grade 3 front wall? Dr suggested surgery due to my age, but that freaked me out! actually nearly fainted! anyhow, have the ring inserted because im really scared to death of surgery! 8 days on, still getting used to it? I don’t think I can feel it? but sometimes when I cough, I get scared (had a cough last few days!). I managed to have sex few days ago, first time in months. Was scared of the pain, but it was ok? not great, hoping that improves, lol. I have 2 questions. I used to LOVE walking, & the other day went out for my 4km walk, first time in months, & by the end of it my vagina felt sore? or did I just imagine it? Is it only possible to feel the ring if it moves? I also used to love bike riding, but am scared to try this also, as that seems really, invasive isn’t the right word, but well I guess its sort of like sex, cause its getting hit, (sorry if TMI) thanks in advance. Kimmy

    • Michelle Kenway says:

      Hi Kimmy

      Thanks for your comments!

      Yes it is a big shock to learn you have a prolapse – then women all around you start coming out of the work work to tell you that they have a prolapse too, currently estimated at one in every two women that ever had a vaginal delivery so don’t feel you’re alone.

      To your questions – are you using vaginal oestrogen with your pessary (to thicken your vaginal tissues?), worth discussing with your doctor about your suitability if you’re not especially being close to menopause.
      Your pessary should feel entirely comfortable and you shouldn’t feel sore walking with a well fitting pessary. Bike riding should not be an issue at all – the pessary sits high within the vagina and should not be noticeable with riding.

      Getting the right fitting pessary does often involve a little trial and error. This article on how to know if your pessary fits you well will give you some more information too.

      Hope this helps you out Kimmy
      All the best
      Michelle

  39. kimmy parsons says:

    HI Michelle, thanks for the reply.
    I’m not using oestrogen? should I be? I am still taking the pill (trifeme) due to heavy periods. My dr wants me to look at other options, but i’m quite happy taking this.
    I’ve just come back from another walk, maybe its just in my mind lol I guess you just get used to one feeling, and now I have to get used to my vagina feeling another way?
    I managed to walk a lot more & NOT think about my vejajay, so maybe just time lol.
    Thank you :)
    KImmy

    • Michelle Kenway says:

      Hi Kimmy
      Good news about your walking and yes Trifeme contains oestrogen which helps nourish the vaginal tissues. This nice little brochure tells you a little more about when vaginal oestrogen is used however I prefer the water or silicone-based lubricants to the petroleum based lubes (eg KY Jelly).

      Give it time and see your doctor if you have concerns

      All the best
      Michelle

  40. Can a pelvic floor physiotherapist fit a pessary?

    • Michelle Kenway says:

      Hi Sharon
      Yes some Pelvic Floor Physios now fit pessaries – phone and ask before your appointment to check.
      best of luck!
      Michelle

  41. Greetings! I was recently told by my GYN the possibility of being fitted for a pessary due to vaginal/bladder heaviness & constant urge to urinate. I’m in extremely pain & concern about this new health issue. My question is… How well does a pessary works on a person with a complete hysterectomy? Is it worth trying the pessary vs. the surgery?

    Thanks for your input.
    Bianca

    • Michelle Kenway says:

      Hi Bianca
      Unfortunately it’s difficult to predict and compare the two. Women who’ve had hysterectomy surgery do get fitted with pessaries. Sometimes vaginal changes post op such as vaginal shortening can make fitting a pessary a little more difficult but there is no hard and fast rule. It is worth considering as a trial to avoid surgery if that appeals to you.
      All the best
      Michelle

  42. Hi Michelle,yes I am afraid in case I can’t get it out, I think I’m not putting it in far enough!! And there was blood on it when I got it out,I know that’s supposed to happen but it put me off using them. I’m not too bad at the moment and think the vitamin d3 is helping and I’m very careful about how I do things now,ie I have a garden stool with wheels so I can do my pots sitting down, and I use it in the house for jobs as well. Thank you for this site it’s very helpful, and it’s good to know that your not the only one this has happened too.Liz.

  43. Hi Michelle

    I wear a pessary for vaginal prolapse. Should I remove it when giving a urine sample during my annual medical exam? I do not have symptoms of UTI but my urinalysis shows microscopic amounts of blood in the urine. Could that be due to the pessary? Thank you.

    • Michelle Kenway says:

      Hi Eileen

      Interesting question – while the pessary is unlikely to be the cause of the bleeding in the urine sample if you can easily remove your pessary a few days prior to your test it might be good to eliminate this as a possible cause as I would think that the cause of the bleeding needs to be established. Check this with your doctor – there could be a very remote possibility of bleeding with the pessary.

      Keen to hear how you go with this

      All the best

      • Michelle

        In response to my prior question/issue, I took out the pessary for two days prior to providing a urine sample and this time the sample came back normal. That would seem to suggest to me that the pessary did create some unnoticeable bleeding?

        • Michelle Kenway says:

          Hi Eileen
          Thanks so much for that feedback – yes is one possible reason otherwise you may have had a UTI that has cleared up? Regardless this is a good outcome for you. I guess the decision for you now is whether to resume wearing the pessary and to ensure the fit is correct. Are you using oestrogen pessaries to thicken the inner vaginal walls? You may like to discuss this with your doctor too?

