Pessary Slipping Out? 5 Causes and How to Fix It (2026 Guide)
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If your ring pessary keeps slipping down, working its way out during bowel movements, or expelling completely — the cause is almost always one of five specific things. None of them mean you have to give up on pessary therapy. This guide walks through each cause, how to confirm which one is yours, and the practical fix.
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Shop Ring Pessaries →Quick diagnosis: which cause is yours?
Match your symptom to the most likely cause:
| What's happening | Most likely cause | Where to read |
|---|---|---|
| Slips down within an hour of insertion | Too small | Cause 1 below |
| Comes out during bowel movements | Too small OR weak posterior floor | Causes 1 + 3 |
| Slips when standing or walking only | Wrong type (need with-support) | Cause 2 |
| Was fine, now slipping after weight loss / pregnancy / menopause | Body changed since fitting | Cause 4 |
| Slips immediately after insertion | Insertion technique | Cause 5 |
Cause 1: The pessary is too small for you
This is the most common reason a ring pessary slips. A correctly-fitted ring sits snugly against the vaginal walls and is held in place by the pubic bone in front and the pelvic floor behind. If it's too small, there's nothing to hold it.
How to confirm: Insert the pessary. Stand up. Bear down gently as if having a bowel movement. If you feel it slip down significantly or expel — it's too small.
The fix: Size up by one. If you're using size 4, try size 5. If size 5, try size 6. The 3-Size Home Fitting Pack ($129.99) gives you sizes 3, 4, and 5 in one shipment — cheaper than ordering wrong-size pessaries one at a time.
Cause 2: Wrong type — you need with-support, not without
SciMed makes two ring pessary types: Ring With Support (membrane across the center) and Ring Without Support (open ring). The membrane stabilizes the ring against the anterior vaginal wall and provides additional bladder neck support. Without that membrane, an open ring can rotate or slip in some women's anatomy.
How to confirm: If you've been using a Ring Without Support and it slips during normal daily activity (standing, walking, light exercise) but feels fine when you're sitting or lying down — the open shape is letting it rotate.
The fix: Switch to the Ring With Support in the same size. The membrane gives the ring something to brace against. Many women who failed with an open ring succeed with a with-support ring.
Cause 3: Weakened pelvic floor muscles (post-childbirth or post-menopause)
The pelvic floor muscles work with the pessary — they grip the ring from below while the pessary supports the pelvic organs from inside. After multiple vaginal births, after menopause, or with severe prolapse, those muscles can be too weak to hold any ring in place.
How to confirm: You've tried 2-3 different sizes and types and the ring still slips. You may also notice difficulty holding urine, bearing down, or contracting your pelvic floor on command.
The fix: Two parallel approaches:
- Start pelvic floor muscle training (Kegels): 3 sets of 10 contractions per day, 5-10 second hold each. After 6-12 weeks of consistent practice, many women regain enough muscle tone to retain a ring pessary.
- Talk to your provider about a different pessary shape: A Gellhorn or donut pessary provides more retention than a ring and is the next step if rings won't stay. SciMed currently focuses on rings, but your OB-GYN or urogynecologist can fit you with a Gellhorn.
Cause 4: Your body changed since the original fitting
Pessary size that fit you 2 years ago may not fit now. Common changes:
- Weight loss — the vaginal canal can become slightly smaller, making your previous size loose
- Weight gain — increased abdominal pressure can push the ring down
- Childbirth — pregnancy and delivery can change pelvic floor anatomy
- Menopause — hormonal changes thin and shorten vaginal tissue
- Hysterectomy — changes vaginal anatomy and may require a different size or type. See our post-hysterectomy guide.
The fix: Get re-fitted. If your original size no longer holds, try the next size up or down. The 2-Size Combo Pack ($89.99) lets you try two consecutive sizes for under $90.
Cause 5: Insertion technique — it's not fully in place
A ring pessary should sit BEHIND the pubic bone (you can't feel it once placed). If the front edge is sitting on or in front of the pubic bone, the ring will slide out during normal activity.
How to confirm: Insert the ring. With clean fingers, feel for the front edge. You should NOT be able to easily feel the front of the ring when standing upright. If you can hook a finger over the front edge, it's too low.
The fix: Re-insert with more depth. Steps:
- Empty your bladder before insertion (a full bladder pushes the ring forward).
- Apply water-based lubricant to the ring and your finger.
- Fold the ring in half (pinch the two sides together).
- Insert with the folded edge angled toward your back — NOT straight in. The vaginal canal angles backward.
- Push the ring in as deep as it will comfortably go.
- Release the fold and use your finger to push the front edge UP behind the pubic bone.
- Stand up and bear down once — the ring should stay.
Practice this in front of a mirror until you're confident. Our step-by-step insertion guide covers this in more detail.
When to give up on rings and try a different shape
If you've tried:
- 2-3 different ring sizes
- Both with-support and without-support versions
- Re-checked insertion technique
- Done 6+ weeks of Kegels
… and the ring still won't stay, talk to your OB-GYN or urogynecologist about a Gellhorn or donut pessary. These are larger, harder to expel, but also harder to manage at home — most patients have their provider remove and clean them.
Frequently asked questions
Should I be worried if my pessary slips down once?
No. Almost everyone has the ring shift slightly during their first few days. If it slips repeatedly or fully expels, then it's time to troubleshoot using this guide.
Will my pessary slip during sex?
Most ring with-support pessaries should be removed before intercourse. Without-support rings sometimes stay in. See our daily life with a pessary guide for full intimacy guidance.
Can I exercise with a ring pessary?
Yes — if it's the right size. See our active lifestyle with a pessary guide for sport-specific tips.
Do I need a prescription to try a different size?
No. SciMed ships pessaries direct without a prescription — you can try a different size at home today. See our no-prescription guide.
How long should a ring pessary last before I replace it?
1-2 years with proper care. If yours is older than that, the silicone may be losing elasticity — which can also cause slipping. See replacement guide.
Order the right size today
- Ring Pessary With Support — $49.99 (most common fix for slipping)
- 3-Size Home Fitting Pack — $129.99 (try sizes 3, 4, 5 at home, keep what fits)
- 2-Size Combo Pack With Support — $89.99 (try two consecutive sizes)
Stuck and not sure? WhatsApp us at +1-669-265-9353 or email sales@scimedstore.com. Free sizing advice. Ships same-day from San Jose.
Shipping: Free shipping on orders $99+ in the US. International orders ship worldwide at calculated rates — UK, EU, AU/NZ, and more. Clinic procurement (DDP) available for GCC and MENA buyers. See our shipping policy.