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The term “pessary” is used in three different ways; the meaning is usually clear in the context. In the first sense, a pessary is a supportive device which is inserted into the vagina or rectum to treat a variety of medical conditions. A pessary can also be a pharmaceutical preparation which is used to deliver drugs rapidly through the mucus membranes of the anus or vagina. Finally, some people refer to birth control devices as pessaries, although this use of the word is not very common.
The word comes from the Ancient Greek pessarion, a word which referred to a piece of medication-soaked wool or lint which was inserted into the vagina. The Greeks used pessaries with the goal of preventing pregnancy, and some Greek women also used them like modern tampons. Historically, all sorts of peculiar things were put into vaginal pessaries to treat medical conditions which were specific to women.
In the sense of a supportive device, a pessary is most commonly used to treat uterine prolapse, a condition in which the uterus slides into the vagina, causing discomfort and medical complications if it remains untreated. Prolapse is caused by a weakening of the pelvic floor muscles, which normally hold the uterus and other organs in place. A pessary is used to support the uterus, holding it firmly in place so that it will not slip. Pessaries are also used to treat incontinence and prolapse of other organs.
Typically, a doctor must fit a pessary, since he or she is involved in the diagnosis of the condition which requires a pessary. There are a number of styles available, along with an assortment of sizes, and a doctor may try several fits before finding one which works. After a pessary is inserted, the patient receives care instructions which may involve periodic removal and cleaning or checkups to assess the patient's condition and to make sure that the device has not drifted.
A pharmaceutical pessary is made by blending drugs with a substance which will dissolve in the warmth of the body. The drugs will slowly leach through the porous membrane of the vagina. When used in the rectum, a pharmaceutical pessary is better known as a suppository; suppositories are sometimes used as alternatives to pills and injections. Some medications must be specifically delivered vaginally or anally to be most effective.
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