          Hope this helps! keep me posted Eileen and thanks for helping others too.
          Michelle

  44. Good evening.
    I’m Courtney. I’m 28 with a stage 2 cystocele, rectocele, and slight uterine prolapse as well. I have two children and I had gained a significant amount of weight, which I think caused the problems. I was fired for a ring pessary today. While the ring use I office felt fine, the ring I’ve tried inserting is causing pressure and cramping in my bottom, near my bum and off to the left. Could it be positioned wrong? I’m not sure if it is too big or not…

    • Michelle Kenway says:

      Hi Courtney
      Yes the pessary should feel comfortable and shouldn’t cause pain when it’s the correct size and fit. Yes it may well be too large – best to phone your gynaecologist’s rooms and let them know.
      All the best
      Michelle

  45. Are there any pessaries on the market that are hypo-allergenic, not made of silicone or latex. I experience severe burning and itching in vagina and other parts of my body. When I take out the pessary, symptoms go away.

    • Michelle Kenway Physiotherapist says:

      Yes Marilyn there are support pessaries mane of vinyl for women who can’t tolerate silicone

  46. Good evening,
    So pleased to have found this discussion.Age 74 with stage 1 cystocele have a ring pessary fitted which has from the start caused bleeding + odour.My GP says the NHS will only provide ring pessary so am unhappy with the situation,do not want to have an operation,the pessary works fine,is it possible for me to overcome this problem,also use estrogen cream ? Would going private help,any advice is welcome.Also have become incontinent.

    • Michelle Kenway says:

      Hi Judith
      Yes oestrogen cream is provided almost routinely here in Australia with the fitting of pessary unless for some reason it is not medically appropriate for that woman. This helps to thicken the tissues internally and reduce the likelihood of bleeding and erosion. It can also help to thicken in and around the urethra which may help a little with your incontinence too – along with the pelvic floor exercises that should be done daily. There are a range of different pessaries avaiable worldwide – not just ring pessaries and I would think that a good gynecologist would provide you with some alternatives to best suit your prolapse and your needs. Does this help you progress a little Judith?
      Kindest regards
      Michelle

  47. Hi there, I had a pessary ring fitted in July, and it was fine, but its now fallen out. I don’t feel comfortable at all putting it back in myself. My questions are, is this common, they fall out? I’m trying to think if I did anything different – I have gotten into an in ground pool, so from a standing position, I’ve sat quite hard on my bottom, on the side of the pool – due to having bad knees, I cant kneel. did that make sense? I have also been doing squats, on my kitchen chairs, for physio, for my knees, so i’m sort of hitting the chair with my bottom, & going back up again – would this hitting – loosen my ring? Interested in your response, thank you. ps, will have to make an appointment to see Dr. my vagina, seems a lil sore? i’m so embarrassed/mortified to say, I’m not sure how many days it was loose/in my vagina – why couldn’t I feel it? – I did have my period, & so I just thought, oh – its my pad I can feel? :(

    • Michelle Kenway says:

      Hi Kim
      Yes pessary rings can fall out from time to time. It will be a good idea to return to your specialist for assessment. You may need to be refitted with a new ring. If it was loose for a while it may have been rubbing causing some internal irritation – another good reason to return to your specialist. Unlikely your exercises caused it to come loose – especially if your knees are sore I assume your squats have not been deep, always keep squats shallow to protect knees and pelvic floor muscles.

      Hope this helps you out
      Michelle

  48. My doctor told me I did not have to come back after fitting me with my pessary. When reading your article I understand you should have medical monitoring. I was just fitted today for the first time, it slipped down a little already after using the bathroom.

    • Michelle Kenway says:

      Hi Annie
      Yes fitted pessaries definitely need to be monitored. Glad this article helped you!
      Michelle

  49. Hi Michelle, thanks so much for your reply. I did go back to my gyno & got a larger ring inserted. So fingers crossed will see how this goes. I’m really not happy about my gyno (& have little options due to where I live) because she is so matter of fact – oh well if this doesn’t work, you will need to have the surgery – like its nothing??? its not nothing!!! the thought of THAT surgery is horrifying to me & she is so nonchalant about it? Didn’t I read somewhere that sometimes the surgery doesn’t always work & you need it AGAIN? any ladies on here, had the surgery? very interested in your responses please . thanks, Kimmy

    • Michelle Kenway says:

      Hi Kim

      Yes agreed the prospect of prolapse surgery can feel terrifying. Yes again the surgery can fail – it can be worth asking the doctor for her own success rates with the type of surgery she is suggesting (as opposed to general success rates).

      Fingers crossed that this pessary does the job for you Kim! Thanks so much for the update and sharing to help others too!

      Don’t forget your pelvic floor exercises – these might be easier with the pessary in position.

      Best of luck Kim
      Michelle

  50. This article about pessaries was very helpful. I have a prolapsed uterus (3rd stage) and would like to avoid surgery. However, since estrogen is used, I am not sure if this is an option for me. I had a breast lumpectomy almost five years ago and take a medication (Arimidex) to block estrogen in my body for five years (I will cease taking the medication on May 1, 2015). My gynecologist says the estrogen used for the pessary is not a problem; my oncologist says it may be a problem. Is there anyone else by any chance in the same situation who may have some input to share? Thank you.

    lj

    • Michelle Kenway says:

      Hi Lynne

      Sounds as though your oncologist and gynecologist need to have a chat with each other about your management. Oestrogen is often prescribed with a pessary to thicken vaginal walls and prevent vaginal erosion as you are probably aware having read this article.

