What to Expect During a Pessary Fitting
What Is a Pessary?
A pessary is a soft, flexible medical device inserted into the vagina to provide internal support. Think of it like a sports bra for your pelvic organs—it helps hold everything in place and reduces the sensation of heaviness, bulging, or pressure that’s often associated with prolapse. Pessaries are made from medical-grade silicone.
What to Expect During a Pessary Fitting
At our clinic, pessary fittings are performed by trained pelvic floor physiotherapists in a safe, private, and supportive environment. Here’s how it works:
Once we've confirmed that a pessary is a suitable option for you, we begin the fitting process in a supportive and private setting. The aim is to find the type and size that provides you with the best possible support, comfort, and functionality for your body and lifestyle. This appointment is booked for 1 hour and may need to be completed over two sessions depending on the person.
Choosing the Right Type and Size
There are many types of pessaries—rings, cubes, dishes, and more—and each comes in multiple sizes. We start by selecting a shape based on your anatomy, symptoms, lifestyle goals, and whether you're interested in managing the pessary independently or prefer clinical support. We may try several pessaries in one session. Each is inserted gently with lubrication and assessed for how well it supports the vaginal walls and pelvic organs.
Functional Testing
Once the pessary is inserted, we guide you through a series of functional tests to ensure it stays in place and doesn't interfere with important functions:
Breathing and bearing down: You’ll be asked to gently bear down (as if opening your bowels) or cough to mimic pressure changes and test whether the pessary stays in place.
Bladder emptying: We assess whether you can still urinate freely with the pessary in place. A good-fitting pessary should not block the urethra or make it harder to empty your bladder.
Movement testing: You’ll be guided through real-life movements that reflect your goals, this may include:
Walking around the clinic
Squatting or sitting and standing from a chair
Lifting a weighted object (if relevant to your daily life or exercise)
Coughing or jumping (for those using pessaries for stress incontinence)
This helps us determine whether the pessary stays in place, continues to feel comfortable, and supports you in the activities that matter most to you. For this reason you may want to wear a dress or skirt for comfort!
How Should It Feel?
A well-fitting pessary should not cause any discomfort. You should not feel pressure, rubbing, or irritation. Many women are surprised at how unnoticeable it feels once inserted correctly. We’ll take the time to make sure the fit is right offering both support and ease.
We may need to adjust sizing or try a different shape to get the best result, and that’s completely normal. The fitting process is collaborative and led by your feedback and may take 1–2 sessions to get 100% correct.
Once the Fit is Right
Once we have found a pessary that is suitable we’ll teach you:
How to insert and remove your pessary (if you want to do this independently)
How to clean and care for it
Signs to watch for (e.g., discharge, irritation)
When and how often to come back for reviews
Follow-up appointments are important to monitor tissue health, ensure ongoing comfort, and make any changes as needed.
How likely is a successful pessary fitting?
Research tells us that pessary fitting is successful in roughly around 60% of people in their first fitting, this means around 40% of people will require more than one fitting to find the perfect pessary for them. We will do everything we can to ensure success on the first fitting, but multiple factors such as vaginal length, surgical history, type of prolapse, goals, sexual function and estrogen levels can all affect your fitting success. Your pessary may work and feel good in the clinic and then may not be perfect or work at home. This may mean we need to do a few fittings in order to find the right one.
