When it comes to pelvic organ prolapse, many women are told to “do pelvic floor exercises” or are fitted with a simple ring pessary, only to be disappointed when symptoms persist or the device fails. At Secret Women’s Business (SWB) Physiotherapy, we want you to know there is far more to prolapse management than just pelvic floor exercises, and the right size and style of pessary support can be life changing as a treatment option.
What Is a Pessary?
A pessary is a small, silicone device inserted into the vagina to support the vaginal walls and/or uterus. It acts like an internal support, helping to reduce heaviness, bulging, or discomfort commonly associated with prolapse. Some pessaries are even designed to assist with bladder leakage, particularly with coughing, sneezing, or exercise.
Pessaries are not new, women have used versions of them for centuries, but modern softer silicone designs are safe, removable, and well tolerated by many women. With the right style, size, and support, they can be genuinely life-changing.
It’s Not Just a Ring (Although ring pessaries are great!)
Some women who come to SWB have tried a ring pessary in the past and assumed pessaries simply “weren’t for them.” But ring pessaries are only one of many pessary designs available. In fact, there are many different pessary styles, including cubes, dishes, rings with knob, shaatz and gellhorns, and each has its own purpose, shape, and suitability for different pelvic support needs.
A failed pessary trial in the past doesn’t mean pessaries aren’t an option. It may simply mean the wrong style or size was used, or that the timing of the fitting wasn’t ideal due to vaginal tissue condition, pelvic floor muscle strength and co-ordination, constipation or lifestyle factors. Working with an experienced women’s health physiotherapist, like the team at SWB, can make all the difference.
Why See a Physiotherapist for Pessary Fitting?
Pessary fitting and management is a specialised area of physiotherapy. At SWB, all of our physiotherapists have advanced training in pessary fitting and maintain a large onsite stock of pessary sizes and styles to trial during appointments.
We take the time to get it right:
- We don’t rush fittings. A pessary is rarely fitted at the initial consultation. Instead, we use the first session to understand your symptoms, address contributing factors (such as bowel or bladder dysfunction, chronic straining, or vaginal tissue health), and discuss a plan for pessary fitting if appropriate.
- We optimise conditions. Sometimes medication such as topical oestrogen is recommended to improve the comfort and success of fitting. This is something your physiotherapist may recommend you discuss with your GP.
- We personalise the plan. Your lifestyle, physical activity, anatomy, past surgeries and symptoms guide our recommendations. We work with your goals in mind, whether that’s getting back to exercise, managing work demands, or simply feeling comfortable walking around the shops.
What Does the Process Involve?
Pessary management is an ongoing process. Once fitted, your SWB physiotherapist will guide you through an ongoing management plan. And remember, it commonly takes a few appointments to trial and refine the right fit. But for many women, finding the right pessary restores confidence, reduces symptoms, and supports a return to normal activities without bothersome prolapse symptoms.
With the right support and expertise, pessaries can be a powerful tool in the management of pelvic organ prolapse.
📍 Menai, NSW
📞 9543 8090
🌐 swbphysio.com.au
