A ring pessary is usually folded, angled toward the small of your back, then eased in until it opens and sits comfortably.
A ring pessary can feel awkward the first few times. That’s normal. The shape is simple, yet getting it in place takes a bit of hand position, body position, and patience. Once the angle clicks, the whole thing tends to get easier.
This article walks through the basic method used for a flexible ring pessary. It also shows what a good fit feels like, what can go wrong, and when to stop and get medical help. If your clinician gave you a different method for your own pessary type, stick with that method.
What A Ring Pessary Does
A ring pessary is a soft support device placed inside the vagina. It’s often used for pelvic organ prolapse, and some people also use one for stress urinary leakage. A well-fitted ring should feel secure but not noticeable during normal daily activity.
That comfort piece matters. If the ring hurts, slips, blocks urine, or feels like it’s poking, the size or position may be off. Brigham and Women’s Hospital notes that a good pessary fit should not feel uncomfortable, should stay in place when you bear down, and should not make it hard to use the bathroom.
Before You Start
Set yourself up so you’re not rushing. Clean hands, a clean pessary, and a private spot help more than people think. Tension in your pelvic floor can make insertion tougher, so a calm setup pays off.
What You’ll Need
- Your ring pessary
- Mild soap and warm water for washing it
- A clean towel
- Water-based lubricant
- Good lighting if you want to check placement
If you’ve been told to use vaginal estrogen or another vaginal product, follow your own care plan. Some clinics use that to help with dryness or tissue irritation.
Body Positions That Usually Work Best
There isn’t one magic pose. The right one is the one that lets your pelvic floor relax and gives your hand room to move. These tend to work well:
- Standing with one foot on a low stool or toilet
- Squatting
- Lying on your back with knees bent
- Standing with knees slightly bent
Many people start with one foot raised because it shortens the reach and opens the angle a bit.
How To Insert Ring Pessary At Home Without Pinching
The ring is meant to be folded. You’re not trying to push a full circle straight in. You’re making it narrow first, then letting it open once it’s high enough inside the vagina.
Step-By-Step Insertion
- Wash your hands and the pessary with warm water and mild soap. Rinse well and dry it.
- Fold the ring in half at the indented sides, or as shown by your clinician.
- Apply a small amount of water-based lubricant to the leading edge.
- Part the labia with your free hand.
- Aim the folded ring backward, not straight up. The path should angle toward your lower back.
- Ease it in slowly until most of the ring is inside.
- Push it far enough back so it can open and settle behind the pubic bone.
- Let go and check how it feels while standing, sitting, and walking.
If you feel a sharp pinch at the entrance, pause and add a bit more lubricant. If it seems stuck halfway, the angle is often the issue. A backward tilt usually works better than pushing upward.
Patient leaflets from Brigham and Women’s Hospital’s pessary instructions and the Aneurin Bevan University Health Board ring pessary leaflet both stress comfort and fit: once in place, you should not really feel it.
What Proper Placement Feels Like
A well-placed ring usually feels like nothing much at all. You may notice mild awareness right after insertion, yet it should not feel sharp, heavy, or as if it’s slipping down.
Try these checks:
- Walk around for a minute
- Sit down, then stand up
- Cough once or twice
- Use the bathroom if you need to
If the ring stays put and you can pass urine normally, that’s a good sign.
Common Problems During Insertion
Most trouble comes down to one of four things: dry tissue, a tense pelvic floor, the wrong angle, or the wrong size. Technique can fix the first three. Size needs a fitting visit.
| Problem | Likely Cause | What To Try |
|---|---|---|
| Pinching at the opening | Not enough lubricant or tissue dryness | Add water-based lubricant and insert more slowly |
| Won’t go in far enough | Angle is too upward | Aim toward the small of your back |
| Feels bulky right away | Ring has not opened in the right spot | Push it a bit farther back, then let it open |
| Slips down when you stand | Placement is low or size may be off | Reinsert once; if it keeps slipping, book a fitting review |
| Pressure when passing urine | Position may be off | Remove it and try again once |
| Sharp pain | Tissue irritation or poor fit | Stop using it and get medical advice |
| Falls out with coughing or straining | Wrong size or style | Get remeasured |
| Feels fine lying down but not walking | Ring is sitting too low | Try placing it farther back and higher |
Removing, Washing, And Reinserting The Ring
Some people leave a ring pessary in place until a scheduled clinic change. Others are taught to manage it themselves. That depends on the type of ring, your comfort level, hand strength, and your clinic’s plan.
Leicester’s patient leaflet says some women can remove, wash, and reinsert a ring pessary themselves, and that washing with warm water and mild unperfumed soap is suitable. It also says not to sterilise the device, since that can damage it.
You can read that advice in the Leicester Hospitals self-management leaflet.
Simple Removal Method
- Wash your hands.
- Hook one finger under the front edge of the ring.
- Gently tilt and fold it as you draw it downward.
- Ease it out slowly, keeping it folded as much as you can.
Once it’s out, wash it, rinse it well, dry it, and check the surface. A cracked or rough pessary should be replaced.
When To Stop And Get Medical Help
Some symptoms mean the pessary should not stay in until your next routine visit. If you hit any of these, call your GP, pelvic health clinic, nurse, or urgent care service.
- You cannot pass urine
- You have bleeding from the vagina
- You have foul-smelling discharge
- You have pain, burning, or a sore spot that doesn’t settle
- The pessary keeps slipping out
- You feel unwell with discharge or pelvic pain
Not being able to pee is the one that needs fast attention. Some hospital leaflets treat that as an urgent problem because the pessary may be pressing in the wrong place.
| What You Notice | What It May Mean | Next Step |
|---|---|---|
| Mild awareness after insertion | Settling in | Walk around and recheck in a few minutes |
| No discomfort during daily activity | Likely good fit | Carry on with your usual plan |
| Pressure or rubbing | Low placement or poor fit | Remove and try once more; then get reviewed |
| Bleeding or bad-smelling discharge | Tissue irritation or infection | Book medical review |
| Cannot pass urine | Possible blockage | Get urgent medical help |
Small Tricks That Make Insertion Easier
A few simple habits can make a big difference. Empty your bladder first. Breathe out while you insert the folded ring. Don’t rush the last inch. That’s the part where the angle tends to matter most.
It also helps to practice at the same time of day for the first week or two. Your body gets used to the motion, and your hands stop feeling clumsy. Many people find that once they can place it correctly two or three times in a row, the fear drops fast.
If You’re Still Struggling
That does not mean you’ve failed. Ring pessaries come in different sizes and styles, and not every pelvis likes the first one tried. If insertion stays painful or the ring keeps moving, book a fitting check. A different size, a support ring, or a different pessary type may work better.
What Most People Need To Know
For a ring pessary, the usual method is fold, lubricate, angle backward, place it high enough to open, then check comfort while standing and walking. If it feels wrong, slips, causes bleeding, or blocks urine, stop and get reviewed. A ring pessary should feel secure, not harsh or obvious.
References & Sources
- Brigham and Women’s Hospital.“Pessary Patient Instructions.”Explains what a good pessary fit feels like and notes that some patients can learn home removal and reinsertion.
- Aneurin Bevan University Health Board.“Patient Information: Insertion and Care of Vaginal Ring Pessary.”Outlines ring pessary comfort, side effects, and routine change intervals.
- University Hospitals of Leicester NHS Trust.“Using A Pessary For Prolapse.”Gives self-management points on washing, checking for cracks, reinsertion, and symptoms that need urgent review.