Can You Have Sex With a Prolapse Pessary?

You have a fitted pessary, but the appointment ended before you asked about sex. Start with the device name: the answer for a ring differs from the answer for a Gellhorn or shelf.

Which type do you have?

The International Urogynecological Association¹ describes these differences:¹

• Ring: intercourse can be possible with it in position. If you or your partner feel it, removal before intercourse and replacement afterward may be an option.
• Gellhorn, cube or doughnut: these largely fill the vagina, so vaginal intercourse is not possible while they are inserted.

UK hospital guidance from Leeds also says a shelf or Gellhorn cannot remain in place for vaginal intercourse. With a ring, a partner may feel the device; a different position may be more comfortable.³

These leaflets explain device compatibility. They do not provide a trial showing which type gives better sexual comfort or satisfaction.

Removal is a skill to learn with your clinic

A device that must come out before intercourse is not automatically a device you can remove yourself.

IUGA¹ says a Gellhorn usually needs removal by a doctor or nurse. Gloucestershire Hospitals, however, describes teaching some sexually active patients to remove and reinsert one. That is a difference in available self-management arrangements, not permission to attempt removal without instruction.¹²

Leeds describes self-management as an option with teaching on removal, cleaning and reinsertion. Ask whether that option applies to your device and your circumstances.³

The play

Try this: ask for a written intercourse plan

Bring the device name, or ask the clinic to write it down. You can start with: “I want vaginal intercourse to remain possible. Please explain how that works with the pessary you fitted.”

Ask whether it can stay in during intercourse. If it must come out, ask for removal and replacement training, including what to do if either step is difficult.

Get a contact name or number for pain, movement of the device, or trouble reinserting it. Keep those instructions with your pessary care plan.

Pain or bleeding deserves a check

Stop intercourse if it hurts and contact the fitting team. A pessary that is uncomfortable or repeatedly falls out may need a different size or another treatment discussion.²

Leeds advises medical review for bleeding and for discharge that becomes very heavy or unpleasant-smelling. Do not assume those symptoms are an unavoidable part of using a pessary.³

Gloucestershire advises seeking prompt medical advice for severe pain or inability to pass urine or open the bowels. Its leaflet names UK services; outside the UK, use your local urgent-care service.²

Laugh, Sneeze, Jump discusses clinician-fitted continence pessaries in Chapter 9 and preparing an appointment around your symptoms and preferences. That preparation can help you raise sex and device care with your clinician. The book’s continence discussion does not supply removal instructions for every prolapse pessary. See the book.