What is a Pessary?

A pessary, or vaginal pessary, is a removable device—usually made from body-friendly silicone or rubber—that is worn inside the vagina. It is designed to provide support where the pelvic muscles are weak and where pelvic organs have prolapsed or are at risk of prolapse.

• A pessary can be removed at home and cleaned (rinsed under the tap), or, if the user finds this difficult, by a GP or healthcare professional at a clinic.
• Some pessaries can be left in place during lovemaking and do not need to be removed for intercourse. However, a diaphragm cannot be used with a pessary, so an alternative form of contraception is required if the user is pre-menopausal.
• There are also “daywear pessaries” that you insert and remove yourself—giving you full control. These can help with stress incontinence leaks. Examples include the Contiform Pessary, Contrelle Activgard Pessary for Bladder Leaks, and Contam Pessaries.

Pessary for Prolapse

Medical research shows that a pessary can help to slow the progression of pelvic organ prolapse (POP) and may improve the severity or “grade” of prolapse.

Early signs of prolapse can include a feeling of heaviness or dragging in the vagina, a visible or noticeable bulge, discomfort during exercise, tampons not staying in place, or a general sensation that “something isn’t quite right”.

From the very first signs of prolapse, support is vital. If you suspect a prolapse—and especially once it has been confirmed—it is important to use a pessary early to help prevent further strain and worsening of symptoms. Medical appointments, referrals and treatment decisions can take time, so a pessary provides immediate support while you consider your options and next steps.

A pessary for prolapse is beneficial because:

• It takes pressure off a weakened pelvic floor, allowing muscles to recover and strengthen
• It can help prevent prolapse from worsening
• It offers a non-surgical option for women wanting more children
• It is a valuable option for women who wish to avoid or delay surgery
• It can support women where previous prolapse surgery has not been successful
• Some women report improvements in symptoms such as vaginal wind. A small study has shown that those experiencing vaginal wind (fanny farts) reported fewer embarrassing episodes when using a pessary.

At Kegel8, we strongly encourage combining pessary use with targeted pelvic floor strengthening to address the underlying cause.

How does a Pessary Work?

A pessary works to support or 'brace' falling pelvic organs. It can offer a valuable non-surgical approach to prolapse and is clinically proven to improve support and reduce sagging (reducing the genital hiatus). The term vaginal opening or genital hiatus is used to describe the distance between the urethra (opening for urine) and the back wall of the vagina. Clinical studies show that the vaginal gap size can be reduced when wearing a pessary for some users in as soon as 2 weeks of use! This means that the pessary is reducing the 'sag or drooping of the pelvic floor - now that is great news! After 3 months of pessary use, genital hiatus size decreased significantly. Pessary use results in significant anatomical changes to the genital hiatus in patients with pelvic organ prolapse.

What does a Pessary do?

When the pelvic floor is weak and loses its support it can result in reduced sensation, leaks of urine, faeces or wind, tampons falling out, lower back pain and hip pain - to name but a few. This weakness can also result in the pelvic organs falling down out of position, so the bladder, uterus, bowel or rectum can drop down due to lack of support - this is known as prolapse.

Prolapsing (or potentially prolapsing) pelvic organs need support and if the pelvic floor muscles are also weak a pessary is a great place to start. Current figures show that 1 in 2 women aged 50 will suffer with pelvic organ prolapse and healthcare professionals are keen to pursue alternatives to pelvic floor surgery since the vaginal mesh scandal (2014) and doubts surrounding this major surgery.

Pessary Types

A pessary acts as a brace or support for the pelvic organs. There are different types, styles, and sizes depending on the level of support required:

Ring Pessary – A hollow ring pessary is ideal for stress urinary incontinence. A ring with support (filled centre) is preferred for cystocele (bladder prolapse). A ring pessary with a knob can also help treat stress incontinence.

Cube Pessary – Recommended for moderate to severe prolapse. It stays in place using gentle suction against the vaginal walls. Versions with drainage holes allow fluid drainage and are easier to remove.

