Ring Pessary Size 5 (3.00 inches / 76 mm): Who Needs It and How to Confirm Your Fit

Ring pessary size 5 measures 3.00 inches (76 mm) in outer diameter. It is the standard step-up from size 4 and is most often fitted in patients with two or more vaginal births, moderate-to-severe pelvic organ prolapse, or post-menopausal tissue laxity. This guide explains who size 5 fits, when to size up to 6 or down to 4, and how to verify the fit at home.

Size 5 at a glance

Every SciMed ring pessary is manufactured from medical-grade silicone in San Jose, California. The size 5 ring shares the same design as every other size — only the outer diameter increases.

  • Outer diameter: 3.00 inches / 76 mm
  • Material: 100% medical-grade silicone (FDA Class II)
  • Variants: with support (silicone diaphragm) or without support (open ring)
  • SciMed direct price: $49.99 (with support), $44.99 (without support)
  • HCPCS code: A4561 (HSA/FSA eligible)

Who size 5 typically fits

You are likely a size 5 if most of the following apply:

  • 2 or more vaginal births
  • Post-menopausal or peri-menopausal
  • POP-Q Stage 2 or early Stage 3 prolapse
  • Size 4 in clinic was secure at rest but slipped during exertion
  • Your provider noted a wider introitus or relaxed pelvic floor
  • You are tall or have a larger overall frame

If you have not been fitted, the 3-Size Home Fitting Pack covers sizes 3, 4, and 5 so you can confirm size 5 at home and keep size 4 on hand if conditions change.

Size 4 vs Size 5 vs Size 6: comparison table

Size Diameter (inches) Diameter (mm) Typical patient Frequency of use
Size 4 2.75" 70 mm 1-2 births, average frame ~57%
Size 5 3.00" 76 mm 2+ births, post-menopausal, moderate prolapse ~29%
Size 6 3.25" 83 mm 3+ births, advanced prolapse ~14%

When to size up to 6

Move from 5 to 6 if any of these occur:

  • The size 5 falls out during a bowel movement, cough, or sneeze
  • The ring rotates with zero resistance — it should turn only with light pressure
  • Bulge symptoms persist after 48 hours
  • Your prolapse is Stage 3 or higher
  • You had 3+ vaginal births or a prior pelvic surgery that increased canal width

If size 6 also slips, your provider may recommend a Gellhorn or donut pessary instead of a ring. Read the uterine prolapse guide for stage-by-stage recommendations.

When to size down to 4

Drop to size 4 if size 5 causes:

  • Vaginal pain or pressure that persists beyond 24 hours
  • Difficulty with urination or bowel movements
  • Tissue indentation or spotting on removal
  • Real effort needed to fold the ring for insertion

If you ordered the fitting pack, you already have size 4 ready to swap.

Need quick sizing advice?

Message Bharat on WhatsApp +1-669-265-9353. Same-day answers, no appointment.

With or without support: which size 5 variant?

Both variants measure 3.00" outer diameter. The membrane in the with-support version is what differs.

Size 5 with support

The Ring With Support is the more common size 5 choice because patients in this size range often have multi-compartment prolapse. Pick this if you have:

  • Cystocele (front-wall / bladder prolapse)
  • Cystocele combined with uterine prolapse
  • Stress urinary incontinence triggered by prolapse

Size 5 without support

The open ring suits:

  • Isolated uterine prolapse
  • Mild rectocele — see the rectocele guide
  • Patients who self-remove often and want easier folding

Post-menopausal considerations

Post-menopausal patients make up a large share of size 5 wearers. Two practical notes:

  • Tissue dryness: low estrogen levels thin vaginal tissue. Use water-based lubricant for every insertion and ask your provider about topical estrogen if recommended.
  • More frequent inspection: check the vaginal tissue every 1 to 2 weeks for the first month, then monthly. Atrophic tissue is more prone to small abrasions.

None of this disqualifies you from pessary therapy — it simply means more attentive care.

How to confirm size 5 fit at home

  1. Walk and stand for 10 minutes. The ring should be invisible to you.
  2. Cough three times. The ring should not migrate.
  3. Use the toilet. Urination and bowel movement feel normal.
  4. Wear overnight. No pain, no spotting.
  5. Remove after 24-48 hours. Tissue is pink and intact, no deep ring marks.

Pass all five and size 5 is yours. If size 5 stays in but symptoms remain, ask your provider whether the ring shape itself is the right device for your prolapse pattern.

Cleaning and replacement schedule

Same routine as any other ring size:

  • Remove and clean weekly with mild soap and warm water
  • Air dry before re-insertion
  • Replace every 6 to 12 months — sooner if you see discoloration or surface roughness
  • Use a water-based lubricant for every insertion

Avoid silicone-based lubricants — they degrade the pessary material.

Where to buy ring pessary size 5

SciMed Store sells direct from California. That keeps size 5 at $44.99 to $49.99 instead of the $80 to $150 typical of distributor channels.

HSA/FSA eligible. Ships from California in one business day.

Frequently asked questions

Is ring pessary size 5 for advanced prolapse?

Size 5 is appropriate for moderate prolapse (POP-Q Stage 2, sometimes early Stage 3). For Stage 3-4 prolapse, providers often switch to a Gellhorn or donut shape. See the uterine prolapse guide.

Is size 5 the same diameter across brands?

Yes — size 5 is always 3.00" (76 mm) outer diameter. Standardized across manufacturers.

Can a size 5 ring shift to a smaller size after I lose weight?

Pessary fit is driven by pelvic floor and vaginal anatomy, not body weight, so modest weight changes do not usually require re-sizing. Significant weight loss, pregnancy, or pelvic surgery can change the fit — re-check after any of those events.

How often should I see my OB-GYN with a size 5 in?

A check-up at 1 to 2 weeks after fitting is standard, then every 3 to 6 months for the first year. Your provider may adjust based on tissue health.

Does insurance cover size 5?

Pessaries (any size) fall under HCPCS A4561 and are HSA/FSA eligible. Most US private insurance covers them with a provider note. SciMed provides itemized receipts on request.

Can I swim or bathe with a size 5 ring in?

Yes. Silicone is non-absorbent. Showering, bathing, and swimming with the ring in place are all fine. Avoid hot tubs above body temperature — prolonged heat can degrade silicone over time.

Order or get help

Questions? WhatsApp Bharat at +1-669-265-9353 or email sales@scimedstore.com. Free sizing guide available on request. Made in California. Ships in one business day.

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