Pelvic organ prolapse (POP) and stress urinary incontinence (SUI) are common conditions affecting people with a vagina across the lifespan, often leading to significant impairments in quality of life. Conservative management is increasingly prioritized, particularly among those who are not surgical candidates, wish to delay surgery, or are managing symptoms during pregnancy or postpartum recovery. Pessaries, intravaginal devices used to support the pelvic organs or compress the urethra, represent a cornerstone of conservative pelvic health management. Their safe, relatively non-invasive nature and growing evidence base make them essential tools in a clinician’s pelvic health toolkit. Pessaries are considered relatively safe for many patient populations and are well tolerated when a proper fit is achieved (Rogers 2017). Well fit pessaries are expected to allow people with POP to participate in a full range of physical activities and exercise comfortably (O’Dell 2012).

This essay explores the current evidence on pessary use, including types, indications, contraindications, patient selection, fitting considerations, and integration with pelvic therapy. Emphasis is placed on empowering pelvic health providers to incorporate pessaries confidently and collaboratively in clinical practice.

Clinical Indications
Pessaries can be used for a range of pelvic health conditions, including: