How to Insert a Ring Pessary at Home — Step-by-Step Guide

Once your OB-GYN or urogynecologist has fitted you for a ring pessary, most patients learn to insert and remove it themselves at home. This guide walks you through the process step-by-step, covering both with-support and without-support ring pessaries.

Important: Only insert a pessary at home after your provider has confirmed the correct size and demonstrated the technique in person. This guide is a refresher, not a replacement for initial provider instruction.

Before you start — what you need

  • Your correctly-sized ring pessary (washed with warm water + mild unscented soap)
  • Water-based lubricant (K-Y Jelly, Astroglide, or equivalent — not petroleum-based like Vaseline)
  • Clean, dry hands
  • A comfortable position — lying on your back with knees bent, standing with one foot on the toilet seat, or squatting
  • Empty bladder

Step-by-step: how to insert a ring pessary

Step 1 — Wash your hands and the pessary. Warm water and mild unscented soap on both. Rinse thoroughly. Dry with a clean towel.
Step 2 — Apply water-based lubricant. A small amount on the leading edge of the pessary makes insertion smoother and reduces friction. Do not use petroleum-based products — they degrade silicone.
Step 3 — Fold the pessary in half. Pinch the ring between your thumb and index finger so the two sides of the ring come together. It should look like a taco or a U-shape. For the with-support version, the membrane will bunch in the middle — this is normal.
Step 4 — Get into position. The three easiest positions for self-insertion:
  • Lying on your back with knees bent and feet flat on the bed — easiest for most first-timers
  • Standing with one foot up on the toilet seat — gravity works with you
  • Squatting — opens the pelvic outlet fully
Try each and see which feels most natural.
Step 5 — Insert the folded pessary. With the pessary folded, gently push it into the vaginal opening. Angle slightly downward toward your tailbone (not straight up). Push until the pessary is fully inside — typically about 2-3 inches in, past your pubic bone.
Step 6 — Release and let it open. Once the pessary is inside, release your pinch. The pessary should unfold and settle behind your pubic bone at the back of the vagina.
Step 7 — Use your finger to check placement. Insert one clean finger and feel for the pessary. You should be able to feel the ring behind your pubic bone. If it's correctly placed, you shouldn't feel it in your daily life once you stand up.
Step 8 — Stand up and test. Walk around. Cough. Bend over. If the pessary stays in place and you don't feel it, you're done. If it slips down or falls out, remove and try again — or contact your provider for a re-fit check.

What proper placement feels like

  • Barely noticeable during daily activity
  • No dragging or pressure sensation at rest
  • Normal urination (no hesitancy, no weak stream)
  • Comfortable to sit, walk, and exercise
  • You may feel it briefly if you strain hard, but not persistently
Wrong placement signs: constant dragging pressure (could mean too big or misaligned), pain, difficulty urinating, or feeling it push down when you cough or stand. If any of these happen, remove and reinsert, or contact your provider.

How to remove a ring pessary

Step 1: Wash your hands.
Step 2: Get into the same position you used for insertion.
Step 3: Insert one or two fingers into your vagina and feel for the rim of the ring.
Step 4: Hook one finger under the front edge of the ring — the edge closest to your pubic bone.
Step 5: Gently pull downward and forward. The ring will fold slightly as it comes out.
Step 6: Wash the pessary immediately with warm water and mild unscented soap. Rinse. Dry. Store in a clean, dry container.
Tip: The with-support pessary is slightly easier to grip during removal because the membrane provides something to hook. If you have arthritis or reduced hand dexterity, the with-support design may be a better fit for self-management.

How often should I remove and clean my pessary?

This depends on your provider's protocol, but common patterns are:

  • Daily removal — out at night, back in during the day. Most hygienic. Best for patients who can easily do self-management.
  • Weekly removal — wash and reinsert every 5-7 days. Standard for many patients.
  • Every 2-3 months — provider does the cleaning at a scheduled office visit. For patients who cannot manage self-removal (reduced dexterity, cognitive impairment).

Ask your OB-GYN which schedule is right for you. When in doubt, more frequent cleaning is safer than less.

Common problems and fixes

The pessary won't stay in

Most likely too small — return to your provider to size up. Or you may have prolapse that has progressed and needs a different pessary type (donut, cube, Gellhorn).

The pessary keeps folding wrong on insertion

Practice the fold at the sink first. Also try more lubricant on both hands. Some patients find the with-support version easier to fold because the membrane keeps the two sides together.

It hurts to insert

Not normal. Stop, remove any partially-inserted pessary, and contact your provider. Possible causes: wrong angle, needs more lubricant, wrong size, vaginal atrophy needing estrogen cream, or an unrelated issue.

I can't feel it once it's inside — how do I know it's in?

Good sign. That means it's seated correctly behind the pubic bone. Insert a finger, feel for the ring, and confirm placement. Once you feel it, you're done.

When to call your provider

  • New bleeding, spotting, or foul-smelling discharge
  • Severe pain during or after insertion
  • Difficulty urinating or a new urinary tract infection
  • The pessary falls out repeatedly despite correct sizing
  • You can't remove it (rare, but possible if it's stuck)
  • Fever, chills, or systemic symptoms — could indicate infection

Order a ring pessary in your size

If you know your size:

If you're between sizes:

Have your pessary but need a case?
Doctor-recommended storage keeps your pessary clean, dry, and protected between wears.
See the Storage Case →

FAQ

How do I insert a ring pessary myself?

Wash the pessary and your hands. Apply water-based lubricant. Fold the pessary in half so it looks like a U-shape. In a comfortable position (lying back, standing with foot up, or squatting), insert the folded pessary and angle down toward your tailbone. Push past your pubic bone. Release to let it unfold behind the pubic bone.

What position is best for pessary insertion?

The three easiest are: (1) lying on your back with knees bent, (2) standing with one foot up on the toilet, (3) squatting. Most first-timers find lying on the back easiest. Practice each and use whichever feels natural.

How do I remove a ring pessary?

Wash your hands. Get into the same position as insertion. Hook one finger under the front edge of the ring — the edge closest to your pubic bone. Gently pull downward and forward. The ring will fold as it comes out.

Should I feel the pessary once it's inserted?

No. If it's placed correctly, you should barely notice it during daily activity. If you feel dragging, pressure, or pain, the placement or size is likely wrong. Remove and try again, or contact your provider.

How often should I take out and clean my ring pessary?

Depends on provider guidance. Common schedules: daily (out at night), weekly (5-7 days), or every 2-3 months at a provider visit. Ask your OB-GYN which is right for you. More frequent cleaning is safer than less.

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