Cleaning a pessary takes only a few minutes and requires nothing more than mild soap and warm water. Whether you remove your pessary nightly, weekly, or only at clinic appointments, the basic process is the same: take it out, wash it gently, rinse it well, and reinsert it or let it dry before putting it back in. No special solutions, sterilizers, or chemical disinfectants are needed for routine home care. The simplicity of the task can be deceiving, though, because questions about how often to clean, what products to avoid, and when a pessary needs replacing are less straightforward than the cleaning itself.
The Basic Cleaning Process
If your provider has taught you to remove and reinsert your own pessary, cleaning it at home follows a simple routine. Start by washing your hands thoroughly with soap and water. Then remove the pessary in whatever position is most comfortable for you, whether that is standing with one foot on the toilet seat, squatting, or lying down. Most ring and dish pessaries can be pinched slightly to fold them for easier removal, much like removing a diaphragm.
Once the pessary is out, wash it under warm running water with a mild, unscented soap. Avoid antibacterial soaps, harsh detergents, bleach, rubbing alcohol, or any product containing fragrance. These can degrade the silicone over time and irritate vaginal tissue when the pessary goes back in. Use your fingers to gently rub all surfaces, paying attention to any grooves, holes, or textured areas where discharge can collect. Rinse the pessary thoroughly so no soap residue remains.
After rinsing, you can reinsert the pessary right away or let it air-dry on a clean towel if you prefer to leave it out overnight. Some people find it helpful to apply a small amount of water-based lubricant to the rim before reinsertion. Avoid petroleum-based or silicone-based lubricants, which can damage the pessary material. That is genuinely the whole process. The more interesting questions involve how often you need to do it and what happens if you don’t.
How Often Should You Clean It
This is where patient experience and clinical evidence diverge from what many people assume. You might expect that cleaning your pessary more frequently would keep you safer and more comfortable. Research does not clearly support that assumption. A prospective study of women with pelvic organ prolapse found that frequent pessary cleaning in women without symptoms did not reduce side effects like pain, discharge, or irritation, and there was no difference in these outcomes between follow-up intervals of three months versus nine months.1PubMed Central. Effect of pessary cleaning and optimal time interval for follow-up: a prospective cohort study
A separate study went further, tracking women who used ring pessaries continuously without periodic removal, cleaning, or replacement. In women who had not had a hysterectomy, continuous use was safe for up to four years, and in those who had, it remained safe for about two years, provided they attended proper follow-up appointments.2PubMed Central. How often should ring pessaries be removed or changed in women with advanced POP? A prospective observational study That does not mean you should never clean your pessary, but it does mean the cleaning schedule should be guided by your provider’s recommendation for your specific situation rather than by anxiety that skipping a day will cause harm.
For most people who self-manage their pessary, a common schedule is removing and washing it once a week or once every few weeks, with a full clinical check every three to six months. Some people remove theirs nightly, especially if they only need it during active hours. Others leave it in continuously and have their provider handle removal and cleaning at scheduled visits. All of these approaches are considered acceptable as long as you are being monitored and know the signs that something needs attention.
What Builds Up on a Pessary Over Time
A pessary sits inside the vagina, which is a warm, moist, bacterial environment. Over time, microorganisms form a thin, organized layer on the pessary surface called a biofilm. One study using electron microscopy confirmed that biofilm formed on every single pessary examined, all 40 devices in the study. About 40 percent of these biofilms were dominated by Lactobacillus, the healthy bacteria that normally keep the vaginal environment balanced. The remaining 60 percent were dominated by other types of bacteria, including anaerobic species that are associated with conditions like bacterial vaginosis.3PubMed. Bacterial biofilm formation on vaginal ring pessaries used for pelvic organ prolapse
Biofilm is not something you can see with the naked eye, and mild soap and water will reduce it but probably will not eliminate it entirely. This is one reason why pessaries eventually need to be replaced, typically every one to two years even if they look fine. Over time the silicone surface can develop microscopic roughness that makes biofilm harder to remove and gives bacteria more surface area to cling to. If your pessary starts to look discolored, feels tacky or rough despite washing, or develops an odor that does not go away after cleaning, it is time to ask your provider about a replacement.
