Pessary and Pelvic Floor Physical Therapy: How the Two Work Together

A pessary and pelvic floor physical therapy do different jobs, and many women find they work well together. The pessary gives your pelvic organs support from the inside, right away. Pelvic floor physical therapy helps you build strength, control and good habits over time. Using both is common, and your clinician can help you decide if it suits you.

This guide explains what a pelvic floor physical therapist does, how therapy and a pessary fit together, and what to expect at your visits. It is general information. Please follow your own clinician's and therapist's advice.

What is pelvic floor physical therapy?

Your pelvic floor is a group of muscles that sit like a hammock at the bottom of your pelvis. They help hold up your bladder, womb (uterus) and bowel, and they help you control urine, gas and stool.

A pelvic floor physical therapist (often called a pelvic floor PT) is a physical therapist with extra training in these muscles. They help with problems such as:

• Pelvic organ prolapse (when organs drop down into the vagina)
• Leaking urine when you cough, sneeze or lift
• Needing to rush to the toilet
• Constipation and straining
• Pelvic pain or pressure

Therapy is not just "doing Kegels." A good therapist looks at how you breathe, sit, lift, stand and use the toilet, and teaches you ways to protect your pelvic floor in daily life. If you want to know more about how Kegels fit in, see our guide Pessary vs Kegel Exercises: Do You Need Both?

How a pessary and therapy help each other

Think of it this way: a pessary is like a supportive brace, and physical therapy is like training the muscles around it. They help in different ways.

	Pessary	Pelvic floor physical therapy
What it does	Holds organs up from inside the vagina	Helps muscles work better and teaches healthy habits
How soon it helps	Often right away, once well fitted	Builds over weeks to months of practice
What you do	Wear it, clean it and attend check-ups	Go to sessions and practice exercises at home

Here are some ways the two can work together:

• Comfort while you train. If heaviness or bulging makes exercise hard, a pessary may make it more comfortable to move and practice.
• Better habits, less strain. A therapist can teach you how to lift, cough and use the toilet with less downward pressure. Less pressure may help your pessary stay comfortable and in place.
• Help with pessary skills. Some therapists help patients practice relaxing the pelvic floor, which can make inserting and removing a pessary easier. Ask your therapist whether this is something they offer.
• Noticing changes. Your therapist may notice if something seems to have changed and suggest you check in with the clinician who fitted your pessary.

For a wider look at your choices, read Pelvic Organ Prolapse: Non-Surgical Treatment Options Explained.

What to expect at a pelvic floor therapy visit

Many women feel nervous before their first visit. Knowing what happens can help.

The first visit

• A talk. Your therapist will ask about your symptoms, your bladder and bowel habits, your health history and your goals. Tell them you wear a pessary, what type and size it is, and how it has been going.
• A look at posture and breathing. They may watch how you sit, stand, breathe and move.
• An internal check, if you agree. Many pelvic floor therapists check the muscles with a gloved finger, much like a gentle exam. This is always your choice. You can say no, ask questions, or ask to stop at any time.

Follow-up visits

Later visits often include exercises, practice with breathing and relaxing, and advice for daily activities. You will usually get a home program. Your therapist will tell you how many visits they suggest and how often.

Should I wear my pessary to therapy?

Ask your therapist before your first visit. Some may want to see how your muscles work with the pessary in, others without, and some both. Bring your storage case in case you are asked to take it out.

Questions to ask your therapist

• What are my goals, and how will we know if therapy is helping?
• Which exercises should I do at home, and how often?
• Are there movements I should avoid with my prolapse and pessary?
• Can you help me relax my pelvic floor to make pessary insertion and removal easier?
• What signs mean I should contact my doctor about my pessary?

When your pessary size may need a fresh look

Over time, your body can change. Your clinician may suggest re-checking your pessary size after things like weight change, surgery, or a course of pelvic floor therapy. Signs that a refit may be worth asking about include a pessary that slips or falls out more than before, new discomfort or pressure, or trouble passing urine.

Please do not change sizes on your own without talking to your clinician. If they suggest trying a nearby size, a fitting pack can help.

About the SciMed Pessary Fitting Pack

The SciMed Pessary Fitting Pack contains three sizes in a row of the SciMed Ring Pessary, each in its own sterile sealed pouch. Re-fitting after weight change, physical therapy or surgery is one of the situations it is made for. Here is how it works:

• Choose a size combination: 1+2+3, 2+3+4, 3+4+5, 4+5+6 or 5+6+7.
• Choose With Support or Without Support.
• Compare the sizes in your hand through the sealed pouches, and open only the one you want to try.
• Send back the two unopened, sealed pouches within 30 days, and SciMed refunds $80.00. Your net cost is then $49.99, the same as a single pessary. Return shipping is paid by the buyer.
• Or keep all three as spares. The $129.99 charge stands.

The rings are medical-grade silicone (USP Class VI), FDA 510(k) cleared as Class II devices, and ship from California. They are HSA/FSA eligible under HCPCS A4562. A pouch that has been opened cannot be returned. Ask your clinician which sizes to try.

Questions about sizes or which pack to choose? Email sales@scimedstore.com or WhatsApp us at +1-669-265-9353.

Frequently asked questions

Do I still need pelvic floor therapy if I have a pessary?

Not everyone does, but many women find both helpful. A pessary gives support from the inside, while therapy helps your muscles and daily habits. Ask your clinician whether a referral makes sense for you.

Can pelvic floor therapy replace my pessary?

For some women, therapy may ease symptoms enough that their needs change. For others, the pessary is still needed. Only your clinician can tell you whether to change or stop using your pessary.

Does a pelvic floor therapist fit pessaries?

It depends on the therapist and where you live. Many pessaries are fitted by a doctor, nurse practitioner or nurse. Ask your therapist what they can help with and who fits pessaries in your area.

Is the internal exam at pelvic floor therapy required?

No. It is always your choice. You can ask questions first, say no, or ask to stop at any time. Your therapist can still help in other ways.

What if my pessary size needs to change after therapy?

Talk to your clinician first. If they suggest trying nearby sizes, the SciMed Pessary Fitting Pack lets you try three sizes in a row and return the two unopened pouches within 30 days for an $80.00 refund.