Feeling Pelvic Pressure? Why Your Prolapse Needs a Pessary & Medically Approved Next Steps

Feeling a heavy, dragging sensation in your pelvis? Noticing a bulge in your vagina? Experiencing discomfort when standing for long periods?

These symptoms may be signs of pelvic organ prolapse, a common condition—especially after childbirth or menopause. While it can feel alarming, prolapse is treatable. One of the most effective, non-surgical treatments is a pessary.

If you're feeling pelvic pressure, here's what you need to know about prolapse, how a pessary works, and what medically approved next steps look like.

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What Is Pelvic Organ Prolapse?

Pelvic organ prolapse happens when the muscles and tissues that support your pelvic organs (uterus, bladder, or rectum) weaken. This allows one or more organs to shift downward into the vaginal canal.

Common types include:

• Uterine prolapse – the uterus drops into the vagina
• Bladder prolapse (cystocele) – the bladder presses against the vaginal wall
• Rectocele – the rectum bulges into the vagina

Common Symptoms

• A feeling of pelvic pressure or fullness
• A visible or felt bulge in the vagina
• Lower back discomfort
• Difficulty inserting tampons
• Urinary leakage or trouble emptying the bladder
• Discomfort during sex

Symptoms often worsen at the end of the day or after standing for long periods.

If you're experiencing these symptoms and want to understand what might be causing them, Ubie's free AI-powered Uterine Prolapse symptom checker can help you identify whether your symptoms align with prolapse and guide your next steps.

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Why Pelvic Pressure Shouldn't Be Ignored

Prolapse is not life-threatening in most cases, but it does not usually fix itself. Without treatment, symptoms may gradually worsen.

More advanced prolapse can lead to:

• Difficulty urinating or emptying bowels
• Recurrent urinary tract infections
• Skin irritation or sores from tissue rubbing
• Increased discomfort with daily activities

That's why early evaluation and treatment matter.

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What Is a Pessary?

A pessary is a small, removable medical device inserted into the vagina to support prolapsed organs. It helps reposition the uterus, bladder, or rectum back into place.

Think of it as an internal brace for your pelvic organs.

Pessaries have been used safely for decades and are recommended by major gynecologic and urogynecologic organizations as a first-line treatment for many women with prolapse.

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How a Pessary Works

A pessary:

• Provides structural support to weakened pelvic tissues
• Reduces the feeling of pressure or bulging
• Improves bladder and bowel function
• May reduce urinary leakage
• Helps you avoid or delay surgery

It does not cure prolapse, but it manages symptoms effectively for many women.

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Types of Pessaries

There are several types of pessary devices. Your healthcare provider will select one based on the severity of your prolapse and your comfort level.

Common types include:

• Ring pessary – often used for mild to moderate prolapse
• Gellhorn pessary – typically used for more advanced prolapse
• Donut pessary – provides additional support

Fitting is important. A pessary that is too small may fall out. One that is too large may cause discomfort.

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What to Expect During a Pessary Fitting

The fitting process is done in a medical office and usually takes less than 30 minutes.

Your provider will:

• Perform a pelvic exam
• Determine the type and size of pessary
• Insert the device
• Check comfort and stability

You may be asked to:

• Walk around
• Cough
• Bear down

This ensures the pessary stays in place and feels comfortable.

Most women describe the process as mildly uncomfortable but not painful.

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Living With a Pessary

Many women live full, active lives with a pessary.

You Can:

• Exercise
• Walk
• Work
• Travel
• Have sex (depending on pessary type)

Care and Maintenance

There are two common approaches:

• Self-care model: You remove, clean, and reinsert the pessary yourself (often weekly or monthly).
• Office-care model: Your provider removes and cleans it every few months.

Cleaning usually involves mild soap and water.

Your doctor may also recommend vaginal estrogen cream if you are postmenopausal. This helps keep vaginal tissue healthy and reduces irritation.

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Is a Pessary Safe?

Yes—when properly fitted and monitored, a pessary is considered very safe.

However, follow-up is important. Without proper care, complications can occur, including:

• Vaginal irritation
• Discharge
• Odor
• Rarely, ulceration of vaginal tissue

Regular checkups significantly reduce these risks.

If you experience pain, bleeding, or difficulty urinating, contact your healthcare provider promptly.

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When Is Surgery Considered?

A pessary is often the first treatment option. Surgery may be considered if:

• The pessary does not relieve symptoms
• You cannot tolerate wearing it
• Prolapse is severe
• You prefer a surgical solution

Surgery aims to repair and strengthen pelvic support structures. It is generally effective but carries the risks associated with any operation.

A pessary allows many women to avoid surgery entirely—or delay it until a more convenient time.

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Who Should Consider a Pessary?

A pessary may be especially helpful if you:

• Want to avoid surgery
• Plan to have more children
• Have medical conditions that make surgery risky
• Need temporary relief while deciding on long-term treatment

It is also a good option for older women who prefer conservative treatment.

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Medically Approved Next Steps

If you're feeling pelvic pressure:

1. Schedule a pelvic exam. Only a clinician can confirm prolapse and determine its severity.

2. Discuss conservative treatments first. Ask whether a pessary is appropriate for you.

3. Ask about pelvic floor physical therapy. Strengthening exercises may improve symptoms.

4. Manage contributing factors, such as:

   • Chronic constipation
   • Heavy lifting
   • Persistent coughing
   • Obesity

5. Follow up regularly. Ongoing monitoring ensures safe, effective treatment.

If you're unsure about your symptoms, consider starting with Ubie's free AI-powered Uterine Prolapse symptom checker to help you better understand your condition and prepare meaningful questions for your appointment.

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When to Seek Immediate Care

While prolapse itself is rarely life-threatening, seek urgent medical attention if you experience:

• Inability to urinate
• Severe pelvic pain
• Heavy vaginal bleeding
• Signs of infection (fever, foul discharge)

Always speak to a doctor about symptoms that are severe, worsening, or concerning.

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The Bottom Line

Pelvic pressure is common—but it is not something you have to "just live with."

A pessary is a medically proven, non-surgical treatment that can:

• Relieve pressure and bulging
• Improve bladder symptoms
• Restore comfort and confidence
• Help you avoid or delay surgery

Prolapse is manageable. The key is early evaluation and the right treatment plan for your body and lifestyle.

If you're experiencing symptoms, take the next step:

• Consider a symptom check for Uterine Prolapse
• Schedule an appointment with a qualified healthcare provider
• Ask whether a pessary is right for you

Most importantly, speak to a doctor about any symptoms that could be serious or life-threatening. You deserve answers—and effective treatment options that improve your quality of life.