Ring Pessary Side Effects: What's Normal and What to Watch For

Ring pessaries are safe, effective, and well-tolerated by the vast majority of women who use them. But like any intravaginal device, they carry a small risk of side effects. Knowing what's normal — and what needs medical attention — helps you get the most from your pessary while staying safe.

Common Side Effects (Normal and Expected)

1. Increased Vaginal Discharge

A mild increase in vaginal discharge is the most common pessary side effect, affecting roughly 25–30% of users. This is a normal response to a foreign object in the vaginal canal. The discharge is usually clear or whitish and typically improves within a few weeks as your body adjusts.

What to do: Clean your pessary regularly (at least once a month for self-managed users). Use a gentle, unscented soap and warm water. See our Ring Pessary Care & Cleaning Guide for step-by-step instructions.

2. Mild Pelvic Pressure or Awareness

When first fitted, many women feel a mild awareness of the pessary — a sense of pressure or fullness in the vaginal canal. This usually fades as you get used to wearing it. A correctly sized pessary should be comfortable enough to forget about during daily activities, including walking, bending, and light exercise.

What to do: If pressure persists beyond the first week or is uncomfortable, the pessary may be too large. Try the next smaller size, or consult your provider for a refitting.

3. Spotting or Light Bleeding

Occasional very light spotting can occur, particularly on insertion or removal. This is more common in post-menopausal women with thinner vaginal tissue (vaginal atrophy). Topical oestrogen cream is often recommended alongside pessary use in these cases to maintain vaginal tissue health.

What to do: If spotting is more than very light or is accompanied by pain, contact your healthcare provider.

Less Common Side Effects (Require Attention)

4. Vaginal Odour

An unpleasant odour may develop if the pessary is not cleaned regularly enough, or if the silicone surface has degraded (developing cracks where bacteria accumulate). Medical-grade silicone is non-porous, which significantly reduces this risk compared to older rubber or latex pessaries.

What to do: Clean your pessary more frequently. If odour persists after thorough cleaning, inspect the surface for cracks or roughness — if found, replace the pessary.

5. Pessary Expulsion

Some women find their pessary comes out during straining, coughing, or bowel movements. This usually means the pessary is too small for the vaginal canal. Expulsion rates are higher in women with more advanced prolapse (Stage III or IV) and in those with a wide vaginal introitus.

What to do: Try the next size up. If expulsion continues across multiple sizes, a different pessary style (such as a Gellhorn or cube pessary) may be needed — discuss options with your urogynecologist.

6. Difficulty Inserting or Removing

A pessary that is difficult to insert or remove is usually slightly too large, or you're new to the technique. Self-management of ring pessaries is a learnable skill with a short learning curve.

What to do: See our How to Insert a Ring Pessary — Step by Step Guide for detailed instructions.

Rare but Serious Complications (Seek Immediate Care)

7. Vaginal Erosion

Vaginal erosion — where the pessary causes pressure sores on the vaginal wall — is rare but the most serious pessary complication. It is most common when:

  • The pessary is left in place for extended periods without removal and cleaning
  • The pessary is too large
  • Vaginal tissue is atrophic (thin) due to menopause

What to do: Remove the pessary and seek medical attention. Your provider will assess the erosion and may recommend a treatment break, topical oestrogen, or a different pessary size.

8. Urinary Tract Infections (UTIs)

Some women notice an increased frequency of UTIs while using a pessary. This can result from pressure on the urethra or from changes in vaginal flora.

What to do: Good pessary hygiene is the best prevention. If UTIs become recurrent, discuss with your doctor — a different size or style may reduce the risk.

Minimising Side Effects: Key Principles

  1. Clean regularly — at least monthly for self-managed users. More frequent cleaning reduces discharge and odour.
  2. Correct sizing — the right size is the single biggest factor in comfort and complication prevention. See our Pessary Size Guide.
  3. Use medical-grade silicone — SciMed's ring pessaries are made from high-purity medical-grade silicone, which is non-porous and far easier to maintain than older materials.
  4. Regular check-ins — even for self-managed users, an annual pelvic exam confirms everything is in order.

The Overall Picture: Pessaries Are Very Well-Tolerated

Despite the side effects listed above, the vast majority of pessary users tolerate them well. Clinical studies show that over 70% of women who try a pessary continue using it long-term — a higher satisfaction rate than most conservative treatments for prolapse.

If you're considering a ring pessary, SciMed offers FDA 510(k)-cleared silicone ring pessaries in 10 sizes (0–9) — available in both without support and with support styles. Both ship same day from California with discreet packaging.

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