July 31, 2026
I was floating around in the sea in Sicily recently on an inflatable ring, holding up a tiny white ring for the camera. "This is a rubber ring," I said, pointing to the float I was lounging in. "And this is also a rubber ring," I said, holding up the other one. One keeps you afloat on holidays. The other, if you have a prolapse, quietly changes your day-to-day life. Only one of them fits in your pocket.
That second ring is a pessary, and I promise it's more useful than it sounds.
Let's start with the problem it solves. That heavy, dragging feeling down below, the one that gets worse the longer you're on your feet. Some women are told it's just their pelvic floor. Some are told it's just getting older. A lot of women are never told anything at all.
What's actually happening has a name: pelvic organ prolapse. It affects roughly 1 in 10 women over 50, though it can happen at any age. It occurs when the muscles and tissues holding up the bladder, womb or bowel weaken, usually after childbirth or during menopause, and those organs begin to bulge down into the vagina. It can cause that dragging or heavy sensation, discomfort during exercise or sex, and bladder symptoms too.
Surgery is one option, but there's a much simpler device that's been used for decades and doesn't get nearly enough airtime.
A ring pessary is a small silicone ring that's inserted into the vagina. Think of it as scaffolding, not a pool float. It holds your pelvic organs up and in place, the same way scaffolding holds up a ceiling, so you can walk, exercise and get on with your day without that dragging sensation. For a lot of women it also helps with incontinence, and it can make sex comfortable again. Genuinely one of the more underrated bits of kit in women's health.
Here's the bit that might surprise you. In one study of women successfully fitted with a pessary, the proportion reporting a vaginal bulge dropped from 90% to just 3% within two months. The heavy, pressure sensation went from 49% to 3%. And 92% of women said they were satisfied with the results. A separate study of women with more advanced prolapse found satisfaction rates above 90% too. Not bad for something the size of a bangle you'd lose in your handbag.
This isn't a niche or last-resort option. NICE guidance recommends considering a pessary for any woman with symptomatic prolapse, either on its own or alongside supervised pelvic floor muscle training, well before surgery comes into the conversation. For many women, it can prevent or delay the need for surgery altogether.
A few practical things worth knowing. Pessaries are fitted by a specially trained pelvic health physiotherapist, a gynae nurse or a gynaecologist, and it can take more than one attempt to find the right size and shape for you (no, you don't get to pick the lemon print). NICE guidance says a pessary should be removed at least once every six months to prevent complications, though your specialist may want to see you sooner, and it's worth having an honest conversation about how it might affect your sex life, since this can vary depending on the type of pessary. For most women, it improves things rather than getting in the way.
If you've been living with that dragging feeling and just accepting it, please don't. Prolapse is common. Common doesn't mean you have to put up with it. Have a chat with your GP, women's health physio or gynaecologist about whether a pessary could be right for you.
And if anyone asks why I was waving two rubber rings around in the sea in Sicily, now you know.
Sources:
Royal College of Obstetricians and Gynaecologists. Pelvic Organ Prolapse. Patient information.
National Institute for Health and Care Excellence (NICE). Urinary Incontinence and Pelvic Organ Prolapse in Women: Management. NG123.
Clemons JL, Aguilar VC, Tillinghast TA, Jackson ND, Myers DL. Patient Satisfaction and Changes in Prolapse and Urinary Symptoms in Women Who Were Fitted Successfully With a Pessary for Pelvic Organ Prolapse. Am J Obstet Gynecol. 2004;190(4):1025-9.
Zhou Y, Sun T, Ju A, Zhu L. Outcomes of Pessary Fitting Trials for Patients With Stage IV Pelvic Organ Prolapse: A Prospective Study. Int Urogynecol J. 2023.
That second ring is a pessary, and I promise it's more useful than it sounds.
Let's start with the problem it solves. That heavy, dragging feeling down below, the one that gets worse the longer you're on your feet. Some women are told it's just their pelvic floor. Some are told it's just getting older. A lot of women are never told anything at all.
What's actually happening has a name: pelvic organ prolapse. It affects roughly 1 in 10 women over 50, though it can happen at any age. It occurs when the muscles and tissues holding up the bladder, womb or bowel weaken, usually after childbirth or during menopause, and those organs begin to bulge down into the vagina. It can cause that dragging or heavy sensation, discomfort during exercise or sex, and bladder symptoms too.
Surgery is one option, but there's a much simpler device that's been used for decades and doesn't get nearly enough airtime.
A ring pessary is a small silicone ring that's inserted into the vagina. Think of it as scaffolding, not a pool float. It holds your pelvic organs up and in place, the same way scaffolding holds up a ceiling, so you can walk, exercise and get on with your day without that dragging sensation. For a lot of women it also helps with incontinence, and it can make sex comfortable again. Genuinely one of the more underrated bits of kit in women's health.
Here's the bit that might surprise you. In one study of women successfully fitted with a pessary, the proportion reporting a vaginal bulge dropped from 90% to just 3% within two months. The heavy, pressure sensation went from 49% to 3%. And 92% of women said they were satisfied with the results. A separate study of women with more advanced prolapse found satisfaction rates above 90% too. Not bad for something the size of a bangle you'd lose in your handbag.
This isn't a niche or last-resort option. NICE guidance recommends considering a pessary for any woman with symptomatic prolapse, either on its own or alongside supervised pelvic floor muscle training, well before surgery comes into the conversation. For many women, it can prevent or delay the need for surgery altogether.
A few practical things worth knowing. Pessaries are fitted by a specially trained pelvic health physiotherapist, a gynae nurse or a gynaecologist, and it can take more than one attempt to find the right size and shape for you (no, you don't get to pick the lemon print). NICE guidance says a pessary should be removed at least once every six months to prevent complications, though your specialist may want to see you sooner, and it's worth having an honest conversation about how it might affect your sex life, since this can vary depending on the type of pessary. For most women, it improves things rather than getting in the way.
If you've been living with that dragging feeling and just accepting it, please don't. Prolapse is common. Common doesn't mean you have to put up with it. Have a chat with your GP, women's health physio or gynaecologist about whether a pessary could be right for you.
And if anyone asks why I was waving two rubber rings around in the sea in Sicily, now you know.
Sources:
Royal College of Obstetricians and Gynaecologists. Pelvic Organ Prolapse. Patient information.
National Institute for Health and Care Excellence (NICE). Urinary Incontinence and Pelvic Organ Prolapse in Women: Management. NG123.
Clemons JL, Aguilar VC, Tillinghast TA, Jackson ND, Myers DL. Patient Satisfaction and Changes in Prolapse and Urinary Symptoms in Women Who Were Fitted Successfully With a Pessary for Pelvic Organ Prolapse. Am J Obstet Gynecol. 2004;190(4):1025-9.
Zhou Y, Sun T, Ju A, Zhu L. Outcomes of Pessary Fitting Trials for Patients With Stage IV Pelvic Organ Prolapse: A Prospective Study. Int Urogynecol J. 2023.