      Lynne you may be interested in reading this academic article on safety of vaginal oestrogen – you will see that it states “Systemic absorption of some local oestrogen preparations has been supported by the observation that breast tenderness occurs among some users of vaginal oestrogen” p 242.

      Hope this gives you some information to discuss with your doctors.

      All the best and always keen to hear how you go.

      Regards
      Michelle

  51. Hi Michelle,

    Many thanks for sending me the academic article about the safety of vaginal oestrogen. My only other alternative is to have surgery, and I have many questions on that subject also. I am trying to become as knowledgeable as possible about both options before making a decision.

    All the best,
    Kind regards,
    Lynne

    • Michelle Kenway says:

      My pleasure Lynne – I hope that it gave you a little more information to help in your decision making.

      All the best to you
      Michelle

  52. I have a bulge in my vagina, and the OBGYN told me it is my colon bulging , What would be the best treatment for me now because this is the second time for me, First surgery did not last,

    • Michelle Kenway says:

      Hi Diana
      Thanks for your comment. Diana which treatment are you referring to? pessary or otherwise as alternative to surgery.
      Kindest regards
      Michelle

  53. Hi Michelle,I wondered if you could help. its my Mum who is 78 year old . She has a prolapse of the bladder . She has been going to the Doctors and has had 5 rings fitted .and all have fell out . She is due in 5 days to have number 6 fitted . What do you surgest? Thanks Christine.

    • Michelle Kenway says:

      Hi Christine

      Your poor mum – she must be beside herself with all this going on! Christine has the doctor tried different styles of pessary for this issue? There are many other styles aside from ring pessaries and some are better suited to mature ladies with this type of issue. This is worth asking the doctor about without doubt.

      All the best
      Michelle

  54. Hi Michelle, My Mum has appointment now at the local hospital, so with any luck she will have better look there. If no luck with the pessaries what would you recommend ? Thanks Christine.

    • Michelle Kenway says:

      Hi Christine
      Your mum’s options are really 1. pelvic floor training 2. pessary 3. prolapse surgery 4. do nothing – the options are limited for someone like your mum who doesn’t want surgery and for whom pessary is unsuitable – I feel for you both and just wish there was more to suggest in the way of possible alternatives. Some mature aged women who are no longer surgically active have a surgical procedure called Colpocliesis where the vaginal walls are stitched up in the mid line preventing any further prolapse by closing up the vagina. I am not suggesting this alternative – just letting you know your options.

      Let me know how you go and what is suggested if you have time, I am keen to hear.

      All the best Christine
      Michelle

      • Christine says:

        Thanks Michelle , I will let you know how she gets on and what they suggest . Hopefully we will have better luck at the hospital. Thanks very much I appreciate your help. Christine.

  55. Hi Michelle, i’m very upset, because my 2nd pessary ring has fallen out & my Dr says the only other option is surgery???? OMG NO. I just presumed she would reinsert the ring? I’m only 47 & terrified! Should I get another opinion? ( I really don’t think I can due to my location) – please can you give me some advice, – or is there any other ladies who have had this surgery, willing to talk to me? PLEASE HELP – IM DISTRAUGHT
    ps, Due to being late December, I have made an appointment just to TALK to my gyno. ……
    thanks,
    kimmy.

    • Michelle Kenway says:

      Hi Kim

      Great idea to talk to your Gynaecologist – I know of women trying 3-4 different designs of pessary before coming across a suitable fit so wait to speak with your specialist before making decisions about this. Not aonly are there different sizes but a range of styles, I think this would be worth discussing with your specialist. Some pessaries are better suited to one form of prolapse than another. Did you just try 2 different sizes of a ring pessary?

      Take an deep breath & let me know
      Michelle

      • Christine says:

        Hi , Michelle, just a quick up date . My Mum went to see a specialist at hospital ,where he said she had a prolapse of her womb ,and also said that the ring pessary would never have worked and could not believe that the doctor had fitted six. He fitted her with a Gell Horn I think and for three weeks she has had no problems , but now she says she thinks it has moved .Its not given her pain , but she says she can feel pressure. So whether that is normal because things are still settling down ,or it has moved I don’t know. Looks like the best option is to take her back to Hospital. Christine.

  56. christine says:

    Hi i had a ring pessary fitted last week, i had to have a bigger size fitted as it kept moving when i had a bowel movement.my worry is about having sex i havent been able to have sex for months as it has be too uncomfortable,can i start having sex again while wearing the pessary is it safe.

    • Michelle Kenway Physiotherapist says:

      Hi Christine
      Yes sex is safe provided that the pessary is appropriate and comfortable during sex e.g. ring pessary. Some pessaries need to be removed e.g. cube and gellhorn.

