What Is a Pessary Used For?
A pessary is a non-surgical option used to manage pelvic organ prolapse symptoms such as heaviness, pressure, or a vaginal bulge. Made of soft medical-grade silicone, a pessary sits inside the vagina and provides internal support to help hold the bladder, uterus, or rectum in a more supported position.
This article explains what a pessary is used for, who may benefit from one, what a pessary fitting involves, and how pessaries work alongside pelvic floor physical therapy. You will also learn what a pessary can and cannot do, how to tell if it fits correctly, the different types available, and how combining pessary use with pelvic floor rehab can improve comfort, function, and confidence with daily activity and exercise.
If you’ve been told you have pelvic organ prolapse, or you’ve noticed symptoms like heaviness, pressure, or a bulge, you may have heard the word pessary come up and thought: What exactly is that… and is it right for me?
Let’s break it down.
What is a pessary?
A pessary is a small, removable medical device (usually made of soft silicone) that is placed in the vagina to support the pelvic organs. Think of it like an internal support structure that helps hold things where they belong.
Pessaries have been used safely for decades and are considered a conservative, non-surgical option for managing prolapse symptoms.
What is a pessary used for?
A pessary is most commonly used to help manage pelvic organ prolapse, which occurs when one or more pelvic organs (bladder, uterus, rectum) drop downward due to decreased support from the pelvic floor.
A pessary can help:
Reduce feelings of heaviness or pressure
Decrease or eliminate a bulge sensation
Improve bladder or bowel symptoms related to prolapse
Make daily activities and exercise more comfortable
Provide support during higher-impact activities (like walking, hiking, or workouts)
Some people use a pessary daily, while others use it only for certain activities—it’s very customizable.
Who might benefit from a pessary?
Pessaries are often a great option if you:
Want symptom relief without surgery
Are postpartum and noticing prolapse symptoms
Are perimenopausal or postmenopausal
Are not a surgical candidate (or simply don’t want surgery)
Want to stay active while working on pelvic floor rehab
They can also be used temporarily or long-term, depending on your goals and symptoms.
Who might not be a good candidate for a pessary?
While pessaries are safe and effective for many people, they aren’t appropriate for everyone. Individuals who have had certain types of pelvic organ prolapse surgery, particularly those involving vaginal mesh or specific reconstructive procedures, may not be candidates for pessary use. A history of active vaginal infections, significant vaginal tissue fragility, or inability to attend follow-up care may also affect eligibility. That’s why a thorough medical history and pelvic exam are essential before fitting—to make sure a pessary is both safe and appropriate for your body.
Does a pessary fix prolapse?
This is an important distinction:
A pessary does not reverse prolapse, but it supports the organs and manages symptoms.
That’s why we often pair pessary use with pelvic floor physical therapy—to address strength, coordination, posture, breathing mechanics, and whole-body contributors that influence pelvic support.
What is a pessary fitting like?
A pessary fitting is a one-on-one, in-clinic visit where we:
Review your symptoms, activity level, and goals
Assess pelvic floor function and prolapse type
Try different pessary sizes and styles
Make sure the pessary is comfortable, supportive, and functional
Teach you how to insert, remove, and care for it (if appropriate)
A good fit should feel supportive and not painful. You should be able to move, sit, and breathe comfortably with it in place.
How do we know the pessary is the right fit?
After the pessary is placed, we test it to make sure it’s the right fit. We’ll have you gently bear down while lying down and again while standing to see how the pessary responds to pressure. From there, we’ll ask you to move in ways that typically bring on your symptoms, such as walking, light jogging, jumping, or other activities that feel relevant to your daily life. Finally, we’ll make sure you’re able to urinate comfortably and completely, without any feeling of blockage. This process helps ensure the pessary provides support without interfering with normal movement or function
Are there different types of pessaries?
Yes! There are several shapes and styles (ring, dish, cube, and more). The “best” pessary is the one that:
Supports your specific prolapse
Feels comfortable
Matches your lifestyle and comfort with self-management
Because there is no one-size-fits-all pessary, fittings may require some trial and adjustment over one or more visits based on your anatomy and activity level.
Does a pessary hurt?
A properly fitted pessary should not hurt. In fact, many people report that once it’s in place, they don’t really notice it at all, but instead notice the absence of that heavy, dragging, or pressure feeling they were having before. During a fitting, we’re paying close attention to comfort, support, and how the pessary feels with movement, sitting, and breathing. If a pessary causes pain, pinching, or irritation, it’s usually a sign that the size or style isn’t right.
How long can you wear a pessary?
How long a pessary can be worn depends on the type of pessary and your individual needs.
Some pessaries, like a cube pessary, are designed to be removed and cleaned daily because they use gentle suction for support. Others, like a ring pessary, can often be worn for longer periods of time, sometimes days to weeks at a time, depending on the person and provider guidance. During your fitting, we’ll talk through which option makes the most sense for your anatomy, symptoms, lifestyle, and comfort with self-management, and we’ll create a plan that feels realistic and sustainable for you.
Are there risks or complications with pessary use?
When properly fitted and monitored, pessaries are generally very safe. However, like any medical device, potential complications can occur—especially if a pessary is worn for too long, is the wrong size, or isn’t checked regularly. These may include vaginal irritation, increased discharge, discomfort, or, in rare cases, tissue breakdown. Regular follow-up visits with your pelvic floor physical therapist are important to ensure the pessary remains well-positioned, continues to fit properly, and isn’t causing irritation. As your body, symptoms, or activity level change over time, adjustments may be needed to keep the pessary both effective and comfortable.
Most early warning signs are mild and easy to address when caught early. These can include new discomfort, vaginal irritation, unusual discharge, spotting, difficulty urinating, or the feeling that the pessary has shifted or isn’t providing the same level of support. If something feels off, check in with your provider right away. O ften a simple adjustment or size change is all that’s needed. Ongoing communication and follow-up help keep pessary use safe, comfortable, and effective.
The bottom line
A pessary can be a powerful, low-risk tool for managing pelvic organ prolapse and helping you feel more confident in your body again—especially when combined with pelvic floor physical therapy.
If prolapse symptoms are getting in the way of your daily life, exercise, or confidence, you don’t have to just “live with it.”
pessary Fitting at Cappuccino Physical therapy
We’re now offering pessary fittings and would love to help you explore whether this option is right for you.
Curious if a pessary could help you? Reach out to schedule a consultation or fitting.
