Pessaries change pelvic floor muscles

By Bryn Zolty, PT

Pelvic organ prolapse is experienced by many women as heaviness in the vagina. For some women this experience is painful, dull, aching. For others it feels as if there is something in the vagina or sliding out. This can occur when a woman has pelvic floor muscle injury and in the presence of increased tissue mobility such as hypermobility disorders. It is commonly seen after a vaginal delivery.

Different images of two different pessary shapes used with permission from Pelvic Guru®, LLC | www.pelvicglobal.com

Although these conditions all sound like weakness and lengthened muscles, as clinicians we often see an increase in pelvic muscle tension and activity. What appears to happen is when a woman stands up, the feeling of heaviness and falling out increases, and either knowingly or unknowingly, she increases the pelvic floor muscle that tries to hold the organs in. This can be seen on biofeedback as pelvic muscle overactivity.

A pessary is a device fitted for a woman that helps reduce the symptoms of heaviness by insertion into the vagina and providing support that your body is not able to provide. New research suggests it may also improve muscle function. One hypothesis is that the muscle will stop contracting all day in attempts to decrease the symptoms of the pelvic organ prolapse. This hypothesis states that the muscles, specifically the puborectalis, will now assume a more normal resting position/tension and therefore allow for better muscle function.  

If you are experiencing symptoms of pelvic organ prolapse and other pelvic muscle dysfunctions, talk to your providers about the use of pessaries to not only improve the symptoms of the heaviness, but improve the way the muscles work. These muscles have important functions for urination, defecation, continence, movement, core strength, and sexual function.