Prolapse and

Pessary fittings

Prolapse and Pessary fittings

A prolapse sounds scary but is very common after childbirth and during menopause but can be managed to reduce your symptoms and allow you to lead an active life.


What is prolapse?

A prolapse means the “dropping down” of your pelvic organs  - your bladder, bowel or uterus, this can occur as a result of the increased load during pregnancy, increased weight gain, repetitive heavy lifting or chronic cough or straining with constipation or the effects of ageing.

Signs and symptoms?

  • Do you ever feel heavy, bulgy or achy in the vagina or vulval area?
  • Do you feel pressure in the vagina like a grape, ping pong ball, egg or tennis ball
  • Do you feel like something is going to fall out of your vagina?
  • Can you feel a sense of rectal fullness at the bottom rather than further up?
  • Do you experience leakage after you stand up after emptying your bladder?
  • Do you experience a new feeling of heaviness or ache just before your period or with ovulation?
  • Don't stress any further - we can diagnose and advise on the management of your symptoms


Common causes of prolapse?

  • Chronic straining of the area due to constipation / heavy lifting or coughing
  • Stretching during pregnancy and childbirth
  • Multiple pregnancies and higher birth weight pregnancies
  • High body weight and aging



How can we help?


Physiotherapy help for prolapse?

We offer individualized assessment and treatment plans, based on your symptoms, severity of prolapse and goals. Treatment may include:

  • Pelvic floor muscle training
  • Advice on healthy bladder and bowel habits
  • A Pessary fitting (a soft silicone device that fits into your vagina to support your pelvic organs, just like an ankle or knee brace for ligament injury to your leg)
  • Education and advice on an exercise program that respects your prolapse but still achieves your fitness levels and goals 
  • Support and encouragement that you can continue to live a full life with a prolapse

