Vaginal Pessary — Complete Guide, Sizing, Cost & Answers (2026) | SciMed
Vaginal Pessary — Complete Guide, Sizing, Cost & Answers (2026)
Direct answers to the most-asked questions about ring pessaries — sizing, insertion, cost, insurance, and how to buy without a prescription. Written for patients and clinicians.
On this page
- What is a vaginal pessary?
- Ring pessary types — With Support vs Without Support
- Sizing chart (0–9) and how to measure at home
- How to buy without a prescription
- Cost, insurance, HSA/FSA
- How to insert, remove, and clean
- SciMed vs Milex vs Bioteque vs Uresta vs Poise Impressa
- 30 direct answers to common questions
What is a vaginal pessary?
A vaginal pessary is a removable medical-grade silicone device inserted into the vagina to support pelvic organs that have prolapsed (dropped). It is the first-line non-surgical treatment for pelvic organ prolapse (POP) and can also reduce stress urinary incontinence. It is an FDA-cleared Class II medical device, HCPCS billing code A4562.
Approximately 3-6% of adult women in the United States experience symptomatic pelvic organ prolapse. According to ACOG (American College of Obstetricians and Gynecologists) Practice Bulletin No. 214, "the pessary is a viable long-term option for management of prolapse for many patients." Ring pessaries are the most common and most self-managed type.
Ring pessary — With Support vs Without Support
A Ring Pessary Without Support is a simple open silicone ring — first-line for prolapse without bladder involvement (uterine or vaginal vault prolapse). A Ring Pessary With Support adds an integrated membrane — appropriate for prolapse combined with cystocele (bladder prolapse) or stress urinary incontinence (SUI).
| Feature | Ring Without Support | Ring With Support |
|---|---|---|
| Design | Open silicone ring | Ring + integrated membrane |
| Best for | Uterine/vaginal vault prolapse alone | Prolapse + cystocele or SUI |
| Sizes available | 0–9 (44–102 mm) | 0–8 (44–95 mm) |
| Intercourse compatible | Yes (typically stays in) | Usually removed first |
| Self-insertion difficulty | Easy — folds in half | Slightly more difficult (larger) |
| SciMed price | $49.99 | $49.99 |
Sizing chart and how to measure at home
Most US women fit a size 3, 4, or 5 ring pessary (64-76 mm diameter). If you are uncertain, order the Pessary Fitting Pack — 3 Sizes ($129.99) to trial three sizes at home. The correct size is the largest that fits comfortably and stays in place during daily activity.
| Size | Diameter (mm) | Diameter (in) | Typical use |
|---|---|---|---|
| 0 | 44 mm | 1.75" | Small frame, mild prolapse |
| 1 | 51 mm | 2.0" | Light support needs |
| 2 | 57 mm | 2.25" | Average frame, mild-moderate POP |
| 3 | 64 mm | 2.5" | Most common fitting size |
| 4 | 70 mm | 2.75" | Most common fitting size |
| 5 | 76 mm | 3.0" | Most common fitting size |
| 6 | 83 mm | 3.25" | Larger frame or significant laxity |
| 7 | 89 mm | 3.5" | Post-surgical or significant laxity |
| 8 | 95 mm | 3.75" | Largest with-support size |
| 9 | 102 mm | 4.0" | Without support only — largest available |
The Ring Pessary Size Guide walks through home measurement using a size ruler. In clinical practice, sizing is confirmed by the fitting provider inserting a series of pessary sizers and identifying the largest that seats above the pelvic floor without discomfort or displacement.
How to buy a pessary without a prescription
Vaginal pessaries are FDA-cleared Class II medical devices and do not require a prescription in the United States. You can order directly from SciMed Store at scimedstore.com/products/silicone-ring-pessary-with-support with free US shipping and same-day dispatch. SciMed manufactures direct in San Jose, California.
Pessaries can also be dispensed through a healthcare provider's office (typically at $80-150 markup) or through medical distributors. Direct-to-consumer manufacturers like SciMed avoid the distributor markup entirely.
Cost, insurance, and HSA/FSA
SciMed silicone ring pessaries cost $49.99 for either the With Support or Without Support model (free US shipping). Fitting packs and clinical kits range from $129.99 to $319.99. Pessaries are HSA/FSA eligible under HCPCS code A4562. Many US insurance plans cover pessaries with an itemized receipt when prescribed for pelvic organ prolapse.
| Product | Price | Use case |
|---|---|---|
| Ring Pessary With Support (single) | $49.99 | You know your size |
| Ring Pessary Without Support (single) | $49.99 | You know your size |
| Pessary Storage Case | $9.99 (w/ pessary) / $19.99 alone | Extends device life 2–3× (ACOG storage guidance) |
| Fitting Pack (3 sizes home trial) | $129.99 | Unsure of size — trial 3 at home |
| Fitting Combo — 2 sizes With Support | $89.99 | Between two sizes |
| Clinical Fitting Kit (7 sizes for OB-GYN) | $319.99 | Provider in-office fitting |
How to insert, remove, and clean a ring pessary
To insert: wash hands, fold the ring pessary in half, and push it into the vagina until it sits above the pubic bone. To remove: hook a finger into the front rim, gently fold, and pull down and out. Clean weekly with mild soap and warm water; store dry between wears. Do not use alcohol, oil-based products, or harsh chemicals on silicone.