  57. Hi everyone..I had a posterior repair two years ago but now have an anterior prolapse. I had a ring fitted today by my doctor as the heavy feeling of something falling out between my legs horrified me. Today I feel normal, it’s the best I’ve felt in a very long time and ever so gratefull for this little ring! I’m awaiting an appointment as I’ve opted for intense physio instead of another operation as I need to keep working being self employed which this moment in time is so hard as I’m constantly on my feet etc….. I would highly recommend a pessary ring, best choice I’ve made so far. I’m wondering if I can still go dancing??!! Any answers from any lady’s in same predicament? Thankyou

  58. hi im 23 and just had my 2nd child 2 weeks ago. I have a prolapsed uterus. from research it seems to be stage 3. protruding from the vagina. when I look with the mirror I can see it between my labia, and when I sit I can feel it being pushed back up. after long periods standing it feels like heaps is being pushed up when I sit, and otherwise I can only feel a little being pushed up. the doctor only suggested doing pelvic floor exercises, but I cant feel it doing anything at all. I was wondering, do you think getting a pessary fitted is a option for me? I don’t want any more kids in the immediate future, and im still young and don’t want to lose my sex life either. what kind would you recommend?

    • Michelle Kenway says:

      Hi Jessica

      Thanks for your comment/question. I think that support pessary is often a great option to help many new mums get on with motherhood and manage prolapse.

      To be honest I am often really often surprised that support pessaries aren’t offered to new mums more often to help them cope, especially when dealing with moderate prolapse combined with the physical workload of a new baby.

      It can take a little trial and effort to get the right size/style however the relief that can be provided by a well fitting support pessary is worth the effort especially when surgery is just out of the question and pelvic floor exercises are going to take quite some time to provide relief immediately after childbirth.

      Hope this helps you Jessica
      All the best
      Michelle

  59. My mum is a stage 4 stomach cancer patient. Her bladder/uterus have prolapsed outside the vagina and is giving her a lot of misery. The pessary inserted by the urologist does not stay in place for long. What else can we do as doctors are not keen on surgery given her chemo treatment and age (she’s 72 years).

    I understand that infection will set in periodically with the hanging uterus/baldder outside the body. Chemo cannot be continued until infection clears up. There does not seem to be any light at the end of the tunnel. This condition is robbing her of the limited quality of life as it already is.

    Appreciate any help rendered. Thanks!
    Linda

    • Michelle Kenway Physiotherapist says:

      Hi Linda
      There are many different types of pessaries – it might be possible that another type or style might help your mum. I understand that your mum doesn’t want to be messing around with repeat trials of pessary however this could be worth discussing with her urologist or gynaecologist. Maybe you could phone her Urologist to discuss this possibility to avoid an extra medical appointment for her? It’s just a thought, I wish I could help you more Linda. Michelle

  60. Its been 4 months my doctor had fixed a pessary, now i am 4 weeks pregnant. need to know whether to remove or let it be throughout my pregnancy. If my gynecologist removes it will there be a problem? Is vaginal sonography possible with pessary inside vagina..?

  61. Hi Michelle,
    My name is Tiffany and I’m 33 yrs old. I had my 3rd baby boy a year ago and I suffer from prolapse of a rectocele. After I had my son (with the 3rd time 3rd degree tearing) I felt like my perineum just didn’t feel as strong anymore. Only a couple days after giving birth I had such a hard time passing my stool (it would get stuck) and was straining (NO ONE EVER TOLD ME NOT TO STRAIN AFTER CHILDBIRTH!) I had pain in my uterus area after straining and never knew what happened but noticed when I tried to push for a bowel movement a bulge would happen in my vagina and freak me out and the muscles of my anus just wouldn’t work. So sorry for the graphic detail! My post partum recovery took me into a urogynecologist for biofeedback stimulation and kegels. I take Magnesium for soft stools but I still just feel like my stomach muscles are flabby and things feel like they are pulling and dragging and not the same.If my stool is not completely soft and I have to push I do not eliminate all my bowels. It has been very depressing and I cant seem to lose the 23 lbs of baby weight that I need to. My questions for you are:
    Do Ben Wall kegel balls help strengthen the muscles?
    What can actually strengthen the vaginal wall itself?

    Also we really would like to have one more child but I am so scared that things will get much worse to where I will need surgery.
    Do you think a c section is better for someone who has a sort of prolapse? I guess I’m trying to see what can help me and what would be the best way to have another child. I think I’m facing correction of a rectocele or some sort of surgical procedure either way, even though I try to do as much as I can naturally. Your advice is greatly appreciated!!!

    • Michelle Kenway Physiotherapist says:

      Hi Tiffany

      Thanks so much for sharing your story – reading it will undoubtedly help other women, there really are just so many women in a very similar situation to yours.Young women need to know about the importance of pelvic floor exercises and not straining before they give birth. Unfortunately this information isn’t always conveyed to the expectant mum who is often blissfully unaware and usually thinks prolapse is something that happens to other (often more mature) women.This being said, there is a lot you can now do to improve your stool consistency and strengthen your pelvic floor. It’s worth bearing in mind that for most women, most pelvic floor damage happens with the first vaginal delivery despite your experience with your third baby and it might be worth speaking with an understanding gynaecologist with your concerns to discuss your options for having another child.

