Pessary and Constipation: Bowel Habits That Help Your Pessary Stay Comfortable

Yes, constipation and a pessary are connected. Hard stools and straining on the toilet press down on the pelvic floor, and that pressure can make a pessary feel uncomfortable, shift lower, or even slip out. Gentle bowel habits, like eating enough fiber, drinking enough fluid and not pushing hard, can help your pessary stay comfortable and in place.

This guide explains why your bowels matter when you wear a pessary and shares simple, everyday habits that may help. It is general information, not medical advice. Please follow your own clinician's guidance, especially if you have other health conditions or take medicines that affect your bowels.

Why constipation matters when you wear a pessary

Your bladder, womb (uterus), vagina and bowel all sit close together in the pelvis. A pessary sits inside the vagina and helps hold up the organs that have dropped. The back wall of the vagina lies right next to the rectum, the last part of the bowel.

When you are constipated, a few things happen:

• Hard stool takes up space. A full rectum can press on the back wall of the vagina and push against the pessary.
• Straining adds pressure. Pushing hard on the toilet bears down on the whole pelvic floor. This is the same downward force that can make a prolapse worse.
• The pessary can move. Many women notice their pessary feels lower, or comes out, during or after a hard bowel movement.

If your pessary keeps coming out, our guide My Pessary Fell Out or Won't Stay In: 7 Reasons + Fixes covers other common causes, such as sizing.

Signs your bowels may be affecting your pessary

Watch for patterns like these:

• Your pessary feels lower or more noticeable after you open your bowels.
• It slips out while you are on the toilet.
• You feel more pressure or aching on days when you are constipated.
• You need to strain for a long time to pass stool.
• You feel you have not fully emptied your bowel.

Keeping a simple note for a week or two, such as "hard stool, pessary felt low," can help you and your clinician spot a link.

Everyday habits that help

None of these are new or unusual. They are the same gentle habits often suggested for anyone who wants softer, easier bowel movements. Small steps add up.

1. Add fiber slowly

Fiber helps stool hold water, so it stays softer and easier to pass. Good sources include oats, whole-grain bread, beans, lentils, fruit (such as pears, prunes and kiwi) and vegetables. Add fiber a little at a time over a few weeks. Adding a lot at once can cause gas and bloating. If you are thinking about a fiber supplement, ask your doctor or pharmacist which one suits you.

2. Drink enough fluid

Fiber works best with fluid. Many older women drink less to avoid leaks or night-time trips to the bathroom, but too little fluid can make stools hard. Ask your clinician how much is right for you, especially if you have heart or kidney problems or have been told to limit fluids.

3. Keep moving

Gentle activity, like a daily walk, helps the bowel keep working. You do not need hard exercise. Even short walks after meals can help.

4. Listen to the urge

When you feel the need to go, try to go soon. Holding it in lets stool dry out and get harder. Many people find their bowels most active after breakfast, so allow a relaxed time then.

5. Check your medicines

Some medicines can cause constipation, including certain pain medicines, iron tablets and some blood pressure medicines. Do not stop any medicine on your own. Ask your doctor or pharmacist whether any of yours could be playing a part.

How to sit on the toilet to avoid straining

How you sit can make a real difference. This position helps the bowel empty with less pushing:

• Raise your feet on a small footstool so your knees are higher than your hips.
• Lean forward a little and rest your forearms on your thighs.
• Keep your back straight and let your tummy relax.
• Breathe out slowly instead of holding your breath. Holding your breath and pushing hard adds pressure on the pelvic floor.
• Do not rush, but do not sit for a very long time either. If nothing happens after a few minutes, get up and try again later.

Some women with a prolapse of the back vaginal wall are taught to gently support that area with clean fingers while passing stool. This is sometimes called "splinting." If this sounds helpful, ask your clinician or a pelvic floor physical therapist to show you how to do it safely with your pessary in place.

What to do if your pessary slips during a bowel movement

It can be upsetting, but it is a common experience. A few practical tips:

• Keep a clean towel or tissue within reach before you start, if your pessary has slipped out before. That way you can catch it or pick it up easily if it comes out.
• If it comes out, wash it as your clinician and the instructions advise before putting it back. If you do not put your pessary in yourself, store it clean and dry and call your clinician.
• If it keeps happening, tell your clinician. You may need a different size or a different type of pessary, or help with constipation.

Where a ring pessary with support fits in

A ring pessary with support is a round silicone ring with a support membrane across the middle. SciMed's Ring Pessary With Support is made of medical-grade silicone (USP Class VI), is latex-free and BPA-free, and comes in sizes 0 to 8 (44 mm to 95 mm). It is FDA 510(k) cleared as a Class II device. It is often chosen for bladder prolapse (cystocele) and for stage I–II uterine or vaginal vault prolapse with bladder involvement. You can learn more in What is a Pessary Ring with Support?

Good bowel habits help any pessary stay comfortable, but they cannot fix a pessary that is the wrong size or type. If your main problem is a bulge at the back wall of the vagina (a rectocele), a different pessary type may suit you better; see our guide to pessaries for rectocele. Your clinician will decide what is right for you.

When to call your clinician

Please contact your doctor or nurse if you have:

• Constipation that lasts more than a couple of weeks, or keeps coming back.
• Pain, bleeding from the vagina or bottom, or unusual discharge.
• Trouble passing urine or stool with the pessary in place.
• A pessary that keeps falling out or feels stuck.
• Any sudden change in your bowel habits.

Questions about sizing? Email sales@scimedstore.com or WhatsApp us at +1-669-265-9353.

Frequently asked questions

Can constipation make my pessary fall out?

It can. Straining to pass hard stool pushes down on the pelvic floor, and that pressure can move a pessary lower or push it out. Softer stools and less straining often help. If it keeps happening, talk to your clinician about your size and type.

Should I take my pessary out before a bowel movement?

Most women keep their pessary in. If yours often slips during bowel movements, ask your clinician what they recommend for you.

Does a pessary cause constipation?

A well-fitted pessary should not stop you from passing stool. If you have new trouble opening your bowels after starting a pessary, tell your clinician, as the size or type may need to be checked.

What is the best way to sit on the toilet with a prolapse?

Many people find it helps to raise the feet on a small footstool, lean forward with forearms on the thighs, relax the tummy and breathe out slowly instead of holding the breath and pushing hard.

Is a laxative safe to use with a pessary?

Your pessary does not usually change which laxatives you can take, but the right choice depends on your health and other medicines. Ask your doctor or pharmacist before starting one.