Ring, with or without support
Often a starting option. Some women can remove and replace it themselves after teaching. Vaginal penetration may be comfortable with it in place.
PELVIC SUPPORT · EVERYDAY COMFORT
Pessary support for prolapse
A pessary supports the prolapse from inside the vagina. It can ease a bulge or dragging feeling and help you stay active, for as long as it suits you.
On this page
When to get urgent help
Seek urgent medical assessment now if you cannot pass urine, have heavy bleeding, feel faint, or develop severe pelvic or abdominal pain, especially with fever or feeling unwell. Use an emergency department if needed; do not wait for a routine appointment or an email reply.
SUPPORT WITHOUT AN OPERATION
How a pessary works.
The removable device holds the vaginal walls or uterus in a more supported position. It manages symptoms while in place; it does not repair the underlying tissues.
Could it suit me?
A pessary may suit you if you prefer an ongoing non-surgical treatment, want support while considering your options, or wish to delay surgery. It can also be useful when future pregnancy matters or an operation carries extra risks.
We consider your anatomy, bladder and bowel symptoms, vaginal comfort and ability to manage the device. You do not need to be a particular age to discuss it.
Physiotherapy and attention to constipation can continue alongside a pessary. Urgency, bowel problems or pain may still need separate treatment.
Compare pessary types
Gellhorn and other supporting shapes
May help when a ring will not stay in place or provide enough support. Removal can be more difficult, so clinic care is often needed. Penetrative sex generally requires removal.
Cube
An option for selected women who can manage regular removal. It needs removal and cleaning every day, following the device instructions. It is removed before penetrative sex.
Shape, size, material and care requirements vary. We choose a device after examination; the illustrations are not a guide to buying or sizing one yourself.
YOUR FIRST FITTING
Comfort comes first.
Discuss and examine
Tell me what you want to do more comfortably, whether intercourse matters, and about any bleeding or previous pelvic surgery. Examination is with your consent; you can ask to pause or stop.
Try the fit
We may try more than one size or shape. Stand, walk and cough to check support, and make sure you can pass urine comfortably before leaving. Persistent pain or pressure needs attention.
Agree the next step
Check how it feels during ordinary life. We arrange a review and explain who to contact if it slips, hurts or affects bladder or bowel emptying. Do not wait for that review if a problem develops.
A PLAN YOU CAN FOLLOW
Care and follow-up.
An early check is commonly arranged around 4–6 weeks after a new fitting. Your appointment may be sooner, depending on the device and symptoms. Keep the date agreed with your clinician.
Care in the clinic
The clinician removes the pessary, checks the vaginal lining and reassesses comfort and support. Ongoing checks are often every 3–6 months, with earlier visits if needed. Arrange a new date if you miss a review.
Managing it yourself
If suitable, you can learn to remove, clean and reinsert your pessary. You need to feel confident with the technique and have access to help. You can choose clinic care if this becomes difficult; self-management still includes planned reviews.
Removal, cleaning and replacement are different things
Follow the schedule for your fitted device. Some need frequent removal; a cube needs daily removal and cleaning. Do not assume that a clinic-review interval is how long every pessary can remain in place.
If taught to self-manage, wash your hands before and after handling it. Follow the product's cleaning instructions: warm water is commonly used; use mild unperfumed soap only if permitted, and rinse thoroughly. Avoid household disinfectants, boiling or other sterilising methods unless specifically instructed for that device.
Check for cracks or damage and ask before reusing a damaged device. A replacement pessary is not necessarily needed at every check: its condition, fit and manufacturer's instructions guide replacement. Never force removal or use instruments to pull it out.
LIVING WITH A PESSARY
Sex, activity and vaginal health.
Sex and intimacy
Tell us your preferences before fitting. A ring may stay in during vaginal penetration if comfortable for both partners. Other shapes usually need removal. If you cannot remove yours yourself, discuss a suitable device and plan rather than trying to force it.
Movement and bowels
Walking, exercise and swimming are usually possible when the fit is comfortable. Address constipation and persistent straining; pelvic floor physiotherapy can help with support and movement. New pain or difficulty emptying needs review.
