With thanks to @popuplift
“You don’t need a pessary.”
“A pessary is a crutch and you can’t strengthen fully with one.”
“Pessaries are just for people with constant symptoms.”
Does this sound familiar?
Pessaries are a tool, and tools don’t always have rules. Unfortunately, we hear from so many people who have been told “rules” like the above which lack supporting evidence and do not consider the individual nature of POP and the tools with which we can manage it.
✨There is research (Bo, Majida, & Engh, 2012) to support that an in situ pessary does not impact the ability of one to contract their pelvic floor. Might it, on an individual level, help or hinder? Absolutely! How do we know if this is the case for us? We test/retest! If you haven’t done this, you haven’t verified what is true (right now) for *you*.
✨There is also a small-but-encouraging study (Handa & Jones, 2002) discussing the potential of pessaries to serve a therapeutic use beyond symptom modification; use after 1 year was associated with a regression in POP stage for a % of the participants. They hypothesized this being the result of having the passive supports of the PF placed under less chronic strain.
✨Another study (Jones et al. 2008) evaluated the use of consistent pessary use on genital hiatus measurements. Their conclusion: “After 3 months of pessary use, genital hiatus size decreased significantly.”
While the research is not robust at this point, it’s encouraging and worth considering! If pessaries have the potential to serve a prophylactic role, why are we so quick to dismiss them until they’re “necessary”? Do we also not recommend teeth cleaning until the decay reaches a level we can’t ignore it?
The reality of POP is that some will lack the passive and/or active PF support that can’t be made up for in training, no matter how diligent one is. Why would we not consider a boost in support to assist what is not being achieved?
Now, do you NEED a pessary?
No! No one “needs” a pessary. Can you benefit from using one? Possibly! It’s worth trying. Is there value in forgoing the use of one? Possibly! The most critical element of this is that you were INFORMED of your options and you had the CHOICE.
Be the advocate you need💪