Your First Week With a Pessary: What to Expect, Day-by-Day
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The first week with a new pessary is the adjustment period. Most women feel a little aware of the device for the first few days, then forget it's there. Some feel fine immediately. A few have minor issues that resolve with a size or position adjustment. This guide walks through what's normal day-by-day, what isn't, and the specific signs that mean you should call your provider rather than push through.
Before you start: what should already be true
You should be reading this AFTER your clinician has fitted you and confirmed the size works. If you've ordered a pessary without an in-clinic fitting, please book a fitting visit before relying on this guide — first-time pessary use without a clinician's confirmation can lead to wrong-size issues this guide won't help with.
What you should have:
- A correctly-sized ring pessary, inserted by you or your clinician
- Written or verbal instructions from your provider on removal and reinsertion
- A follow-up appointment scheduled (typically 1–2 weeks after fitting)
- A way to reach your provider with questions in the interim
Day 1: First 24 hours
Normal sensations:
- Mild fullness or pressure in the vagina. Most patients describe it like "I can feel it" but not painfully.
- Slightly different sensation when urinating — the urine stream may feel slightly altered. This usually normalizes within 24–48 hours.
- Awareness of the device when sitting down or standing up. This typically fades by day 2–3.
- Possible mild discharge as the vagina adjusts to the new device. Light, clear or whitish.
What to do:
- Walk around normally — don't restrict activity
- Use the bathroom as needed (the pessary doesn't block urination or bowel movements in normal anatomy)
- Avoid intercourse for the first 24–48 hours unless your provider said otherwise
- Track sensations mentally so you can describe them at your follow-up
Days 2–3: The peak awareness window
Normal sensations:
- You may notice the pessary more on days 2–3 than day 1 — this is normal as your body responds to the new device
- Mild lower abdominal awareness, especially when bearing down (Valsalva)
- Light vaginal discharge continuing
- Possibly mild back or pelvic ache, similar to a long day on your feet
What to do:
- Keep activity normal. If you exercise regularly, resume — the pessary is designed to stay in place during walking, gym work, lifting
- If you remove the pessary daily, practice removal once in days 2 or 3 so you're comfortable with it
- Drink plenty of water — helps the vaginal tissue adjust
Days 4–7: Settling in
Normal sensations:
- By day 4–5, most women report "forgetting" the device most of the time
- Awareness only when bearing down significantly (heavy lifting, hard sneeze, etc.)
- Discharge usually decreases by day 5–7
- Normal urination, normal bowel movements
What to do:
- If you haven't yet, practice removal and reinsertion at least once
- Clean the pessary as your provider instructed (most commonly weekly with warm water and mild soap)
- Note any concerns to bring up at your follow-up appointment
What's NOT normal — call your provider
- Sharp pain at any point — mild fullness is OK, sharp pain is not
- Vaginal bleeding not explained by your menstrual cycle
- Foul-smelling discharge — a sign of irritation or infection
- Inability to urinate or significantly slowed urine stream
- Inability to have a bowel movement or significantly painful bowel movement
- Pessary falling out when bearing down or during a bowel movement — means size is too small
- Visible blood on the pessary when you remove it for cleaning
- Burning during urination — could signal UTI or device irritation
- Persistent pelvic pain lasting more than 1–2 hours after activity
None of these mean something is dangerously wrong — most are easily addressed by a quick size adjustment, position correction, or short course of vaginal estrogen if the tissue is dry. But all of them should be reported to your provider rather than tolerated.
Common questions in the first week
Can I have sex with a pessary in?
Depends on the pessary type. A ring pessary without support generally allows intercourse with the device in place. A ring pessary with support (with the membrane across the center) usually needs to be removed for intercourse. Discuss with your provider for your specific situation.
Can I leave the pessary in during my period?
Yes, in most cases. Some women prefer to remove it during heavier flow days for hygiene. Your provider will tell you what's best for your specific situation.
What if I can't feel the strings?
Ring pessaries don't have strings (those are for IUDs). The pessary stays in place by anatomic positioning behind the pubic bone and against the posterior fornix. To remove, you'll insert a finger and hook the rim.
How often should I remove and clean it?
Most providers recommend removing weekly for cleaning. Some patients prefer daily removal, others go 2–4 weeks between removals. The key is regular inspection — catch any wear or irritation early. Follow your provider's specific guidance.
I'm scared to remove it the first time. What do I do?
Very normal. Most women take 2–3 attempts in the first week to feel comfortable. Tips: relax (warm bath or shower first), use one foot up on the toilet seat, breathe out as you reach in, hook your index finger under the rim and ease the pessary out. If you can't get it after a few tries, see your provider — they can help and check fit.
Your 1–2 week follow-up visit
Most clinicians schedule a follow-up 1–2 weeks after the initial fitting. They'll:
- Check that the pessary is still seated correctly
- Look at the vaginal walls for any irritation or pressure spots
- Ask about your daily experience
- Adjust size or type if needed
- Confirm cleaning and replacement schedule going forward
Bring your notes on Days 1–7 sensations. If you've had any concerning symptoms (anything in the "NOT normal" list above), tell your provider — even if the issue has resolved.
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FAQ
How long does it take to adjust to a pessary?
Most women adjust within 1–2 weeks. By day 4–5, most report not noticing the device most of the time. If you're still distinctly aware of the pessary after 2 weeks, see your provider for a size or position check.
Is it normal for a pessary to feel uncomfortable at first?
Mild fullness or awareness in the first 3–7 days is normal. Sharp pain, bleeding, or persistent discomfort beyond a week is not normal and warrants a provider visit.
What if my pessary falls out in the first week?
It usually means the size is too small. Don't keep trying to use a pessary that falls out — it won't support your prolapse adequately and can cause friction injuries. Call your provider for refitting.
Can I exercise with a pessary?
Yes — a correctly-sized pessary is designed to stay in place during normal activity including walking, lifting, gym work, and most exercise. If it dislodges during specific activities, see your provider for refitting.
How will I know if the size is wrong?
Two signs: too small = the pessary falls out, especially during bearing down or bowel movements. Too large = it causes persistent pain (not just fullness), inability to urinate, or visible irritation. Both are addressed by a refitting with the adjacent size.