      Steps you can now take to help:
      1. See a Pelvic Floor Physio for assessment and treatment if you can access one.
      2. Manage your stool consistency & get your bowel emptying pattern corrected.
      3. Start your pelvic floor exercises as soon as possible – this is how you will firm your vaginal supports, improve bowel emptying. The vaginal wall once stretched is stretched and this stretching is repaired with prolapse surgery. Leave Ben Wa balls and focus on getting your basic pelvic floor exercises going and progressed over a good 6 month time frame
      4. Get exercising to manage your body weight and help you feel better about yourself. You will have more strength and energy, you’ll feel better emotionally and you will better manage your body weight. Exercise helps promote bowel movements. Losing weight will take the load off your pelvic floor too.
      5. You may benefit from a support pessary – this can be fitted by a gynaecologist and some Pelvic Floor Physiotherapists fit them too (in Australia)

      I have information and videos on all these suggestions onsite – there is a search menu on the right hand side of every page below the library where you can type in search terms. If you need help in finding the information you need just let me know. You might like to start here with this information on constipation and this video on bowel emptying technique

      I hope this gives you somewhere to start Tiffany – let me know if you need anything further
      All the best
      Michelle

      • Hi Tiffany – I just read your story and it is too familiar to mine! I’m 34 and had our 2nd boy 10 months ago (2nd degree tear with my first and only 1st degree tear with our 2nd). Both boys were small – less than 7 pounds – but I am small too. However, 2-3 days postpartum I experienced the same things you did as far as a rectocele prolapse. I am in the US and had to self-refer myself to MGH Pelvic Floor Dysfunction Unit b/c my doctors were doing nothing to help me except telling me to wait for surgery or stop breastfeeding, yikes! From MGH (the nicest and most compassionate docs in the world!) I got diagnosed with Stage 2 Posterior prolapse (rectal wall) and short tight pelvic floor. I have been in physical therapy for about 5 months to help relieve the tight muscles and strengthen core/pelvic floor and create a safe overall exercise program. Going to see a Pelvic Floor PT was invaluable in helping improve physically and emotionally (I think the emotional toll of prolapse can often get down played by doctors but it’s so real). The PT helped with suggestions for bowel movement (diet and positioning when sitting on toilet) and so many other areas. I was eventually fitted for a basic support pessary that I wear with exercise and it can also help keep the rectal wall in place during bowel movements. I actually needed to firm up my stool to pass it easily – and she taught me breathing/relaxation techniques instead of straining. There is so much they can offer to help you!! I wish you the best on your recovery. Stay strong – there are things you can do you just have to advocate for yourself and find the right care – you DESERVE IT! Best,
        Julie

        • Michelle Kenway Physiotherapist says:

          Thanks Julie, great information! Yes agreed – the emotional aspect is often largely unrecognised or not addressed.

  62. Hello Michelle,
    I am 6 weeks post op for repairs of anterior and posterior repairs. So far the defects seem to be repaired but there are no guarantees that they won’t recur. I had a stage 4+ vaginal vault prolapse with cystocele, rectocele and enterocele. It was a very devastating condition which had been getting continually worse since my vaginal hysterectomy in 2011 at age 56. I had put off surgery as I was terrified and surgeon couldn’t give me a great prognosis. In desperation I finally went ahead with the surgery which was 6 hours long and I am still on ibuprofen 3 times a day to keep pain to a level 3. I feel a lot of pressure and bowel movements can be tricky. I am on stool sfteners twice a day and drink at least 8 glasses of water a day. I was advised to walk for exercise and because of the reconstruction of my pelvic floor I have read that healing will take many months and I should avoid any movements/exercise that puts stress on the repair. I have been avoiding stairs as much as possible. I don’t see my surgeon for 2 more weeks for followup appointment. I will never go through surgery again! I am the mother of 4 grown children and was prolaping since after my first pregnancy, but I just put up with it because there was no information. Even though I saw several gynacologists through the years I was never offered a pessary until it was too late for me. I am hoping that this repair holds and that I can have some quality of life again once healing is complete. Your articles and videos are excellent and I think the methods could help me but I am so afraid to begin something that could harm my repair.
    Thanks for your website and having information available. I hope no young moms ever have to go through what I did due to lack of information.

    • Michelle Kenway Physiotherapist says:

      Hi Helen

      Thankyou – yes I can understand your fear of doing anything to harm your repair, you’ve been through so much for a large part of your life dealing with this issue. Bowel movements are tricky post op and it sounds as though you’re managing this well at the moment too. Sadly I think young women are still going through prolapse issues. While there is better conservative treatment and surgery available prolapse still isn’t discussed openly and some women remain too embarrassed to even speak with their doctor. I wish you all the best for your recovery Helen and thank you for sharing your personal experience to help other women.

      Best wishes to you
      Michelle

  63. Hi michelle, I,ve had 2 operations for bladder and bowel prolapse and hysterectomy in the last 2 years. I have a rectocele again and have been using a ring pessary for 6 months .
    It’s comfortable most of the time but I can,t walk very far because I get a really bad ache in my vagina and rectum. My consultant advised taking the pessary out for a month because it’s rubbing and also making me bleed. He suggest I have surgery again, a sacrospinous fixation of the vagina. I,m so fed up with this and don,t know anything about this operation. Has any other ladies had this done?
    I,m 64 and do pelvic floor exercises every day

    • Michelle Kenway Physiotherapist says:

      Hi Marjorie
      Have your tried another style or size of pessary? Are you using vaginal oestrogen pessaries with your support pessary? Many women do have sacropspinous fixation which put simply stitched the top of the vagina to the inside or the pelvis to hold it up. Other ladies might like to report their experiences with sacrospinous fixation.
      Michelle

  64. I just wanted to say thank you for this monthly news letter and all the easy to understand information. It is really helpful and I appreciate your time, effort and hard work.

