Pelvic health is a vital part of overall well-being, yet many women experience pelvic floor concerns quietly. Conditions such as urinary incontinence, pelvic organ prolapse, and pelvic floor weakness are common and affect women across all ages—from their twenties through their nineties. Despite this, many women hesitate to seek care or feel unsure about how to manage treatment options on their own.

One highly effective non-surgical option for managing these conditions is a pessary—a device designed to support pelvic organs and reduce symptoms. If you’ve been prescribed a pessary and feel unsure about how to insert it safely, you’re not alone. Concerns about discomfort, incorrect placement, or whether it can “get lost” are very common. With proper guidance, however, pessary insertion can be safe, simple, and empowering.

Understanding the Pessary

A pessary is a flexible silicone device placed inside the vagina to support pelvic organs. It is most commonly used for pelvic organ prolapse and urinary incontinence, but it can also relieve pressure, bulging, and other pelvic floor symptoms.

Pessaries come in many shapes and sizes, and proper fit is essential—much like wearing the right size shoe. A correctly fitted pessary should feel comfortable, stay in place, and not interfere with daily activities.

One common fear is that a pessary can get lost inside the body. This is not possible. The vagina is a closed space. When inserted correctly, the pessary remains securely in place and cannot travel elsewhere in the body.

Preparing for Pessary Insertion

Preparation helps make insertion smoother and more comfortable. Before inserting your pessary, gather the following and choose a private, relaxed environment.

Clean Hands

Wash your hands thoroughly with soap and water before handling the pessary. While the vagina is not sterile, clean hands help reduce infection risk.

Lubricant

Use a small amount of water-based lubricant. Apply it to the tip of the pessary—not the entire device—so it slides in smoothly without becoming difficult to grip.

The Pessary

Your healthcare provider will prescribe the appropriate type and size for your anatomy and symptoms. Most pessaries are flexible and designed to be folded for insertion.

Comfortable Position

Choose a position that feels stable and relaxed. Common options include:

Lying on your back with knees bent
Sitting on the toilet
Standing with one leg elevated on a stool

The best position is the one that allows you to relax your pelvic floor.

Step-by-Step Guide to Inserting a Pessary

Follow these steps carefully for safe and effective insertion.

Step 1: Fold the Pessary

Most pessaries are made of soft silicone and can be folded. For ring pessaries with support, fold the device in half along the wider opening to create a narrow shape for easier insertion.

Step 2: Apply Lubricant

Apply a small amount of water-based lubricant to the leading edge of the pessary. Avoid over-lubricating, as this can make the device slippery and harder to control.

Step 3: Relax Your Pelvic Floor

Relaxation is key. Tension or anxiety can cause pelvic floor muscles to tighten, making insertion more difficult. Take slow, deep breaths and consciously release tension.

Step 4: Angle Toward the Back

The vaginal canal is angled slightly toward the lower back, not straight upward. Gently aim the pessary toward your tailbone to follow your natural anatomy.

Step 5: Insert Gently

Slowly guide the pessary into the vagina. Do not force it. If you feel resistance, adjust the angle slightly rather than pushing harder. Proper insertion should not be painful.

Step 6: Position Behind the Pubic Bone

Once fully inserted, the pessary should sit behind the pubic bone. You may feel it open or settle into place. When positioned correctly, it should feel secure and comfortable.

How to Know the Pessary Is Positioned Correctly

A well-positioned pessary should be comfortable and mostly unnoticeable during daily activities. Signs that placement may not be correct include:

Persistent pressure or discomfort
The pessary slipping out with walking, squatting, or exercise
Pain near the pubic bone

If any of these occur, contact your healthcare provider. You may need a size adjustment or a different pessary type.

When to Contact Your Doctor

While many women manage pessaries independently after instruction, you should seek medical guidance if you experience:

Persistent pain or discomfort
Vaginal bleeding, especially after menopause
Difficulty keeping the pessary in place
Pain during insertion
Trouble emptying your bladder

These symptoms may indicate that the pessary size or type needs adjustment.

Pessary Care and Maintenance

Most women remove and clean their pessary regularly. General care includes:

Removing the pessary as instructed
Washing it with mild soap and water
Allowing it to dry before reinsertion

Many women remove their pessary for intercourse, while others use it only during exercise or prolonged standing. Follow-up is typically recommended a few weeks after fitting to ensure proper placement and comfort. Ongoing follow-up depends on individual needs.

A pessary is a safe, effective, non-surgical option for managing pelvic organ prolapse, urinary incontinence, and other pelvic floor concerns—when used correctly. Proper technique, relaxation, and understanding your anatomy are essential for success.

Pelvic health matters at every stage of life. Learning how to use tools like a pessary confidently is an important step in caring for your body. With the right guidance, pessary insertion can become a routine part of self-care that improves comfort, function, and quality of life.

If you have questions or concerns, don’t hesitate to reach out to your healthcare provider. Support and effective solutions are available—and you deserve to feel comfortable and informed.

How to Insert a Pessary Safely: A Step-by-Step Guide