Vaginal comfort
After menopause, vaginal oestrogen may help dryness or soreness and reduce some pessary-related complications. It is not essential for everyone and does not guarantee a trouble-free fit. A history of breast cancer needs an individual discussion about treatment.
WHEN SOMETHING CHANGES
A problem with your pessary?
These are reasons to review the fit or care plan. You do not need to put up with pain. Check the urgent warning signs above.
It slips or falls out
Contact the practice to arrange a refit. Keep the device and bring it with you. If it has fallen into the toilet or become contaminated, ask for advice before reusing it. Reinsert it only if you have been taught, it is safe to clean and there is no pain or bleeding. Repeated expulsion may mean a different shape or size is needed.
If you are otherwise comfortable and passing urine normally, this can usually be arranged through the practice. Pain or difficulty passing urine needs earlier assessment. Read about possible changes and costs.
It presses, rubs or hurts
Contact the practice promptly. If you have been taught removal and can do it easily, leave it out until advised. Do not push it further in or repeatedly reinsert it through pain. Severe or worsening pain, fever or feeling unwell needs urgent assessment.
There is more discharge or an unpleasant smell
A little extra pale discharge can occur. Offensive, blood-stained or troublesome discharge, itching or soreness needs review; the lining and fit may need checking. Avoid douching or repeatedly treating presumed thrush without assessment. Fever or significant pelvic pain needs same-day assessment.
There is spotting or bleeding
Contact the practice promptly, even if you think the pessary rubbed. Bleeding after menopause needs assessment and must not automatically be attributed to the device. Heavy bleeding or faintness needs urgent care. Examination may lead to a temporary break, treatment of the lining or further investigation.
I cannot pass urine, or it is much harder
If you cannot pass urine, seek urgent assessment now. Do not wait overnight or for the next review. If you are passing some urine but the stream or emptying has become much worse after fitting, contact the practice for same-day advice. Do not force the device out.
I notice new urine leakage
Supporting the prolapse can reveal stress leakage that was previously masked. This does not automatically mean the device has caused damage. Arrange review to check the fit and distinguish cough/exercise leakage from urgency or infection symptoms. Continence treatment may need its own plan.
Opening my bowels is more difficult
New difficulty after fitting needs a check of the fit as well as constipation care. Avoid repeated straining. Severe abdominal pain, vomiting or inability to pass stool and wind needs urgent assessment.
I cannot remove or replace it
Stop if removal is painful or the device feels stuck. Never use tools or pull forcefully. Contact the practice for help; seek same-day advice if a daily-removal device cannot be removed. If you cannot put it back comfortably, leave it out and arrange assistance. Pain, bleeding or difficulty passing urine makes review more urgent.
REVISIT THE PLAN
If it does not suit you.
We can reconsider the size or shape, treat vaginal soreness, review self-care or discuss another approach. Physiotherapy, observation when appropriate and surgery remain options. Your preferences may change over time; you do not have to keep trying devices indefinitely or progress to surgery because you tried a pessary.
COMMON QUESTIONS
A few useful distinctions.
Can I use a pessary after hysterectomy?
Yes. A pessary can support vaginal-wall or vault prolapse after hysterectomy. The fit depends on your anatomy and any previous repairs.
Is this the same as a vaginal hormone pessary?
No. Here, “pessary” means a removable support device. The same word is sometimes used for a vaginal medicine or tablet; that treats a different problem.
Does it prevent pregnancy?
No. A prolapse pessary is not contraception. Discuss contraception or plans for pregnancy separately.
YOUR NEXT STEP
Find support that suits your life.
Bring your questions and, if you already use a pessary, its type or packaging. We can discuss a first fitting, a problem with your current device or a different treatment.
General information to support your individual fitting and care plan. Updated .
Images: International Urogynecological Association (IUGA) patient information. Original labels retained; the illustrations show examples.
Sources & further reading
- UK pessary guideline, updated 2026 · NICE: pessary treatment and follow-up
- IUGA: vaginal pessaries for prolapse
- Cambridge University Hospitals: self-management · South Tees: pessary care and problems
- AUGS–SUNA: pessary management consensus
- 2025 trial: vaginal oestrogen with ring pessaries
- TOPSY self-management trial · Four-year follow-up