    • Michelle Kenway Physiotherapist says:

      My pleasure Lizzie – so glad it helps you & thanks so much for your comment.

  65. Hi Ladies!! I’m much older that you spring chickens, but have had similar problems and recently had a procedure done for prolapse of the bowel lining. I don’t know if any of you who are having problems with emptying your bowels properly and without any straining, would be interested in something I spotted on the web……a ‘SquattyPotty’. It sits in front of your wc, and the idea is that with your feet on that, it makes you ‘squat’ on the the toilet, which is apparently the way for correct and complete elimination of stools without straining. I’m going to buy one….hope this helps some of you, and wonder what you think of these, Michelle?? ps Anybody thinking of buying, check the prices. They range from around £26 to £50……cheaper price is for a plastic one, dearer ones can be wooden/bamboo.

    Kind Regards

    • Michelle Kenway Physiotherapist says:

      Hi Janice

      Yes I’ve seen the squatty potty online thanks for raising it here.

      Janice I can only comment on the position of knees raised higher than the hips which can help some women. It’s worth testing by placing the feet on 2 wrapped toilet rolls to test the effect of having the knees raised. This can help some ladies and not others. It’s important to keep the inward curve in the lower back and to bulge the belly forward during emptying to relax the anal sphincter. I think for some women with long legs if the knees are raised too high they lose the curve in the lower back. So I think height does come into it as well as the type of emptying problem the woman is having for example if the stool is too hard or too soft to empty this will be an issue regardless of position. So I think it’s very individual Janice – would love to hear how it goes for you.

      Cheers
      Michelle

      • Another relaxation technique that my PT taught me that, was super helpful for me (I do have knees slightly raised using my kids step stool/floor potty), is to breath out slowly like you’re trying to fog up a mirror with your breath. Or you can cup your hand (make circle with index and thumb and line rest of fingers up behind index) and bring to lips and do the same breathing through the circle you’ve made to help relax the muscles and allow for easier bowel movement – this breathing technique and the positioning Michelle describes worked wonders for me. I hope it can help others!

  66. Hi Michelle,
    I have had a hysterectomy and prolapse repair then again 13 months ago another repair, I was wondering if you would recommend The Body Blade system as a safe form of exercise for a woman with this history, I am doing all I can kegels and your DVD and walking mostly. I am rather concerned that it can simply just happen again, I feel that it may have reoccurred because I was doing circuit training at Curves under the delusion it was ok for me!
    Thanks for your books and DVDs and all your great information on the subject I really appreciate it.
    Regards Natalie

    • Michelle Kenway Physiotherapist says:

      Hi Natalie
      Thank you for your comment. My apologies I can’t really comment on Body Blade having never seen it first hand. From their promo video I see that it does include some abdominal exercises however these are not demonstrated. It looks as though the resistance is created by shaking the blade? If so the upper body exercises appear reasonably pelvic floor friendly provided resistance is manageable however I cannot recommend the Body Blade system.
      Michelle

  67. I play tennis regularly and I will have a rubber pessary inserted this Thursday and play a tournament right after. Will I be OK to play tennis?

    • Michelle Kenway Physiotherapist says:

      Hi Lucinda
      Most women are usually fine to go about regular activities with the pessary inserted. A minor risk would be it slipping out of place which it will probably do anyway if it’s not the correct fit.
      Michelle

  68. Hi Michelle, I have found your website, videos and advice invaluable since discovering I have a prolapse and have had to stop things I love such as running for now. I have been fitted today with a doughnut pessary which the doctor says he will check again in four weeks. I’m concerned that a side effect is odour from discharge and as I won’t be taking it out to wash it and because I work in a public place and have already felt acutely embarrassed that the smell of any urine leakage is obvious, I am nervous about smelling of this. Could you advise me as to what best to do to avoid any difficulties like this please? Thank you

    • Michelle Kenway Physiotherapist says:

      Hi Cevan
      Thanks for your comment. Are you pre or postmenopausal? The odour can be caused by odour producing bacteria in the vagina so maintaining healthy vaginal flora is important for keeping odor at bay along with regular pessary cleaning. It’s probably worth mentioning to avoid those types of things that can upset vaginal flora balance for example oil or petroleum-based lubricants, vaginal perfumes or soap (washing with water is best). It’s also worth mentioning that some pessaries are designed to have a dual role in prolapse support and helping to prevent bladder leakage.
      Michelle

  69. Hi Michelle. Thank you so much for your website. It’s so reassuring to know I’m not alone and that good advice is available. I am 44 years old with 2 kids (ages 8 and 10). I was recently diagnosed with a stage 1 rectocele, a cystocele and a hypermobile uterus that prolapses when I’m upright and returns (almost) to normal when I’m lying down. I have constant abdominal and lower back pain and pressure in my bladder that results in regular trips to the loo. My gaenacologist says I’m too young for a pessary and should consider surgery. However I have a hypermobility syndrome (possibly erhlers danlos syndrome) and I am concerned that I am high risk for further prolapses over time. Would a pessary be a better option for me? I am the fourth generation of women in my family to have this problem (that I know of) and I am worried sick!