When Discharge Is Normal and When It Is Not
One of the most common concerns among pessary users is vaginal discharge. A pessary is a foreign body, and its presence naturally changes the vaginal environment. Clinicians describe the resulting discharge as typically thin, watery, and not requiring treatment on its own.4PubMed. Complications of Pessary Use Many people find that wearing a thin panty liner is enough to manage it comfortably.
The discharge becomes a concern when its character changes. Watch for these signs that warrant a call to your provider:
- Foul smell: A persistent offensive odor that does not resolve after cleaning the pessary could indicate bacterial vaginosis or another infection.
- Color change: Discharge that turns green, yellow, or gray suggests infection rather than a normal physiologic response.
- Itching or burning: These symptoms suggest the vaginal tissue is irritated or infected, not just reacting to the pessary’s presence.
- Bloody discharge: Small amounts of pink or brown spotting can happen, especially when a pessary is new or if the tissue is thin, but recurring or heavy bleeding needs evaluation.
Some providers suggest using a mild vinegar-and-water rinse (about one tablespoon of white vinegar in a cup of water) to soak the pessary for a few minutes once a week, which may help manage odor. This is not a disinfection step; it simply lowers the pH slightly. Ask your provider before adding this to your routine.
What Happens When a Pessary Is Neglected
The cleaning discussion matters more when you consider what can go wrong with a forgotten or neglected pessary. The most common complications overall are vaginal discharge, vaginitis, erosion of the vaginal lining, and bleeding.5PubMed Central. An integrative review and severity classification of complications related to pessary use in the treatment of female pelvic organ prolapse These tend to be mild and manageable when caught early. The danger comes from pessaries that stay in place for years without any follow-up.
A systematic review of surgical complications from pessaries found that about two-thirds of dangerous complications occurred in cases where the pessary had been neglected.6PubMed Central. Complications of Pessaries Amenable to Surgical Correction: Two Case Reports and a Systematic Review of the Literature “Neglected” in this context means the device was left in without any medical monitoring, sometimes for a decade or more. In extreme cases, the pessary can erode through the vaginal wall into the bladder or rectum, creating abnormal openings called fistulas. These are serious surgical problems. In very rare instances, death has resulted from severe neglected pessary complications.
These worst-case scenarios are genuinely rare and almost entirely preventable. The key is not obsessive daily scrubbing. It is making sure you attend your follow-up appointments and contact your provider if you notice pain, bleeding, difficulty urinating, or unusual discharge. If you self-manage your pessary, you have an advantage because you are physically handling the device regularly and can notice problems earlier than someone who forgets the pessary is there.
Products to Avoid
Because pessaries are medical-grade silicone, the list of products that can damage them or irritate your tissue is short but worth knowing. Never use any of the following to clean a pessary:
- Bleach or hydrogen peroxide: Too harsh for silicone and dangerous to vaginal tissue if residue remains.
- Antibacterial hand soap: The antimicrobial agents can disrupt vaginal flora and may degrade silicone over time.
- Scented soap or body wash: Fragrance chemicals are a common cause of vaginal irritation.
- Boiling water: While medical silicone can tolerate high heat, repeated boiling is unnecessary and can warp the shape of some pessary types. Your provider will tell you if your specific device tolerates boiling.
- Silicone-based lubricant: This can break down the pessary surface. Stick to water-based lubricant for reinsertion.
Plain, unscented dish soap or a gentle hand soap like castile soap works well. Some providers recommend a specific cleanser; follow their advice over any general guide, including this one.
The Role of Vaginal Estrogen
If you are postmenopausal, your provider may have mentioned vaginal estrogen cream or suppositories alongside your pessary. The idea is that estrogen helps keep vaginal tissue thicker, more elastic, and better lubricated, which could reduce irritation from the device. One study found that postmenopausal women who used vaginal estrogen were roughly half as likely to develop increased vaginal discharge compared to those who did not use it.7PubMed Central. Effect of vaginal estrogen on pessary use
However, the evidence is not entirely one-sided. A randomized controlled trial found that vaginal estrogen did not reduce bacterial vaginosis, vaginal abrasions, vaginal bleeding, or pain in postmenopausal pessary users.8PubMed. Effect of vaginal estrogen in postmenopausal women using vaginal pessary for pelvic organ prolapse treatment: a randomized controlled trial So estrogen may help with discharge and tissue dryness but might not prevent the mechanical side effects of having a device pressing against the vaginal walls. This is a conversation to have with your provider, especially if you are dealing with recurring irritation or dryness that makes the pessary uncomfortable. Estrogen therapy is a complement to good pessary care, not a substitute for it.
