If you have been diagnosed with pelvic organ prolapse or are experiencing vaginal heaviness, pressure, a vaginal bulge or bladder leakage, you may have heard about pessaries.
You may also have wondered:
Can an osteopath fit a pessary?
The answer is yes, when the osteopath has undertaken the appropriate additional training and has the competence and experience to provide pessary fitting within their scope of practice.
At Empower Osteopathy in Tugun, Gold Coast, Emma Power has undertaken advanced training and accreditation in pessary fitting and provides pessary fitting as part of her pelvic health practice.
What is a pessary?
A pessary is a medical device that sits inside the vagina and provides support to the vaginal walls and pelvic organs.
Pessaries are commonly used as a non-surgical option for managing symptoms associated with pelvic organ prolapse.
Depending on the type of pessary and the individual, they may also be used to provide support for some types of stress urinary incontinence.
What is pelvic organ prolapse?
Pelvic organ prolapse occurs when one or more of the pelvic organs, such as the bladder, uterus or bowel, move downwards and place pressure on the vaginal walls.
Symptoms can include:
A feeling of vaginal heaviness
Pelvic pressure
A sensation of something coming down
A vaginal bulge
Symptoms that worsen after standing for long periods
Symptoms that increase with exercise or lifting
Difficulty with certain physical activities
Bladder leakage or changes in bladder function
Prolapse symptoms can vary significantly between women.
Some women may have a prolapse with very few symptoms, while others may experience symptoms that affect exercise, work, sex or everyday activities.
How does a pessary help?
A pessary provides internal support.
Rather than surgically changing the position of the pelvic organs, a pessary sits within the vagina and can provide mechanical support to the vaginal walls and pelvic structures.
For some women, this can reduce the sensation of heaviness or pressure and make certain activities more comfortable.
A pessary does not cure prolapse. It is one management option that can be considered alongside pelvic floor rehabilitation, exercise modification and other appropriate healthcare.
Can an osteopath fit a pessary?
Yes, but specific training matters.
Osteopathy is a regulated health profession, but pessary fitting is not something that should be assumed to be part of every osteopath's standard training.
An osteopath who provides pessary fitting should have appropriate education, training and experience to provide the service safely and competently.
At Empower Osteopathy, Emma Power has completed advanced training and accreditation in pessary fitting.
This additional training supports her ability to provide:
Pelvic health assessment
Assessment of pelvic organ support
Pessary selection
Pessary fitting
Assessment of comfort and positioning
Education around pessary use
Guidance regarding insertion and removal where appropriate
Pessary care education
Follow-up and ongoing management
What happens at a pessary fitting?
Your appointment starts with a conversation about your symptoms and goals.
This may include discussion about:
Pregnancy and birth history
Bladder symptoms
Bowel symptoms
Exercise
Work and daily activities
Previous pelvic health treatment
Your prolapse symptoms
What you would like to be able to do more comfortably
With your consent, an internal pelvic health assessment may then be performed.
The appropriate pessary type and size can be discussed and selected based on your individual presentation.
The pessary is then fitted and assessed for comfort and support.
You will also receive education about using and caring for your pessary.
What if the first pessary isn't right?
Finding the right pessary is sometimes a process.
Different women have different anatomy, symptoms and activity requirements, and there are different pessary styles and sizes available.
A follow-up appointment may be required to assess how the pessary is working and whether an alternative size or style would be more suitable.
This is completely normal and is part of individualised pessary management.
Can you exercise with a pessary?
For many women, one of the advantages of pessary support is being able to continue physical activity.
Some women use a pessary specifically for activities where their symptoms become more noticeable, such as:
Running
Gym training
Walking
Lifting
Jumping
Sport
Longer periods of standing
Your individual response to exercise is important, so your pelvic health assessment should take your lifestyle and goals into account.
Pessary fitting after pregnancy
Pelvic floor symptoms can develop or become more noticeable during pregnancy or following childbirth.
You may notice:
Vaginal heaviness
Pelvic pressure
A vaginal bulge
Bladder leakage
Symptoms during walking or exercise
Symptoms that increase towards the end of the day
If you are experiencing these symptoms after having a baby, a pelvic health assessment can help you understand what is happening and what management options may be appropriate.
A pessary may be one option alongside pelvic floor rehabilitation and a gradual return to exercise.
Osteopath or pelvic health physiotherapist, who should I see?
Both osteopaths and pelvic health physiotherapists can have additional training in pelvic health.
The most important consideration is the individual practitioner's training, experience, scope of practice and the service they provide.
If you are specifically looking for pessary fitting, ask whether the practitioner:
Has undertaken specific pessary fitting training
Has experience fitting the type of pessary you may require
Provides follow-up after fitting
Can assess your pelvic health needs
Can refer or collaborate with other healthcare professionals when appropriate
At Empower Osteopathy, Emma Power's additional training includes pessary fitting, allowing this service to be provided within her pelvic health practice.
When should you seek medical assessment?
Not every pelvic health symptom is appropriate for pessary management alone.
If you experience significant pain, unexplained vaginal bleeding, difficulty emptying your bladder, recurrent urinary tract infections, unusual discharge or other concerning symptoms, medical assessment may be required.
Depending on your individual presentation, your care may involve collaboration with your GP, gynaecologist, urogynaecologist, pelvic health physiotherapist or another healthcare professional.
Pessary fitting on the Gold Coast
If you are looking for pessary fitting in Tugun or on the Gold Coast, Empower Osteopathy provides individualised pessary fitting and pelvic health care.
Emma Power has undertaken advanced training and accreditation in pessary fitting and can assess whether pessary support may be appropriate for your symptoms and lifestyle.
Whether you are managing prolapse, returning to exercise after pregnancy or looking for a non-surgical option to support your pelvic health, a pelvic health consultation can help you understand your options.
Related reading
You may also be interested in:
Pelvic Organ Prolapse
Pelvic Floor Dysfunction
Postpartum Pelvic Health
Pregnancy Osteopathy
Pelvic Health Osteopathy
Bladder Leakage and Urinary Incontinence
This information is general in nature and does not replace an individual assessment or medical advice.