Related Blogs

By Kylie Conway June 4, 2025
Pelvic Organ Prolapse, or POP, is a symptom that affects many people but is not always openly discussed. It occurs when one or more pelvic organs—such as the bladder, bowel, or uterus—shift from their normal position and descend, often resting against the vaginal wall. While some degree of movement is considered normal, a prolapse is diagnosed when symptoms are present. What Does POP Feel Like? People with POP often describe a sense of heaviness or dragging in the pelvis. Others may notice a bulge in or outside the vagina, discomfort during daily activities, or a feeling that something is “coming down.” POP can also affect bladder and bowel function, leading to symptoms like incomplete emptying or frequent urgency. What Increases the Risk of POP? The most significant risk factor for developing POP is vaginal childbirth. However, it's not just childbirth itself, but certain factors around the delivery that play a role: Birth weight over 4kg Pushing for less than 20 minutes or more than 2 hours Obstructed labour or instrumental delivery (forceps, vacuum) Other contributing lifestyle factors include: Chronic constipation or long-term straining Persistent coughing (e.g., due to asthma or smoking) Heavy lifting over extended periods Family history of prolapse Menopause, due to hormonal changes affecting tissue support Conservative Treatment Options For many people, POP can be managed conservatively without surgery. Treatment may include: Pelvic Floor Muscle Training : Strengthening these muscles improves the support they provide to pelvic organs. Horizontal Rest : Lying down throughout the day can help reduce the sensation of heaviness and give your body time to recover. Hormonal Therapies : Your doctor may prescribe topical oestrogen to help strengthen vaginal tissues, particularly after menopause. Pessary Use : A pessary is a small silicone device inserted into the vagina to provide internal support for the organs. Lifestyle Modifications : Addressing chronic constipation or cough and avoiding unsafe repetitive heavy lifting can reduce strain on the pelvic floor. For personalised guidance, it’s important to consult a qualified pelvic health physiotherapist who can tailor your treatment to your specific needs and goals. When Is Surgery Considered? In more severe cases of prolapse, or when conservative measures do not relieve symptoms, surgery may be recommended. If this is the case, your healthcare provider will refer you to a specialist for a comprehensive assessment and to discuss your surgical options. Conclusion Pelvic Organ Prolapse is common, but with the right support and management strategies, it doesn’t have to limit your quality of life. Early intervention through physiotherapy and lifestyle changes can significantly improve symptoms and help you feel confident in your body again. If you're experiencing symptoms or want to know more, reach out to a pelvic health physiotherapist to explore your options.
By Kylie Conway March 2, 2025
Vaginal pessaries are a common medical device used to treat a variety of gynecological conditions. Although not often discussed openly, these devices can significantly improve quality of life for many women experiencing pelvic floor issues. In this blog, we’ll explore what vaginal pessaries are, how they work, their benefits, and key considerations for using them. What Are Vaginal Pessaries? A vaginal pessary is a small, flexible device that is inserted into the vagina to provide support to the pelvic organs. It comes in various shapes and sizes, depending on the specific condition it is meant to treat. These devices are typically made of medical-grade silicone or rubber, ensuring they are both durable and comfortable for long-term use. Vaginal pessaries are primarily used to treat pelvic organ prolapse (POP), urinary incontinence, and other conditions related to the pelvic floor. Pelvic organ prolapse occurs when one or more of the pelvic organs (such as the bladder, uterus, or rectum) slip out of their normal position due to weakened or stretched pelvic floor muscles and tissues. Common Uses for Vaginal Pessaries Pelvic Organ Prolapse (POP): Prolapse occurs when pelvic organs, such as the bladder, rectum, or uterus, drop or bulge into the vaginal canal. This can happen due to childbirth, aging, menopause, or other factors that weaken the pelvic floor muscles. Vaginal pessaries help by supporting the organs and keeping them in place, preventing discomfort and improving symptoms like vaginal bulging and urinary leakage. Urinary Incontinence: Many women experience urinary incontinence, particularly stress incontinence, which involves leaking urine during activities like coughing, sneezing, or laughing. Pessaries can help reduce these symptoms by providing support to the bladder and urethra. Post-Surgical Support: After certain surgeries, such as a hysterectomy or pelvic floor surgery, a pessary may be used temporarily or long-term to provide support during the healing process. Benefits of Vaginal Pessaries Non-Surgical Solution: For women who are not ready or unable to undergo surgery, vaginal pessaries provide a non-invasive, low-risk alternative to manage pelvic organ prolapse and other conditions. Cost-Effective: Compared to surgical options or long-term treatments, vaginal pessaries are generally affordable, especially when considering the ongoing costs associated with surgeries or more complex medical interventions. Customizable Treatment: Pessaries come in a range of sizes and shapes, allowing healthcare providers to customize treatment based on the patient's specific needs and anatomical considerations. Improved Quality of Life: Many women report significant improvement in symptoms, including reduced vaginal bulging, pelvic discomfort, and urinary incontinence, leading to a better overall quality of life. Minimal Maintenance: Pessaries are relatively easy to maintain with regular cleaning and occasional adjustments by a healthcare provider. They can also be used temporarily or long-term, depending on the severity of the condition. How to Use a Vaginal Pessary Using a vaginal pessary is straightforward but requires some instruction from a healthcare provider. Generally, the pessary is inserted into the vagina, where it rests against the pelvic organs to provide support. Many individuals can insert and remove the pessary themselves, while others may need help from us. Here are the basic steps for using a vaginal pessary: Consult with a Healthcare Provider: Your physio will assess your condition and recommend the appropriate type of pessary for your needs. Insertion and Removal: Pessaries are typically inserted when lying down or standing with one leg raised. After insertion, the pessary should be checked periodically to ensure it stays in place. Your physio will also provide instructions for cleaning and maintaining the device. Regular Checkups: While vaginal pessaries can be worn for long periods, regular follow-up appointments with your healthcare provider are essential to monitor the condition and ensure the pessary remains effective and comfortable. Considerations and Possible Side Effects While vaginal pessaries are a helpful treatment option for many individuals, there are some considerations to keep in mind: Discomfort: Some individuals may initially experience discomfort or irritation when using a pessary, though this often improves as the body adjusts. A well-fitted pessary should not cause pain or excessive pressure. Vaginal Discharge or Infection: Regular cleaning of the pessary is essential to avoid vaginal infections or discharge. It is also important to use the pessary as directed by a healthcare provider to minimize risk. Need for Replacement: Over time, pessaries may need to be replaced due to wear and tear or changes in the shape of the vagina. Not for Everyone: While pessaries are an effective option for many, they are not suitable for everyone. Individuals with severe vaginal atrophy or other complicating factors may require alternative treatments. Vaginal pessaries are an essential tool in the management of pelvic floor disorders, particularly pelvic organ prolapse and urinary incontinence. They offer a non-invasive, customizable solution for many who seek relief from symptoms without opting for surgery. While the device may take some getting used to, the benefits—such as improved comfort and quality of life—make it a valuable treatment option for those affected by these conditions. If you think a vaginal pessary might be right for you, consult with your gynecologist, healthcare provider or pelvic health clinician to determine the best approach for your individual needs. With the right guidance and care, vaginal pessaries can help restore pelvic health and provide lasting relief.
By Kylie Conway March 9, 2023
Cystocele, caesarean & clitorodynia all start with the letter C and are all related to pelvic health.
December 2, 2021
Your pelvic floor is a 'sling' of muscles, a bit like a small muscle hammock that runs between the pubic bone in the front, and the tailbone at the back.

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