A Woman's Guide to Using a Pessary

A pessary is a plastic product which fits in your vagina to aid and support your uterus (womb), vagina, bladder or rectum.

The pessary is often times used for "prolapse" of the uterus. Prolapse means that your uterus droops or tends to "fall out" because it loses support after you give birth or have pelvic surgery. This challenge is generally fixed with surgical treatment, however, you may also utilize a pessary to maintain the uterus in place.

A pessary might help for those who have a "cystocele" (when your bladder droops straight down into your vagina) or for those who have a "rectocele" (if your rectum sticks up into the bottom of your vagina). A pessary can also help a lot of women with stress bladder control problems (the leaking of urine when you cough, strain or exercise).

Women that are pregnant with incontinence can also use a pessary. What type of pessary will I use? Your doctor will determine which type of pessary you should use dependent on the issue you have. The pessary has to be fit perfectly. There won't be any equipment that will tell what the right size is. The pessary is fit by trial and error.

It typically needs a couple of attempts to find the correct one. Following your initial fitting, you will need to return to the medical doctor's office to have the pessary rechecked. Your doctor will most likely look at the pessary in two or three days. After that you will most likely be examined every month or two. Occasionally the size or model of the pessary will have to be changed.

How do I Care for my Pessary?

It is vital that you adhere to your medical doctor's guidelines about taking good care of pessaries. Nearly all pessaries can be worn for many days to weeks at a time before they need to be taken out and cleaned with ordinary soap and water. You should be sure to keep your check-up appointments and clean the pessary as your doctor tells you. Does the pessary cause any side effects? You may notice more vaginal discharge than normal.

Your vaginal discharge could also develop an odour. Certain vaginal gels can sort out these types of unwanted effects. Your personal doctor might or might not have you douche too. Vaginal irritation is yet another possible unwanted effect. Ladies who are past menopause might need to use oestrogen cream for the discomfort.

The vaginal pessary can fall out of the vagina if you strain or lift something. This usually means that your pessary is too small. Check with your doctor if your pessary keeps falling out. What else should I know? Many pessaries can be worn during intercourse--your doctor will explain if you can't. Make sure to tell your physician immediately when you have any discomfort with the pessary or if you have trouble urinating or having a bowel movement.

For further advice on dealing with uterine prolapse through the help of vaginal pessaries or vaginal dilators, visit MyPessary.com.

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Irregular and Heavy Periods

Irregular periods and heavy periods are amongst the most common gynaecological problems that trouble women during their childbearing years. Published studies report that between 4% and 50% women suffer from heavy periods; this large variation is probably due to cultural differences and the way that 'heavy periods' are defined or measured. However, it is likely that approximately one in eight to ten women experience heavy periods.

What is a heavy period?

The published research suggests that heavy periods are when a woman loses more than 60 to 80 millilitres of blood with menstruation. However, this definition is unhelpful as it is impractical to measure the blood loss in real life. For this reason it is better to define periods as heavy when they interfere with a woman's physical, social or emotional quality of life. In other words, the definition of heavy periods (or menorrhagia to use the medical term) is a subjective symptom as experienced by individual women.

What is a normal period?

Periods, (also defined as menstruation, menses or menstrual periods), are a woman's monthly bleeding from her womb (uterus) as a result of the cycle of hormonal changes. A period contains blood, tissue (lining of the womb) and fluid from inside the womb. Although periods are usually described as 'monthly' bleeds, there is actually a huge variation in how frequently they occur. There are no certain rules, but it is generally accepted that periods that come every 22 to 35 days are within the normal range. The duration of bleeding varies between three to eight days in most women, with an average of four to five days bleeding. The length of the cycle and duration of bleeding tend to decrease with age but, in contrast, blood loss tends to increase. Irregular periods are more common in younger women and periods become more regular with advanced age up until premenopausal years when irregularity becomes more of a problem again.

What is abnormal vaginal bleeding?

Periods are generally considered abnormal if they are excessively heavy and if they are irregular outside their usual pattern. In addition, vaginal bleeding is considered abnormal if it occurs in between periods (also known as intermenstrual bleeding), after sexual intercourse (postcoital bleeding) or if a woman restarts bleeding after the menopause (postmenopausal bleeding). Irregular periods, bleeding in between periods or after sex, or bleeding after the menopause are all symptoms that are more likely to indicate a potential underlying medical problem and they require investigation.

About the author

Mr Ertan Saridogan is a Consultant in Gynaecology, Reproductive Medicine and Minimal Access Surgery at the University College London Hospitals (UCLH) and the The Portland Hospital. http://www.totalhealth.co.uk/clinical-experts/mr-ertan-saridogan

About totalhealth

totalhealth provides authoritative medical information in plain English. http://www.totalhealth.co.uk/

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