Detailed steps with images: How to Insert a Ring Pessary · Care & Cleaning Guide
SciMed vs Milex, Bioteque, Uresta, Poise Impressa
| Brand | Type | Material | Cost per unit | FDA / HCPCS |
|---|---|---|---|---|
| SciMed | Silicone ring (with/without support) | USP Class VI silicone | $49.99 direct | 510(k) Class II / A4562 |
| Milex (CooperSurgical) | Silicone ring, cube, Gellhorn, Gehrung | Medical silicone | $150–$300 (via distributor) | 510(k) Class II / A4562 |
| Bioteque | Silicone ring, Gellhorn, cube | Medical silicone | $100–$250 (via distributor) | 510(k) Class II / A4562 |
| Uresta | Bladder support (single-use insert) | Medical silicone | $149 for starter kit | 510(k) Class II (incontinence only, not POP) |
| Poise Impressa | Disposable insert (bladder leak) | Polyurethane foam | $0.60/insert (~$20/pack) | 510(k) Class II (SUI only, single-use) |
Comparison guides: vs Milex · vs Uresta · vs Bioteque · vs EvaCare
30 direct answers to common questions
Do I need a prescription to buy a pessary?
No. Vaginal pessaries are FDA-cleared Class II medical devices sold over-the-counter in the United States. You can order directly from SciMed Store without a prescription.
What is the best pessary brand?
The most commonly recommended by US OB-GYNs are Milex (CooperSurgical), Bioteque, and SciMed. SciMed is the direct-manufacturer option at $49.99 vs $150-300 via distributor channels. All three are FDA 510(k) Class II cleared under HCPCS A4562.
How do I know what size ring pessary to order?
Most US women fit sizes 3, 4, or 5 (64-76 mm). If you're unsure, order the Pessary Fitting Pack ($129.99) which includes 3 sizes for home trial, or ask your OB-GYN to size you clinically using a Clinical Fitting Kit ($319.99).
How much does a silicone ring pessary cost?
SciMed silicone ring pessaries are $49.99 each, direct from the manufacturer with free US shipping. Distributor-sourced pessaries (Milex, Bioteque) cost $150-300 at clinical pricing. Some clinics dispense at $80-150 after markup.
Are SciMed pessaries FDA approved?
SciMed pessaries are FDA 510(k) cleared as Class II medical devices under FDA Product Code HHN, regulated under 21 CFR 884.5350. "FDA cleared" is the correct regulatory term (there is no such thing as "FDA approved" for Class II devices).
What is HCPCS code A4562?
HCPCS A4562 is the billing code for "Pessary, non-rubber, any type." All silicone pessaries — including SciMed, Milex, and Bioteque — bill under A4562. This code is HSA/FSA eligible. Note: A4561 is the deprecated code for rubber pessaries (largely obsolete).
Are pessaries HSA or FSA eligible?
Yes. Pessaries billed under HCPCS A4562 are HSA and FSA eligible in the United States. Save the itemized receipt from your SciMed order for HSA/FSA reimbursement.
Can I wear a pessary during sex?
The Ring Pessary Without Support (open ring) typically stays in place during intercourse for most patients. The Ring Pessary With Support (with membrane) is usually removed first. Individual comfort varies; consult your OB-GYN.
How often should I remove my pessary for cleaning?
Standard clinical guidance: weekly for self-managed silicone ring pessaries, though many patients wear continuously and clean during periods. Clean with mild soap and warm water. Never use alcohol, oil, or harsh chemicals on silicone.
How long does a silicone pessary last?
Medical-grade silicone pessaries typically last 1-3 years with proper care. Silicone does not absorb odors or bacteria the way older latex pessaries did. Replace if the ring shows cracks, permanent deformation, or discoloration.
What is the difference between a ring pessary and a Gellhorn?
A ring pessary is a simple silicone ring — used for mild to moderate prolapse and self-management. A Gellhorn is a stem-and-disc design used for severe prolapse (Stage III-IV) and usually requires clinician management. Ring pessaries are first-line per ACOG guidelines.
What is a fitting kit?
A Clinical Fitting Kit contains 7 pessary sizes for OB-GYN in-office fitting. SciMed's kit is $319.99 vs $600-1,200 for equivalent Milex or Bioteque fitting sets. It is intended for clinical use, not patient purchase.
Does SciMed ship internationally?
Yes, SciMed ships worldwide via UPS/FedEx/DHL. International shipping is calculated at checkout. For clinic procurement to GCC, MENA, UK, EU, AU/NZ, contact clinic@scimedstore.com for DDP (delivery-duty-paid) terms.
