A vaginal pessary is a soft, removable device that goes in your vagina. It supports areas that are affected by pelvic organ prolapse (POP). This happens when the bladder, rectum, or uterus drops or bulges down toward the vagina.

A pessary can also help if you have stress incontinence, which causes you to leak urine when you cough, strain, or exercise. Women who have incontinence during pregnancy might find a pessary helpful, too.

Types of Pessaries

Most are made out of silicone -- a harmless, soft, and nonabsorbent material. Types of pessaries include:

• Ring. This circle-shaped device is often the first type of pessary doctors recommend. You can easily insert and remove it without a doctor’s help.
• Gehrung. A U-shaped pessary that’s used for more advanced uterine prolapse, it is molded to fit its user.
• Gellhorn. This disk-shaped device with a small knob in the middle is used for more severe prolapse.
• Cube. This pessary is used for advanced-stage prolapse. It’s compacted down and inserted into the vagina where it uses suction to support the areas affected by prolapse.

Your doctor will perform a vaginal exam to see how severe your prolapse is. That’ll help them decide if a pessary is a good option for you. If so, they can determine which type would be best.

They’ll take measurements and fit you for one in their office. It’s important to get the right fit. If a pessary is too small, it can fall out. If it’s too big, you might feel too much pressure or discomfort. It may take a few tries to find a pessary that fits you best.

How to Care for Your Pessary

Be sure to follow your doctor’s instructions for how to remove and clean your pessary. If you have a type that you can remove on your own (such as the ring), remove it and clean it every night or every week. Use a mild soap with water. Rinse and dry the pessary completely before you reinsert it into your vagina.

If you have a type of pessary that you need your doctor to remove, like the Gellhorn, you’ll visit your doctor about every 1 to 3 months to have it taken out and cleaned.

Possible Risks

Call your doctor if you experience pain, discomfort, or pink or bloody discharge.

These could be signs that your pessary doesn’t fit right. You may need a different size. Blood may mean that the pessary is rubbing against the walls of your vagina. The area will heal when the pessary is removed.

When you have a pessary, you may notice a whitish discharge. This is normal. But call your doctor if the discharge changes color or smells bad. You may have an infection or vaginal irritation. Your doctor may prescribe an antibiotic or estrogen cream to help protect the skin in your vagina, which becomes thinner as you age.

What About Sex?

You can have sex while wearing certain types of pessaries, like the ring. Or, you might prefer to remove it before sex. You can reinsert it afterward.

Other pessaries, like the Gellhorn and cube, fill the vagina. If you use one of these, you can’t have sex. Talk to your doctor if you plan to have sex. They’ll consider this when choosing the type of pessary that’ll work best for you.