What Is a Vaginal Pessary? How Pessaries Help Prolapse & Stress Incontinence

Vaginal pessaries have been used for centuries to help women manage pelvic floor conditions, with references dating back to ancient Egyptian medical texts and the writings of Hippocrates. While early pessaries were made from natural materials such as pomegranates soaked in wine or vinegar, modern pessaries are safe, comfortable medical devices designed to support women experiencing pelvic organ prolapse, stress urinary incontinence, or both conditions at the same time.

Today, vaginal pessaries offer an effective, non-surgical way for women to take control of their pelvic health and improve their quality of life. By providing gentle internal support to the pelvic organs and bladder, pessaries can help reduce symptoms such as pelvic heaviness, bladder leaks, and discomfort during daily activities. For many women, they provide a safe, empowering alternative to surgery — whether surgery is not suitable, not desired, or simply something they wish to delay while managing their symptoms confidently and comfortably.

What Is Pelvic Organ Prolapse and How Can a Pessary Help?

Pelvic organ prolapse occurs when pelvic floor ligaments, tissues, muscles and nerves that support the pelvic organs (uterus, bladder, rectum) become weak or damaged and cause one or more pelvic organs to descend into or out of the vagina.

Prolapse affects up to 50% of women at some point in their life time and it usually occurs after pregnancy, although can occur from other causes.

Awareness of a bulge or lump protruding from the vagina is the most common prolapse symptom. Women with prolapse may also experience a dragging sensation in the pelvis or low back ache. Prolapse may also interfere with bladder emptying or bowel evacuation and cause difficulty with sexual intercourse.

What Is a Vaginal Pessary?

A vaginal pessary is a removable medical device inserted into the vagina to help support pelvic floor conditions, including pelvic organ prolapse, stress urinary incontinence, or sometimes both conditions together. Different pessary designs provide different types of support depending on a woman’s symptoms and pelvic floor needs.

For women with pelvic organ prolapse, a pessary helps support the vaginal walls and pelvic organs, reducing feelings of heaviness, dragging, or discomfort. Other pessaries are specifically designed to help manage stress urinary incontinence by supporting the bladder neck and urethra to help reduce leaks during coughing, sneezing, laughing, or exercise. Some pessaries can also provide combined support for women experiencing both prolapse and bladder leaks simultaneously.

Vaginal pessaries can be used short term or long term, depending on the severity of symptoms and individual treatment goals. Some women use a pessary while waiting for pelvic floor surgery or after childbirth, while others choose a pessary as an ongoing, non-surgical way to manage their pelvic health confidently and comfortably.

Many pessaries can be worn throughout the day, including during exercise and normal daily activities. They are also commonly recommended alongside pelvic floor muscle training, as they can help women become more aware of their pelvic floor muscles and provide additional internal support during rehabilitation.

How Is a Vaginal Pessary Fitted?

How a vaginal pessary is fitted depends on the condition being treated and the type of pessary being used. Some pessaries designed specifically for stress urinary incontinence can often be selected, inserted, and managed by women themselves at home, while prolapse pessaries usually require an initial fitting by a pelvic health professional.

For women experiencing stress urinary incontinence — such as bladder leaks during exercise, coughing, sneezing, or laughing — self-managed continence pessaries such as Contiform, Contrelle, and the Contam range are designed to be simple to use at home. These devices are available in different sizes and are inserted similarly to a tampon to help support the bladder neck and reduce leaks during physical activity. Many women can confidently manage insertion, removal, and cleaning themselves without needing a clinical fitting appointment.

However, if pelvic organ prolapse is present — particularly if there is more than one type of prolapse or prolapse combined with stress urinary incontinence — a professional pessary fitting is strongly recommended. During the fitting appointment, a qualified healthcare professional experienced in pelvic health will assess your symptoms, anatomy, and the level of pelvic support required to determine the most suitable pessary type and size.

Because prolapse pessaries are not one-size-fits-all, finding the correct fit can sometimes take a few attempts. A properly fitted pessary should feel comfortable, remain securely in place during daily activities, and provide effective symptom relief without discomfort or irritation. Although the fitting process may require some trial and adjustment, achieving the correct size and style is one of the most important factors for successful long-term pessary use.

Once the correct pessary has been identified, many women are then able to move on to pessary self-management. This allows them to confidently insert, remove, and clean their pessary at home while continuing to benefit from comfortable, ongoing pelvic support and improved bladder control.

How Long Can a Pessary Be Worn?

How long a pessary can remain in place depends on the type of pessary, the manufacturer’s guidance, the patient’s symptoms, and whether the woman self-manages her pessary care.

Some pessaries are designed to be removed daily for cleaning (cube types), while others may only need to be removed and checked weekly. Certain healthcare professionals may also recommend leaving the pessary out overnight occasionally to allow the vaginal tissues to rest.

For women using a pessary long term — particularly those managing pelvic organ prolapse without surgery — regular follow-up appointments are important to ensure ongoing comfort and vaginal health. In some cases, a healthcare professional may remove, clean, and replace the pessary every six months.

Women who are comfortable self-managing their pessary are often able to remove, clean, and reinsert the device themselves at home. Regular replacement schedules and clinical reviews help ensure the pessary continues to fit correctly and provide effective support for prolapse and/or stress urinary incontinence symptoms.

Does a Pessary Stop a Prolapse From Getting Worse?

Clinical data tells us the following:

Vaginal Pessary Users Report the Following:

High Success Rate for Symptom Relief: Studies show a 56–89% success rate in continued usage at 2–3 months.

Immediate Relief: Patients often experience immediate improvements in symptoms like pelvic pressure, heaviness, and urinary incontinence.

Comparable to Surgery for Quality of Life: One-year outcomes in terms of quality of life and symptom management are often similar to surgical interventions, though patients tend to prefer the "fix" of surgery.

Improved Quality of Life: Many women can return to activities like exercise and work that were previously impossible due to the prolapse

Sources

Do pessaries prevent the progression of pelvic organ prolapse? A study investigating long-term pessary use in women with pelvic organ prolapse found that after one year, prolapse severity had significantly improved in some women, while no participants experienced worsening of their prolapse. These findings suggest that supportive vaginal pessaries may not only help manage prolapse symptoms but could also have a positive therapeutic effect on pelvic floor support over time. NIH National Library of medicine PubMed [viewed 06/05/2026]

Updates in Pessary Care for Pelvic Organ Prolapse: A Narrative Review  2025 Vaginal pessaries remain an effective, non-surgical option for managing pelvic organ prolapse and improving quality of life. Ongoing innovations in pessary design, comfort, and self-management are helping more women confidently take control of their pelvic health with long-term support. [viewed 06/05/2026]

Pessary for Prolapse - Patient Information Leaflet, Swansea Bay University Health Board. [viewed 06/05/2026]

Vaginal Pessaries for Pelvic Organ Prolapse or Stress Urinary Incontinence: A Health Technology Assessment 2021 Research suggests that vaginal pessaries can be an effective, non-surgical treatment option for managing pelvic organ prolapse (POP) and stress urinary incontinence (SUI), helping improve symptoms, comfort, and quality of life. Many women report positive symptom relief with pessary use, particularly as part of a conservative pelvic health treatment approach. [viewed 06/05/2026]