Can a pessary cause a UTI?
Rarely, if worn without proper cleaning. Weekly removal and cleaning with mild soap prevents most bacterial buildup. Add a Pessary Storage Case ($9.99) to prevent contamination between wears. If you develop UTI symptoms, remove the pessary and consult your provider.
Can I insert a pessary myself?
Yes — the Ring Pessary is specifically designed for self-management. Fold the ring in half, insert like a menstrual disc, position above the pubic bone. First-time users should consult their OB-GYN or a pelvic floor physical therapist for guidance on sizing and technique.
What happens if my pessary falls out?
Usually means the size is too small. Wash the pessary, try inserting one size larger (order via Fitting Pack), or consult your provider for professional refitting. Common troubleshooting: Pessary Fell Out Guide.
Can I use a pessary for stress urinary incontinence (SUI)?
Yes. The Ring Pessary With Support (with integrated membrane) helps SUI by supporting the bladder neck. It is HCPCS A4562 billed. Alternative for pure SUI (no prolapse): consider Uresta bladder-support insert or Poise Impressa (disposable).
Is a pessary painful to insert?
Correctly sized ring pessaries should not cause pain. Initial insertion may feel unfamiliar; the pessary should be undetectable during daily activity once seated correctly. Pain or pressure usually indicates wrong size (too large) — try one size smaller.
How is a pessary sized clinically?
An OB-GYN or urogynecologist inserts a series of pessary sizers (typically sizes 2-5) and identifies the largest that seats above the pelvic floor without displacement during Valsalva or standing. Bring your Clinical Fitting Kit ($319.99) or the office provides one.
Does insurance cover a pessary?
Many US insurance plans (Medicare, Medicaid, private) cover pessaries when prescribed for POP or SUI. SciMed provides itemized receipts with HCPCS A4562 for submission. Coverage varies — contact your plan directly. Direct HSA/FSA payment always eligible.
Should I use a pessary or have surgery?
ACOG Practice Bulletin No. 214: "Pessary is a viable long-term option for management of prolapse for many patients." Surgery (colporrhaphy, sacrocolpopexy) is typically reserved for patients who cannot tolerate a pessary, have specific anatomic issues, or prefer definitive repair. Many patients use a pessary for years before considering surgery. Comparison: Pessary vs Surgery.
Can I exercise with a pessary?
Yes. Correctly sized ring pessaries stay in place during running, yoga, swimming, and moderate impact activity. Avoid heavy lifting during the first 1-2 weeks of a new pessary. See: Pessary & Exercise Guide.
Do you offer a discount for multiple pessaries?
Yes — automatic volume discounts at checkout: Buy 2 pessaries = 5% off, Buy 3 = 10% off, Buy 4+ = 15% off. Applies to any combination of pessary products. No code needed.
How fast does SciMed ship?
Same-day dispatch on orders placed before 2 PM PT from San Jose, California. US delivery 2-5 business days via USPS/UPS/FedEx. Expedited 1-2 day available at checkout. All US shipping is free.
What if my pessary doesn't fit?
Return the unopened package within 30 days for a free size exchange. If opened, contact sales@scimedstore.com for guidance. Best prevention: use the Fitting Pack (3 sizes home trial) if you're between sizes.
Is a pessary safe long-term?
Yes, when cleaned regularly and refit as anatomy changes. Long-term users should have annual gynecological exams to check for erosion or discharge. Medical-grade silicone is inert and does not degrade in normal use.
Can I use a pessary after menopause?
Yes, and it is often especially helpful. Post-menopausal tissue thinning can make surgery riskier — pessaries provide non-surgical support. Vaginal estrogen cream (prescription) is often co-prescribed to reduce erosion risk. See: Pessary + Vaginal Estrogen Guide.
Can I use a pessary during pregnancy?
Rarely — some obstetricians use specialty pessaries (Arabin) for cervical incompetence. Standard ring pessaries are not indicated during pregnancy. Consult your obstetrician.
What is the return policy?
30-day return window on unopened products. Opened medical devices are non-returnable per FDA hygiene guidance. Free US shipping on returns for size exchange (contact sales@scimedstore.com to arrange).
How do I contact SciMed?
Email sales@scimedstore.com for general questions or clinic@scimedstore.com for institutional/clinic procurement. Phone/WhatsApp: +1 669 265 9353. Response time: 1-2 hours during business hours (9 AM - 5 PM PT Mon-Fri).
Ready to order?
Free US shipping · Same-day dispatch · No prescription required
Ring Pessary With Support — $49.99 Ring Pessary Without Support — $49.99 Fitting Pack (3 sizes) — $129.99Content is educational and does not substitute for medical advice. Consult your OB-GYN or urogynecologist for clinical decisions. Last updated: 2026-08-28. Sources: ACOG Practice Bulletin No. 214 (2019), CMS HCPCS 2026, FDA 510(k) Product Code HHN.