The Gellhorn pessary is made of a flexible silicone material. It has a circular flat plate that supports against the cervix or vaginal vault. It also has a stem which stabilises the pessary in the vagina.
How to insert a Gellhorn pessary:
Find a position you feel relaxed, comfortable and able to reach your vaginal opening:
- Sitting on the edge of a chair or toilet or bed.
- Deep squat.
- Standing with a leg up on a chair or toilet seat or bed. If you are right-handed, put your left foot up on the surface.
- Lying down with knees bent.
Fold the stem towards the base of the pessary.
Lubricate the edge of the pessary which you will first put in your vagina. Avoid getting lubricant on your hands or anywhere else on the pessary as it can make it too slippery to insert.
Breathe in and out and relax your pelvic floor muscles.
Part the labia with your non-dominant hand.
Angle the base of the pessary on a diagonal from 2 o’clock to 7 o’clock and gently slide the pessary into the vagina by angling it towards your tailbone.
Once inserted, release the stem and use your finger(s) to push the base or stem of the pessary up as high as it can go comfortably.
How to remove a Gellhorn pessary:
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Sitting on the edge of a chair, toilet or bed.
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Deep squat.
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Standing with a leg up on a chair or toilet seat or bed. If you are right-handed, put your left foot up on the surface.
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Lying down with knees bent.
With your finger, jiggle the base of the pessary down towards the opening to the vagina.
Insert the thumb and index finger inside the vagina, compress the stem to the base, rotate diagonally, and remove the pessary.
Note: Do not panic if you are having difficulty removing the pessary. Try a different position, and bear down by “straining” or coughing. If you do not succeed, then contact your physio or GP who will be able to help you. If you cannot contact your physio or GP and are in pain or cannot empty your bladder and bowel you can go to your nearest hospital accident and emergency and tell them that you have a vaginal pessary that may be causing a problem.
Different positions for insertion and removal:
How to clean the Gellhorn pessary:
A Gellhorn pessary should be removed weekly and left out overnight or for a 24 hour period.
Once you have removed the pessary:
- Wash with mild soapy water by rubbing pessary with your fingers or a soft brush.
- Clean drainage holes with pipe cleaner.
- Rinse the pessary well with water.
- Dry the pessary completely with a clean paper towel or clean cloth and allow to air dry.
- Check the pessary for any obvious cracks or signs of wear.
- Store in a dry, safe place (plastic container or wrapped in a clean cloth) if not re-inserting immediately.
- Discolouration of the pessary often occurs and is not harmful.
When should I have the pessary checked or changed?
After the initial fitting, you should attend a review appointment at
- 1-2 weeks: to review your ability to remove and insert and to check the pessary is comfortable. It is also important to check for good bladder and bowel emptying.
- 3-4 months: to check that the vaginal mucosa is tolerating the regular pessary wearing.
- 1 year: this annual review should be with your GP or gynaecologist so they can check the health of your vaginal walls via speculum exam. You will also need to see your pessary physiotherapist for a replacement pessary and to check if your pessary type or size is still appropriate.
If you have any concerns about the fit of your pessary, please contact your physiotherapist to arrange a review.
Do I need to use vaginal oestrogen with the pessary?
If you have been prescribed vaginal oestrogen, you will need to continue using it as maintenance (usually 1-2 times/week as per your GP's recommendation) whilst using the pessary. This can improve the condition of the vaginal walls and may protect them from injury, reducing your risk of infection or ulcers.
Can I have sex whilst wearing the pessary?
No. A Gellhorn pessary will need to be removed prior to having penetrative intercourse, and then reinserted again afterwards.
How do I manage my period whilst wearing the pessary?
A gellhorn pessary does have drainage holes but only allows for limited menstrual flow so you will need to remove during your heavier menstrual flow days.