A pessary is a non-surgical, medical-grade silicone device inserted into the vagina to provide internal support to the pelvic organs. This device is commonly used to manage symptoms related to pelvic organ prolapse, where organs like the bladder or uterus descend into the vaginal canal, or to address stress urinary incontinence. For active individuals, the answer to whether running is possible with a pessary is often an encouraging yes, and the device is frequently recommended to help women return to or maintain high-impact activities. When correctly fitted, a pessary acts as a supportive internal brace that allows for comfortable and symptom-free movement.
How Pessaries Provide Support During High-Impact Activity
Running and other high-impact activities generate significant downward force on the pelvic floor, primarily through an increase in intra-abdominal pressure. When the abdominal muscles contract rapidly, this pressure is transmitted to the pelvic organs and supporting tissues. For women managing pelvic organ prolapse or stress urinary incontinence (SUI), this repetitive downward force can worsen symptoms like leakage or feelings of heaviness.
The pessary provides mechanical counter-support, acting as a stable platform that helps to lift and maintain the pelvic organs in a better anatomical position. By stabilizing the organs, the device helps to mitigate the negative effects of this increased pressure. This structural reinforcement prevents the organs from descending further during the jarring motion of running.
For those with SUI, the pessary offers dynamic support by stabilizing the bladder neck and urethra. This stabilization helps the urethra remain compressed against the pubic bone during activity, which is necessary to prevent involuntary urine loss. The device ensures the anatomical structures responsible for continence stay positioned to function effectively, even when subjected to intense physical exertion.
In many cases, a pessary is used only during exercise, acting as a temporary orthotic for the internal support system. This use allows women to engage in high-impact sports without fear of exacerbating symptoms or causing tissue strain. The ability of the device to move with the body while maintaining its supportive position is what makes it effective for dynamic activities like running.
Choosing the Best Pessary Type for Running
Selecting the appropriate pessary shape and size is a highly individualized process that determines its effectiveness, especially for running. The choice often depends on the specific condition being treated, such as the type and severity of prolapse or the primary symptom of incontinence. A healthcare provider, like a urogynecologist or pelvic floor physical therapist, typically performs a fitting to determine the best option.
For active users, the pessary must be secure enough to withstand repetitive impact without becoming dislodged or expelled. Space-occupying pessaries, such as the cube or the specialized support pessaries like the incontinence ring or dish, are frequently preferred for high-impact activity. The cube pessary, for example, uses suction to remain securely in place, making it a popular choice for athletes and often requires daily removal.
The ring pessary, especially the thick ring or one with a supportive knob, is a common starting point and can be effective for milder conditions or SUI. However, for more advanced prolapse or for individuals participating in vigorous running, a device that occupies more space or uses a different mechanism of stabilization may be necessary.
The fitting process involves trying different sizes and shapes, often requiring the patient to simulate activities like coughing or bearing down to ensure the device remains stable. The ideal fit is one that you do not feel during movement, indicating that the device is supporting the tissues without causing undue pressure. Since running is a high-demand activity, the fit must be dynamic, meaning the pessary needs to remain comfortable and effective through a full range of motion. Finding the right type and size may require a period of trial and error with a specialist to achieve the perfect balance of support and comfort.
Troubleshooting Common Issues for Active Users
Even with a perfect initial fit, active use can sometimes lead to practical complications that require troubleshooting. The most immediate concern during a run is the feeling of the pessary slipping or being expelled. If this occurs, it is a clear indication that the size or shape is incorrect for high-impact activity, and you should stop running immediately and contact your clinician for a refitting.
Increased vaginal discharge is a common side effect of pessary use, as the device is a foreign object in the canal. Active users may notice this more due to increased body temperature and moisture. Maintaining proper hygiene, including regular cleaning of the device as directed by your provider, is important to manage this and prevent potential infection.
If you notice any foul-smelling discharge, unusual vaginal itching, or yellow or green discharge, you should remove the pessary and consult a healthcare professional. These symptoms can indicate a vaginal infection or irritation of the vaginal wall tissues, which requires attention before resuming use.
Spotting or localized pain, often described as a pinkish tinge on the device upon removal, suggests the pessary is rubbing or causing irritation to the vaginal tissues. If this happens, discontinue use and seek an examination, as the tissue may need time to heal. For devices that are self-managed, such as the cube, temporary removal before and after a run is often the recommended protocol to simplify hygiene and reduce the risk of irritation.