Pessaries Explained: A Simple, Practical Option for Prolapse (That Most Women Don’t Know About)
- Hannah
- Apr 20
- 5 min read
Understanding Prolapse (and Why It’s Often Ignored)
Prolapse is something I see regularly in clinic, yet it is still not something many women feel comfortable talking about.
For a lot of women, it starts as a subtle feeling. A heaviness. A dragging sensation. Or simply a sense that things do not feel quite the same as they used to.
Pelvic organ prolapse happens when the supporting vaginal walls begin to descend and no longer support the pelvic organs as well as they should. Depending on the area affected, this may involve support for the bladder, bowel, uterus or the top of the vagina.
Symptoms can vary, but commonly include:
heaviness or dragging in the pelvic area
a feeling of something coming down
noticing a bulge or lump
difficulty emptying the bladder or bowel fully
urinary leakage or urgency
changes in your stream or needing to get up at night to wee
discomfort during exercise or longer days on your feet
It is often put down to:
“just one of those things after having children”
“something I should probably just manage”
not having the time to deal with it
or avoided for fear of what it might mean
Fear is a huge part of why many women delay seeking help.
The word prolapse can sound frightening. Many women suspect that is what might be going on, but hope it is not, so they put off getting it checked.
In the early stages, symptoms are often not constant. There may be good days and bad days. Many women notice symptoms are worse at certain times of the month, particularly in the week before their period, and then settle again afterwards. That can make it easier to dismiss or delay.
When women do receive a diagnosis, they are often devastated. They worry their body has failed them, that exercise is over, or that things will only get worse from here. None of that is true.
Prolapse does not mean your body has failed, and it certainly does not mean life as you know it is over.
It is also important to say that prolapse is not only something that happens later in life.
I see women in their early thirties. I see women who have never had children. Risk factors can include pregnancy and birth, but also chronic coughing, carrying excess weight, constipation, heavy lifting with poor pressure management, and repetitive strain over time.
This is more common and more varied than many people realise.
But these symptoms are common - they are not something you have to just accept.
Find more on the NHS website here.
What Is a Pessary?
A pessary for prolapse is a flexible medical silicone device that is inserted into the vagina to help support the pelvic organs and reduce symptoms.
They come in different shapes and sizes, because one size fits all belongs in socks, not pelvic health.
A pessary can be used for many reasons, including:
reducing prolapse symptoms
helping with stress urinary incontinence
supporting return to sport
helping postnatal recovery
assisting bladder or bowel emptying in some cases
as a temporary option while awaiting surgery
or as a longer-term conservative treatment option
For many women, the biggest surprise is how simple and effective they can be.
Why Preparation for a Pessary for Prolapse Matters
This is the part many women are never told.
A pessary can be an excellent treatment option, but its success often depends on how well your body is prepared before it is fitted.
I often compare it to preparing for surgery. If someone goes into a hip or knee replacement with weak muscles, poor coordination and reduced stability, recovery is often harder. The same principle applies here.
A pessary works best when the whole support system around the pelvis is functioning well.
That includes:
pelvic floor muscles working well
muscles that are not too weak, too tight or overactive
healthy vaginal tissues
good breathing and pressure management
hips, glutes and core working in balance
If these areas need support, a pessary may feel less comfortable or less effective. That does not mean it has failed. It often means the body needs support too.
This is why pelvic health physiotherapy is so valuable alongside pessary fitting. We are not just looking at the device - we are looking at the whole person.
What Happens in a Pessary Appointment?
Appointments are designed to be thorough, practical and tailored to you. We begin by discussing your symptoms, lifestyle, goals and any relevant medical history. We will talk through whether a pessary is appropriate, and answer any questions you may have.
Assessment may include:
pelvic floor strength, coordination and timing
vaginal tissue health
prolapse assessment
movement and functional positions
how symptoms show up in real life
Where appropriate, internal examination may be used. Ultrasound can also be a really helpful addition in some cases, particularly for assessing muscle function or where someone would prefer an alternative or adjunct to internal assessment.
If we proceed with fitting, we then check comfort and function properly. That may include walking, squatting, coughing, lifting or moving around - because real life rarely happens lying flat on a treatment bed.
If needed, we can trial a different size or type to find the best fit.
What I See in Clinic
Many of the women I work with have already started to adapt their lives around symptoms before they come to see me. They may have stopped running. Avoided lifting. Thought twice about exercise. Planned days around toilet access. Or quietly lost confidence in their body.
Usually, it has happened gradually.
Once we properly assess what is going on and look at the right options, things often feel far more manageable. Sometimes that involves rehabilitation alone. Sometimes a pessary is a brilliant part of the plan. Often, it is a combination.
The aim is always the same: to help you feel stronger, more confident, and able to get back to the things you enjoy.
Taking the Next Step
If you are experiencing heaviness, pressure, leaking, discomfort, or a feeling that something is not quite right, it is worth getting it checked properly.
There is no one-size-fits-all approach to pelvic health, but there are options.
Having experienced this myself, I know how easy it is to put symptoms to one side or assume they are something you just have to live with. It is also a big part of why I feel so passionate about helping women access the right support and understand that things can improve.
If you would like to explore your options, book a pelvic health assessment or Mummy MOT. We can work out the right plan for your body, your goals, and your life.
FAQ's
What is a pessary for prolapse?
A pessary is a medical silicone device inserted into the vagina to support pelvic organs and reduce prolapse symptoms.
Can a pessary help me avoid surgery?
For many women, a pessary can be an effective conservative treatment option and may delay or remove the need for surgery.
Do I need children to get prolapse?
No. Prolapse can affect women who have not had children too.
Is a pessary appointment painful?
Appointments are tailored to you and designed to be as comfortable and supportive as possible.
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