What Is a Pessary & Which Type Is Right for You?
Pregnancy, childbirth, aging, and menopause can all bring changes to your pelvic floor, and sometimes, those changes lead to symptoms like pelvic pressure, heaviness, or leakage.
If you’ve been told you have a pelvic organ prolapse or pelvic floor weakness, your provider may have mentioned something called a pessary. And if not, we definitely recommend asking about this option! These small, customizable devices can be life-changing for comfort, confidence, and daily function without requiring surgery.
What Is a Pessary?
A pessary is a small, medical-grade silicone device inserted into the vagina to support the pelvic organs- the bladder, uterus, or rectum. Think of it as a soft internal brace that helps lift and stabilize the vaginal walls when pelvic tissues have stretched or weakened. We often call it a “bra” for the pelvic floor.
Pessaries can help with:
Pelvic organ prolapse (bladder, uterine, or rectal)
Sensations of pressure or heaviness
Urinary leakage, especially with coughing or exercise
Comfort during activity or exercise
Postpartum or perimenopausal pelvic support
They’re safe, removable, and come in a variety of shapes and sizes. For many women, they’re an empowering alternative to surgery.
What Is a Pessary Fitting?
A pessary fitting is a gentle, in-office process where a pelvic floor therapist or other trained medical provider helps you find the right size and style for your unique anatomy and needs.
During the fitting:
Your provider assesses organ position, pelvic tone, support, and comfort.
A pessary type is recommended based on your anatomy, symptoms and lifestyle, and that pessary is inserted to test efficacy.
You’ll be asked to use the restroom, go for a walk, lift weights/run, and test how the pessary feels and if it improves symptoms during normal activity.
You’ll learn how to insert, remove, and care for the device.
The right pessary should feel comfortable and supportive. You shouldn’t notice it during daily life, and it should eliminate your symptoms!
Types of Pessaries
There are several types of pessaries, each designed for different levels of support and symptoms. Pelvic organ prolapse can impact the bladder, uterus, and/or rectum, and the type of pessary is chosen to support the structures at the front, back or top of the vaginal canal. The most common are rings and cubes, but people with more significant symptoms may benefit from another shape, called a gellhorn.
Ring Pessary
The ring pessary is often the first choice for bladder or uterine prolapse and/or urinary symptoms. It is a flexible ring that folds for easy insertion - similar to a menstrual disc. Some have an extra knob to support the urethra, or may have a membrane for extra support.
Cube Pessary
A cube is often chosen for a prolapse that affects the rectum, and/or multiple organs. It sits lower in the vaginal canal than a ring and offers more suction-based support. This type needs to be removed and cleaned on a daily basis.
How to Know Which One Is Right For You
A pelvic floor therapist can help assess your needs and collaborate with your OB-GYN or urogynecologist to ensure optimal support and comfort.
How to Care For Your Pessary
Proper pessary care is simple and keeps your tissues healthy:
Remove and wash it with mild soap and water (frequency depends on type and your provider’s instructions).
Allow it to air dry before reinsertion.
Schedule regular check-ups-usually every 3–6 months-to assess fit and tissue health.
Use vaginal moisturizer or estrogen cream (if prescribed) to maintain tissue resilience and comfort.
If you notice any discomfort, odor, or spotting, remove the device and contact your provider.
Taking the Next Step Toward the Right Pessary
Finding the right pessary can be a turning point for comfort, confidence, and activity. Whether you’re newly postpartum, managing prolapse, or navigating menopause, a properly fitted pessary can help you move through life without pressure or worry. A certain amount of organ descent is expected following a vaginal birth, and early pessary placement can actually improve long-term pelvic health and minimize the risk of developing further symptoms.
At OWN Your Pelvic Health, our pelvic health therapists provide personalized pessary fittings and education so you can make an informed, confident choice for your body. Request an appointment to learn more!