    • Michelle Kenway Physiotherapist says:

      Hi Jackie

      I am not sure why any woman would be told they are too young for pessary, especially at 44 years of age. Traditionally pessaries were fitted for older women, these days they are fitted to women of all ages and they can be particularly beneficial for young women, especially those seeking to have more children and avoid surgery. I have seen them fitted for women in their early 30’s through to 80’s. I would be interested to know the rationale for age being a barrier for you being fitted with a pessary otherwise seek another opinion.

      All the best Jackie
      Michelle

  70. Hi Michelle, I’m sorry if this is not the right way of asking questions I couldn’t find anywhere else to post. Iam looking for some hope! I have found all of your advice to others comforting and I do think you are amazing for taking the time to respond to each and every one. Iam 31years old and 5weeks almost postnatal. I have three beautiful children in which have unfortunately been big babies and now after my third it has taken its toll. Only now however am I to learn about prolapse and the risk labour and birth has on the pelvic floor. I have been referred for physio as my nurse upon examining me said I have barely any muscle contraction of the pelvic floor. I have been told I have quite a bit of movement in my cervix upon baring down and that’s it’s low. I have watched your videos on how to determine if my PV exercises are correct and whilst in an upright position on a chair I feel like Iam drawing in and up but laying on my side and examining myself there is no squeeze upon my fingers(feel a slight lift toward the back but that’s it) Please can you tell me firstly in your experience do I have any hope of my body healing to pre baby and these symptoms going away? Iam in pain with the dragging throbbing,it’s really affected my life and also caring for my children. Feel an overwhelming sadness when I look at them as I just want to care for them without feeling like this. Secondly as a physiotherapist yourself I have seen your mention in pessaries, would you have recommended I have one fitted whilst waiting for a referral to ease my pain and symptoms? My nurse said she would ask as she’s never fitted one postnatal before. Would this help me build my muscle strength up (and could they be weak due to childbirth) even though there is not much squeeze there should I continue to try and do them? So sorry for the overload in questions, I have seen so many horror stories regarding surgery and I’m afraid if physio doesn’t work I can’t be left feeling like this and surgery scares me! Many thanks for listening and I do hope I have written on the right place, if not could you direct me to your forum where I can seek help and advice Kind regards Kim

  71. Hi Michelle, I’m sorry if this is not the right way of asking questions I couldn’t find anywhere else to post. Iam looking for some hope! I have found all of your advice to others comforting and I do think you are amazing for taking the time to respond to each and every one. Iam 31years old and 5weeks almost postnatal. I have three beautiful children in which have unfortunately been big babies and now after my third it has taken its toll. Only now however am I to learn about prolapse and the risk labour and birth has on the pelvic floor. I have been referred for physio as my nurse upon examining me said I have barely any muscle contraction of the pelvic floor. I have been told I have quite a bit of movement in my cervix upon baring down and that’s it’s low. I have watched your videos on how to determine if my PV exercises are correct and whilst in an upright position on a chair I feel like Iam drawing in and up but laying on my side and examining myself there is no squeeze upon my fingers(feel a slight lift toward the back but that’s it) Please can you tell me firstly in your experience do I have any hope of my body healing to pre baby and these symptoms going away? Iam in pain with the dragging throbbing,it’s really affected my life and also caring for my children. Feel an overwhelming sadness when I look at them as I just want to care for them without feeling like this. Secondly as a physiotherapist yourself I have seen your mention in pessaries, would you have recommended I have one fitted whilst waiting for a referral to ease my pain and symptoms?
    If Iam only feeling this pressure due to being so early pp would a pessary help I the meantime with out making it worse ?
    My nurse said she would ask as she’s never fitted one postnatal before. Would this help me build my muscle strength up (and could they be weak due to childbirth) even though there is not much squeeze there should I continue to try and do them? So sorry for the overload in questions, I have seen so many horror stories regarding surgery and I’m afraid if physio doesn’t work I can’t be left feeling like this and surgery scares me! Many thanks for listening and I do hope I have written on the right place, if not could you direct me to your forum where I can seek help and advice Kind regards Kim

    • Michelle Kenway Physiotherapist says:

      Hi Kim

      First and foremost it’s very early days in your recovery – it can take many months for the pelvic floor to recover from pregnancy and childbirth. There is really no need to start reading about surgery stories at this very early stage.

      The best place to start is with your Physiotherapist. She will assess your pelvic floor and determine the cause of your discomfort and dragging sensation. From there she will be able to prescribe the most appropriate intervention for your condition depending upon the cause.

      Kim there is every hope of things improving a great deal. Take the right measures now until seeing your Physiotherapist; resting with feet elevated where possible even if this means lying on the ground while your little ones play, minimising lifting and prolonged standing, sitting rather than standing where possible, gentle walking exercise as tolerated, get as much rest and relaxation as possible as the fatigue associated with looking after a new baby just makes things worse, using warm or cold flannel compress when lying down to ease discomfort if this helps. Your Physio will guide you on pelvic floor exercises as appropriate and yes pessaries can help a great deal for postnatal prolapse if indeed this is what you are dealing with.

