What is a pessary and how can they help?
If you're living with pelvic organ prolapse or urinary incontinence, a vaginal pessary could be the solution you've been searching for. A vaginal pessary can stop bladder leaks, ease pelvic heaviness, help you stay active and provide the internal support you need to get on with life. No surgery required.
And if you are suffering from a prolapse or incontinence, you're far from alone. Up to half of women over 50 will experience a prolapse, and 1 in 5 will deal with urinary incontinence at some point in their lives.
So what exactly is a pessary? It’s a removable device, usually made from silicone, latex, vinyl or rubber. It sits comfortably inside the vagina to hold your pelvic organs and bladder where they should be. For many women, it is a life-changing alternative to surgery, and often so effective that surgery is no longer needed or wanted.
If you think you might be experiencing a pelvic organ prolapse, as with all medical conditions, it is vital to talk to your doctor as early as possible.
In this article:
- How do vaginal pessaries work?
- What are the benefits of using a vaginal pessary?
- What are the common side effects of a vaginal pessary?
- Is a pessary right for you?
- Types of Vaginal Pessary
- Pessaries you can try at home
How do vaginal pessaries work?
Think of a pessary like a supportive cradle for your pelvic organs. It sits comfortably inside the vagina and supports you exactly where you need it.
So if you’re wearing a pessary to treat a prolapse, it will provide the internal support your pelvic floor can no longer manage alone. It reduces symptoms and helps prevent things from getting worse.
And if it’s for incontinence, a pessary gently supports the bladder neck and urethra, reducing or stopping leaks during everyday activities like coughing, sneezing, laughing or exercise.
The best thing about pessaries is that as well as providing instant relief, they also prevent things progressing, particularly in the case of prolapse. For example, a study found that after one year of pessary use, none of the 56 studied patients saw their prolapse worsen.
What are the benefits of using a vaginal pessary?
Vaginal pessaries are hugely beneficial and widely used for several reasons:
- Research suggests wearing a pessary can slow the progression of prolapse and reduce its severity over time.
- Pessaries put you in control of your own care. Some are removable at home, much like a tampon, while others can be fitted by a healthcare professional and worn for up to six months.
- You can be sexually active with a pessary in place. Neither you nor your partner should be aware of it during sex.
- A pessary works well alongside pelvic floor exercises. It takes care of symptoms in the short term while you build strength for longer-term improvement.
- Around 1 in 3 prolapse surgeries are unsuccessful. For women who'd rather avoid going under the knife, a pessary offers a reliable, non-surgical alternative.
- Some women find that a pessary helps reduce episodes of vaginal wind. It's a lesser-known benefit, but one that can make a real difference to everyday comfort and confidence.
What are the common side effects of a vaginal pessary?
Vaginal pessaries have been used as a solution for incontinence and prolapse for decades. They are a well studied and recommended solution for women. But of course, as with most things, there are some potential side effects. Here’s what you need to know:
- Some women may experience an increase in urinary incontinence due to the position of the pessary. For self-fitted pessaries, try adjusting the position or moving to a different size. If yours was fitted professionally, a quick appointment to reposition it usually solves the problem.
- Some vaginal discharge is completely normal with a pessary. If you notice anything unpleasant or unusual, you may need to take a break from wearing it. If you wear a removable pessary, always make sure that you are cleaning it thoroughly between uses. If the discharge persists, speak to your healthcare provider.
- Occasional light bleeding can occur if the pessary rubs. Try repositioning it or moving to a smaller size. If it continues, an oestrogen cream from your GP can help soothe and heal the area.
- If your pessary slips out of position, it simply means the size or style isn't quite right. Try a different size first as it often takes a couple of attempts to find your perfect fit.
Is a pessary right for you?
Pelvic organ prolapse
If you've been diagnosed with pelvic organ prolapse, a pessary is almost certainly your best option. Prolapse surgery is heavily restricted in the UK, so for most women a pessary isn't just a first step, it's the most effective and accessible solution.
It’s very often the case that after using a pessary, many women don’t need surgery at all. Even in the most severe cases of prolapse, up to 62% of women report success, and over 70% of women who try one go on to never need surgery at all.