Self-Managing Versus Office-Only Care
Whether you handle your own pessary or rely entirely on clinic visits for removal and cleaning depends on several factors: your comfort level, your dexterity, the type of pessary you use, and your provider’s philosophy. Ring and oval pessaries are the easiest to self-manage because they can be folded for removal and insertion. Space-filling pessaries like the Gellhorn or cube are trickier and sometimes require provider assistance.
Research supports self-management as a cost-effective approach that gives you more control and reduces the number of clinic visits you need.9PubMed Central. Updates in Pessary Care for Pelvic Organ Prolapse: A Narrative Review If you can learn to remove, clean, and reinsert your pessary, you are not tethered to a clinic schedule for routine maintenance. You still need periodic check-ups so your provider can examine the vaginal tissue and make sure the pessary fits properly, but the day-to-day upkeep becomes yours.
Not everyone takes to self-management, and that is completely fine. Some people find removal uncomfortable or anxiety-provoking, especially early on. Others have mobility limitations that make the maneuver difficult. If you fall into this category, your provider can set up a visit schedule for pessary removal, cleaning, and vaginal inspection. The typical interval for office-based management is every three to six months, though your provider may adjust this based on your history.
Cleaning Different Pessary Types
Most modern pessaries are made of medical-grade silicone, and the cleaning instructions are essentially the same regardless of shape. But the shapes do present different practical challenges.
Ring pessaries are the simplest to clean. They have a uniform surface with no deep crevices. A quick wash under running water with mild soap covers every surface easily. Dish or oval pessaries are similarly straightforward. If yours has drainage holes, make sure water runs through them to clear any accumulated discharge.
Gellhorn pessaries have a stem and a concave disc, which means there are more surfaces to reach. Pay particular attention to the junction where the stem meets the disc, as discharge can collect there. Cube pessaries have suction cups on each face, and the small indentations in these cups can trap discharge. Rinse them under direct water pressure and use your fingers to clean each face individually.
Donut pessaries are solid and rounded, making them easy to wash, but their bulk can make removal and reinsertion harder without help. If you use a donut pessary and manage it at home, take a few extra seconds to feel the entire surface for any rough spots or sticky patches that could indicate silicone degradation.
When to Replace Rather Than Clean
Cleaning extends the life of a pessary but does not make it last forever. Silicone gradually wears down from exposure to vaginal secretions, the mild mechanical stress of insertion and removal, and the biofilm that forms on its surface. Most providers recommend replacing a silicone pessary every one to two years, though some devices hold up longer.
Replace your pessary sooner than scheduled if you notice any of the following: visible cracks or tears in the silicone, permanent discoloration that does not wash off, a rough or gritty texture on what should be a smooth surface, or a persistent odor even after thorough cleaning. A damaged pessary can harbor bacteria in places you cannot clean and can irritate or erode the vaginal lining more aggressively than an intact one.
Your provider will also check the pessary’s condition during follow-up visits. Even if you think it looks fine, they may recommend a new one based on changes they can see or feel that are not obvious to you. Since pessaries are relatively inexpensive compared to surgical alternatives, replacement is a minor cost for ongoing comfort and safety. If you are on a tight budget, ask your provider’s office whether they stock sample pessaries or can help you access one through your insurance.
Travel and On-the-Go Care
If you travel frequently or spend time away from home, a few practical adjustments can keep your routine simple. Carry a small ziplock bag with a travel-sized bottle of unscented soap and a water-based lubricant packet. If you typically remove your pessary nightly, hotel bathrooms work fine; just make sure you have a clean surface to set the pessary on while you wash it. A clean washcloth laid on the counter does the job.
If you are camping or somewhere without reliable access to clean water, it is fine to leave the pessary in for an extra day or two rather than cleaning it with questionable water. The research on continuous wear makes it clear that short extensions of your usual schedule are not dangerous. What you want to avoid is going weeks or months without attending to the device at all. A missed day here and there is trivial compared to the cumulative neglect that leads to real complications.
For air travel, keep the pessary in during your flight if you normally wear it continuously. If you remove it at night and plan to reinsert it in the morning, just pack your soap and lubricant in your carry-on liquids bag. There is nothing about air travel, altitude, or cabin pressure that changes how a pessary fits or functions.