      The priority now is to get to see an experienced Pelvic Floor Physiotherapist to help you.

      All the best
      Michelle

      • Thanks Michelle for your response

        In have since spoken to my nurse and she’s sure il hear within a week or so regarding seeing a physiotherapist.

        I know it’s really early days as yet and I have seen many stories of women in similar situations to myself who have either improved or dealt with the condition.

        I think everything I read upon a state of panic made my worries worse and then I came across your site which helped me so much!
        You have put my mind at ease I can’t thank you enough! Sometimes doctors just don’t seem interested !
        I’m most certainly going to concentrate on taking it a little slower and putting my feet up a bit more!

        Thanks once again
        Kim

        • Michelle Kenway Physiotherapist says:

          Hi Kim

          I’m really glad that you feel a little bit a little more relaxed about things. Yes taking slower and put your feet up its early days yet.

          All the best
          Michelle

  72. Thanks you Michelle for replying,
    I just feel the gp’s I the uk have no interest in women’s problems pre or postnatal, do pelvic floor exercises is all they say and when many women do them incorrectly it can be time wasted in aiding the healing process.
    I guess I just have this constant weight at the moment complete worry, every time I sneeze or cough I feel like something is trying to sneak out And I’m scared Itl get worse.
    I have a 2 week wait until I can c my gp again which feels like a lifetime away, I understand times a great healer post natal I just need to try an focus.

    Thank you again Michelle
    Kim

  73. Hi Michelle, once again!

    Could I please ask regarding pessary fitting.
    I have been diagnosed with grade 2 and I’m awaiting pt and he reccomemd electrical muscle contraction, but in the meantime I’m trying a pessary.
    The first one slipped out pretty much right away.
    This one I had fitted today although bigger still is visible from the vagina. It doesn’t seem to quite test on or above the pubic bone.
    Would you say is again need to try a bigger one?
    Are you supposed to see a portion of the White ring?
    It still moves when I cough etc, and I still feel a bit achy(was only put in 1 he age) I haven’t tried anything more vigorous as I’m a little afraid just now
    Regards
    Kim

    • Michelle Kenway Physiotherapist says:

      Hi Kim

      It sounds as though you may need to get your specialist to check your pessary as it shouldn’t be noticeable when it’s well fitting. The electrical stimulation will most likely be for your pelvic floor muscles.

      All the best
      Michelle

  74. I’ve been wearing a pessary for 2 years and it is comfortable. I see my doctor every 3 mos. for removal and cleaning which I cannot do for myself. Six months ago I noticed bleeding from irritation and the pessary was removed for 3 months & refitted with a smaller one. Over this period of time I have had 3 infections & put on antibiotics but infection keeps returning in about 1 to weeks. I notice a very strong yeast smell upon voiding along with other indications. Originally I was told I had a dropped bladder. Can you advise me?

    • Michelle Kenway Physiotherapist says:

      Hi Jackie
      I’m not sure if you’re saying that your infections with vaginal or otherwise. As you know antibiotics can cause thrush. It would be best to see your doctor for a thorough assessment and appropriate management. Some women use the vaginal oestrogen to help thicken the vaginal walls to help when wearing our pessary. Hope this gives you some direction.
      Michelle

  75. Hi Michelle
    Thank you for your site … It is comforting to know that you are not alone and that women of all ages experience prolapse issues. My question is ‘do you have to use oestrogen creams with a pessary or are there alternatives ?’ My concern comes from my strong family history of breast cancer (maternal grandmother and mother both passing away from it) and being 50 years old I am focused on minimising my risks. I also enjoy regular sexual intercourse, am pre menopausal and have very young children (6 and 3).I have not had a pessary prescribed as yet, however I wish to be as fully informed as possible before exploring this option further. Looking forward to your advice .

    • Michelle Kenway Physiotherapist says:

      Hi Jan
      As you know the issued and cream is for thickening the vaginal wall and reducing the risk of erosion with the pessary. Considering your family history, this is something worth discussing with your doctor. Not all women use oestrogen cream with the pessary in place.
      All the best
      Michelle

  76. MaryJane says:

    My pessary fits very well and I have born it and cleaned it myself for two years… How often do I need to buy a new pessary?

    • Michelle Kenway Physiotherapist says:

      Hi Mary Jane

      Most women have the pessary checked and cleaned every 6 months. It’s really best to follow your gynaecologists recommendations and it may be worth a repeat visit for review and advice regarding when your pessary needs to be replaced.

      Michelle

  77. P.Anne says:

    I’m 63 and have had bladder prolapse for 9 mo. now. Got my pessary last week. First day I was disappointed as I could feel it, very mild spotting, which the OB said was normal as the vaginal walls were irratated with the insertion/addition of pessary. well into day 3, 4 and feels great in that I didn’t feel it. Day 5, not so much. After a bowel movement I noticed I felt the pessary more, and have had some VERY mild twinging cramps every few hours. Normal? I’ll be calling my OB Monday. And now I feel like I’m walking around with a diaphram in. Curious what others have experienced. I’m also hoping this will help the “gotta go” syndrome I’ve had for years. Thanks.