Used alongside daily pelvic floor exercises and support clothing, a pessary provides a long-term solution. And if you do eventually decide surgery is right for you, using a pessary beforehand can strengthen your pelvic floor and improve your recovery.
A pessary is also the best option if you're planning to have more children. Pregnancy after prolapse surgery is likely to undo the results entirely.
Incontinence and leaks
If you're dealing with stress incontinence or prolapse-related leaks, a pessary is one of the most effective and immediate options available. Pads and panty liners only mask the problem. A pessary tackles it at the source, physically supporting the bladder neck and urethra to stop leaks before they happen.
Better still, incontinence pessaries like Contiform and Contrelle can be fitted at home. That means you can manage your bladder leaks entirely on your own terms, and stay active and confident without relying on pads.
Types of Vaginal Pessary
There are many different types, styles and sizes of vaginal pessary. The right one for you will depend on your symptoms, anatomy, and the level of support you need. A well-fitted pessary should feel comfortable, stay in place during daily activities, and not interfere with using the toilet.
Some pessaries can only be fitted by a medical professional. These include ring, shelf, Gellhorn, Gehrung, Shaatz, Lever, and Falk pessaries. Your clinician will recommend the right type based on your anatomy and the severity of your prolapse.
Pessaries you can try at home
Not all pessaries require a clinical appointment. A number of styles can be self-fitted and managed at home, so you don't have to wait for an NHS referral to start feeling better. They're discreet, often reusable, and designed to be inserted and removed much like a tampon, putting you in control of your own care from day one.
For prolapse
A versatile option that supports uterine, bladder (cystocele) and bowel (rectocele) prolapse. The dish shape distributes support evenly across the pelvic floor, making it a good all-rounder. It can be fitted at home or by a healthcare professional, is reusable and hormone-free, and comes in three sizes.
Designed for moderate to severe prolapse, including second and third-degree uterine prolapse, cystocele and rectocele. The soft, rounded shape applies gentle, even pressure making it a great choice for postmenopausal women or those with sensitive vaginal tissue.
A good option for more advanced prolapse, supporting up to stage 3, including cases where the cervix may slightly protrude. Made from medical-grade foam that softens in water for easier insertion, then springs back into shape.
A more natural, accessible alternative to traditional pessaries. The extra-dense sponge adds internal bulk to ease the dragging sensation associated with prolapse. It can be trimmed at home for a personalised fit, doesn't require professional fitting, and tends to be more affordable than medical-grade options.
For incontinence
Clinically proven for stress incontinence, this pessary folds for insertion and gently supports the bladder during coughing, sneezing, laughing and exercise. Reusable up to 30 times, it can be worn all day and comes in three sizes as well as a handy starter pack. Also available on NHS prescription.
Clinically proven with a 95% success rate, this pessary lifts the bladder to its correct position, without needing to be removed to use the toilet. Made from soft moulded foam, it's inserted like a tampon and can be worn for up to 16 hours.
A tampon-like design that lifts the vaginal wall and gently closes the urethra to reduce leaks. It also engages the pelvic floor during wear, which can help strengthen muscles over time. It can be worn for 12 hours, and is available in multiple sizes including a starter pack.
Unlike a standard dish pessary, this version is specifically designed for stress urinary incontinence. The enlarged support knob targets the bladder neck and urethra directly, helping to prevent leaks during everyday activities. It can be self-fitted or professionally fitted, is reusable and hormone-free, and can be worn for up to 30 days between cleans .
A wider, slightly shorter variation on the Contam Normal, offering enhanced leak protection for women who need a bit more coverage. Allows normal urination and can be worn for up to 12 hours.
The same tampon-like design as the Contam Normal, but with a central groove for applying oestrogen cream, vaginal moisturiser or lubricant. A particularly good choice for women managing incontinence alongside vaginal dryness, atrophy or menopausal symptoms.
A number of pessaries work for both prolapse and incontinence - the ProFem iDish Incontinence Pessary, Contam range and Contam Cube Pessary all offer benefits for both conditions. If you're unsure which is right for you, each product page includes guidance on suitability, or you can speak to your GP or pelvic health physiotherapist.
Living with prolapse or incontinence doesn't have to mean surgery, pads, or putting your life on hold. For most women, a pessary offers real, immediate relief. If you're ready to take back control, explore our full range and find the one that works for you.