Shelf Pessary – Often used for uterine prolapse or prolapse of the top of the vagina, helping to avoid surgery such as hysterectomy.

Gellhorn Pessary – Suitable for severe prolapse (e.g. 3rd degree or procidentia). It has a stem to aid insertion and removal.

Inflatoball Pessary – An inflatable pessary designed for severe prolapse cases.

Doughnut Pessary – Larger than a ring pessary and offers more support for moderate prolapse.

Falk Pessary – A solid pessary used to support uterine prolapse.

Shaatz Pessary – Designed for 2nd or 3rd degree uterine prolapse, often with cystocele.

Gehrung Pessary – Used for moderate to severe prolapse. A folding version allows easier insertion.

Dish Pessary – Commonly used for stress incontinence and mild prolapse.

Hodge Pessary – Used for bladder prolapse (cystocele), sometimes with a knob to reduce leaks.

How About Buying a Day Wear Pessary Now? One You Control & Fit at Home?

At Kegel8, we offer a range of easy-to-use, self-managed pessaries designed to give you the control and support you need, whenever you need it. Our Contrelle, Contam (for bladder leaks and prolapse) Contiform and ProFem pessaries can be comfortably inserted and removed at home, providing extra support tailored to your daily activities. Perfect for managing bladder leaks and prolapse, these pessaries are designed for convenient use, giving you the confidence to take charge of your pelvic health on your own terms.

How to use a Pessary

There are different styles, shapes and sizes of pessary and your clinician will fit one depending on your requirements.  It is vital that your pessary is fitted by a professional - this is to ensure the right fit. Sadly many women have 'tried' a pessary but say it doesn't work, or 'fell out'. If a pessary falls out it was not the right size and we urge you to return to your healthcare provider and have another go. For a successful pessary fitting your clinician will use the largest pessary possible, a well fitted pessary will feel comfortable, it won't fall out, and it won't interfere with the emptying of your bladder or bowel.

A pessary for prolapse is ideal for women wanting to keep active and avoid surgery. Since one of the most popular prolapse surgeries fell out of favour due to the controversy surrounding vaginal mesh the humble pessary has been thrust into the spotlight - and quite rightly so! To date transvaginal mesh has become the most sued-over medical device in US history and will probably follow suit here in the UK. There has never been a 'quick fix' for prolapse but we now understand that with careful management a prolapse can be managed with:

• Targeted pelvic floor strengthening exercise - that’s where Kegel8 Ultra 20 can help with special programmes for deep effective exercise that is clinically proven (and it's made here in the UK). Physio Amanda Savage has created a Kegel8 12 week prolapse treatment programme - get started as soon as you can!
• Lifestyle changes, weight reduction, stop smoking, low impact sports, no straining with constipation when you visit the toilet!
• Vaginal pessary to add support and stabilise the prolapse. A pessary will reduce the size of the vaginal opening (genital hiatus) and prevent pelvic floor dropping (perineal descent)

• Specialist Prolpase Support Garments help you keep active and offer vital support to stop the prolpase getting worse. SRC offers medical grade support and support to the areas that need it most - very different from conventional 'shapewear'. See the best selling styles for prolapse SRC Restore Shorts and SRC Prolapse Support Leggings.
• Download our e book for FREE it will help you with signs and symptoms of Prolpase, and what other things you must do to manage prolapase right now. 

Sources:

[1] Obstet Gynecol. 2008 Sep;112(3):630-6. doi: 10.1097/AOG.0b013e318181879f Jones K¹, Yang L, Lowder JL, Meyn L, Ellison R, Zyczynski HM, Moalli P, Lee T.

The POGP Your Pelvic Floor 2021 [Viewed 31/10/2024] Vaginal prolapse infographic and details of pessary use. https://thepogp.co.uk/_userfiles/pages/images/pessary_infographics_darker01.png 

Your Pelvic Floor 2024 IUGA  [Viewed 31/10/2024] Vaginal Pessary For Prolapse Leaflet here

Effect of pessary use on genital hiatus measurements in women with pelvic organ prolapse   Obstetrics & Gynecology ACOG.org  [Viewed13/04/2026]