A pessary is a medical device inserted into the vagina to provide support for pelvic organs that may have shifted from their normal position, a condition known as pelvic organ prolapse. It can also help manage stress urinary incontinence, where urine leaks during activities like coughing or sneezing. Many individuals considering or using a pessary are concerned about potential pain. This article explores the common sensations associated with pessary use and identifies situations where discomfort may indicate a need for medical attention.
The Insertion Experience
The initial insertion of a pessary by a healthcare professional is generally not painful. During this process, individuals may experience a feeling of pressure or fullness within the vagina as the device is positioned for support.
Mild discomfort may occur, but the procedure is usually quick, often completed in minutes. Relaxing the pelvic floor muscles can contribute to a smoother insertion. The transient sensations experienced during insertion are distinct from any ongoing discomfort with prolonged wear.
How a Pessary Should Feel
Once a pessary is correctly fitted and in place, it should largely be unnoticeable. It should provide support without causing ongoing pain or irritation. Individuals might experience a mild awareness of its presence, particularly during activities that increase abdominal pressure, such as coughing, sneezing, or lifting.
A properly fitted pessary should not interfere with daily activities or bodily functions like urination or bowel movements. If the right size, it should remain securely in place and not fall out during movement or when using the bathroom. A whitish vaginal discharge can be a normal occurrence with a pessary.
When Discomfort Turns to Pain
Pessary use can lead to pain or discomfort, often indicating an issue with the device or vaginal health. An improper fit or size is a common cause; a pessary that is too large can cause excessive pressure, while one that is too small may not provide adequate support and could even fall out or rub against vaginal walls. This rubbing can lead to irritation, or even small lesions or ulcers on the vaginal tissues, sometimes resulting in pink or bloody discharge.
Incorrect placement of the pessary can also contribute to pain, as it may not sit optimally to provide support or could press on sensitive areas. Signs of infection, such as unusual discharge that changes color, becomes copious, or has an unpleasant odor, along with itching or bleeding, can also cause pain and indicate a need for medical intervention. Persistent pressure from the pessary can lead to pressure sores on the vaginal walls. Lower back pain or pressure may also be a side effect if the pessary is not fitted correctly.
What to Do About Pessary Pain
Contact a healthcare provider promptly if you experience persistent pain or significant discomfort from a pessary. Ignoring pain can lead to further complications, such as increased irritation or the development of more severe issues like pressure sores. The provider can assess the pessary’s fit, as discomfort often indicates that a different size or type might be needed.
The provider may reposition the pessary or prescribe a different device altogether. If irritation or infection is suspected, topical creams (e.g., vaginal estrogen) or antibiotics may be prescribed to help heal the vaginal tissues or clear the infection. Avoid attempting to self-adjust the pessary if you are unsure, as this could worsen the issue.