Pessary

If you feel pelvic pressure, heaviness, or urine leakage during daily activities, you may wonder what is causing it and how to manage it. These symptoms often come from pelvic organ prolapse or stress urinary incontinence. They can affect your comfort, confidence, and daily routine.

A pessary is a simple, non-surgical option that can help support the pelvic organs and reduce these symptoms.

At our offices serving Charlotte, NC and Columbia, SC, we provide personalized pessary fittings to help you feel more comfortable and in control. With the right fit, many women return to normal activities with fewer symptoms and more confidence.

A pessary is a small, flexible device placed in the vagina to support pelvic organs. It helps manage symptoms of pelvic organ prolapse and urinary incontinence.

Pessaries come in different shapes and sizes. Your provider fits the device during an office visit. With the right fit, many women reduce symptoms and avoid or delay surgery.

A pessary can help manage symptoms related to pelvic support and bladder control.

Pelvic Organ Prolapse

Pelvic organ prolapse happens when the pelvic floor loses strength. This allows pelvic organs to shift downward. You may notice:

• A feeling of pressure or heaviness
• A bulge at the vaginal opening
• Changes in urination or bowel movements
• Discomfort with activity
• Pain during sex

A pessary does not fix the underlying cause. It helps support the organs and reduce symptoms.

Stress Urinary Incontinence

Stress urinary incontinence means urine leakage during activities like:

• Coughing
• Sneezing
• Laughing
• Exercising

Some pessaries support the urethra. This can help reduce leakage during movement or strain.

Pessaries are grouped by how they support the pelvic organs. These options vary in how much support they provide and how easy they are to use.

Support Pessaries

Support pessaries lift and support pelvic organs. They are often used for mild to moderate prolapse.

• The ring pessary is the most common and easiest to manage. It often does not need to be removed during sex
• The Gehrung pessary offers more support but can be harder to fit and manage

Space-Occupying Pessaries

These pessaries fill space in the vagina to hold organs in place. They are used for more advanced prolapse.

• Types include donut, cube, Gellhorn, inflatable, and shelf pessaries
• They provide strong support but are harder to insert and remove
• Some must be removed for sex and may require provider help

A pessary may be a good option if you want to manage symptoms without surgery. It may be right for you if you:

• Want to avoid or delay surgery
• Have health conditions that make surgery higher risk
• Plan to have children in the future
• Are pregnant and have symptoms
• Want a reversible treatment option
• Have had prior pelvic surgery
• Prefer a non-invasive approach

The main question is whether you can manage the device on your own or with regular follow-up care.

You may want to consider a pessary if your symptoms affect your daily routine, comfort, or activity level. Many women choose a pessary when symptoms start to affect daily comfort, activity, or confidence.

A pessary fitting is done in the office and does not require surgery. Your provider will perform a pelvic exam to check:

• The type and severity of prolapse or incontinence
• Vaginal size and shape
• Overall pelvic support

A good fit should:

• Feel comfortable and not noticeable
• Stay in place during movement
• Allow normal urination and bowel function

If the pessary feels too tight, too loose, or shifts, it may need adjustment.

Some women insert and remove the pessary on their own. Others prefer office visits for care. You can clean a pessary with mild soap and water. The cleaning schedule depends on the type.

Pessaries are very safe when used and maintained properly. Serious problems are rare and usually linked to a lack of follow-up care.

Common side effects may include:

• Increased vaginal discharge
• Mild irritation
• Odor if cleaning is delayed

Less common side effects may include:

• Vaginal erosion or ulceration
• Discomfort during sex, depending on the type

Some postmenopausal women may use vaginal estrogen to keep tissue healthy and reduce irritation.

If you have pelvic pressure, discomfort, or urine leakage, a pessary may help you manage symptoms without surgery.

At our offices serving Charlotte, NC and Columbia, SC, we provide expert fittings and follow-up care to ensure the right fit and long-term comfort. Our team will guide you through the process, answer your questions, and make sure your pessary feels comfortable and works for your daily life.

Schedule an appointment today to find out if a pessary is right for you.

1. Will I be able to feel the pessary once it is inserted?

A properly fitted pessary should feel comfortable and mostly unnoticeable. Some women notice a mild sense of fullness at first, but this usually fades within a few days. You should not feel pain, pressure, or slipping. If you do, it may need to be adjusted.

2. Can I exercise or stay physically active while wearing a pessary?

Yes. A pessary is designed to support your body during daily movement. This includes walking, running, and exercise. If it fits well, it should stay in place.

3. What happens if I forget to clean or change my pessary?

Missing a cleaning once is not likely to cause harm. But going too long without care can lead to odor, discharge, or irritation. If you prefer, your provider can manage cleaning during office visits.

4. Can I have sex while using a pessary?

It depends on the type. Some pessaries can stay in place during sex, while others must be removed. Your provider will help you choose the right option.

5. How long can I use a pessary?

You can use a pessary long term if it fits well and is cared for properly. Many women use one for years with regular checkups.

6. What if the pessary doesn’t work for me?

If a pessary does not relieve symptoms or feels uncomfortable, your provider can adjust the size or type. If it still does not work, other treatment options are available.

Consultations for a pessary are available with all of our providers.