need advice

I am in a similar situation, and don't have answers, but I can share. I declined to use a pessary because I didn't want to keep running to the doctor. The recommended surgeries don't sound like they are going to heal anything or return me to a mobile condition, so I am not doing them, either. The doctor prescribed Prevarin for me , and warned that although it says it may cause cancer (and also contains propylene glycol and sodium lauryl sulfate) she has many women who are using it long term with no side effects. She considers it safe. (She also recommends surgery) I am using it for now because I don't think paper thin vaginal tissue is good, either. However, if I can find a herbal to do the job, I will discontinue this one. I have posted the question, but have not received an answer. Maybe trying one of the menopause websites will be necessary, when I get the time. I also have to work for a living. I teach preschool, which requires a fair amount of standing, and which also requires extra hours for which I am not paid, in order to do a decent job. I may have to change jobs, which is not easy because there is prejudice against hiring workers at or nearing retirement age, regardless of how qualified or healthy they are. I am also (slowly) investigating what kind of supports I might use. Am trying to get a V2 supporter cleared with the Dr., who said my homemade supporter would only serve to erode tissue as it came in contact with the support.

One has to keep working at it and the learning sometimes comes in bits and pieces instead of all at once. Finding ways to keep a positive emotional balance helps to counteract the fear and the downs at having to make changes some of which may involve giving up things one is used to and likes. I think we can do this, but need to stay committed to it and as emotionally positive as we can. Hang in there. You will feel better.

I have uterine and bladder prolapse I find the posture has helped to stabilize them.
When I am on my feet a lot they will protrude if I don't have my pessary inserted One doctor I went to prescribed the premarin cream but when I changed doctors she told me to quit using it as they don't recommend it anymore. I take my pessary out and clean and re insert it myself. I just use ky jelly on one end of the pessary when I re insert it. I have used a pessary for about 5 years now. I go to the doctor every 3 to 6 months and get checked to make sure everything is okay down there. I go without my pessary when I'm around the house and am not going to be on my feet a lot.
I have had to change pessaries a few times, but considering the options of surgery and complications that could arise, plus being laid up for six weeks, no thanks. I am 70 plus years.
Hope this helps.
Flora

My mother is 63 - And she had a pessary ring inserted last year for the first time and she says it is great. In UK they change it every 5-6mths for a brand new one. She can cope with having it done every now and then - I would say to you - To definitely try the pessary ring before ou go all out for an op...

Sue

Dear Flora

I chose not to use the pessary because the urogynecologist, aka surgeon, to whom I was referred by my gynecologist, said that I would have to use a complicated kind of pessary that only the doctor or the nurse could take out or insert, and that I would have to go back every 6 weeks to have it cleaned.

When your second doctor told you to stop using the Premarin, did she prescribe anything else for thinning vaginal tissue? I have reservations about using it, but the gynecologist offers nothing else, and since my insurance is HMO, I have limited choice of doctors.

I, too, do not want to be laid up for surgery, or risk the complications. Since I have to work to support myself, there is no time for those things (and also no desire to do it.)

It was good hearing from you. thanks.

Was the pessary your surgeon suggested a gelhorn? My first doctor gave me a gelhorn pessary it worked quite well. It is quite difficult to remove and insert but I learned how after I had words with him and refused to go back. My second doctor just recommended the trimosan that comes with a new pessary but it has an ingredient in it that can cause cancer. There is information about it in some of the posts.
I told my second doctor I preferrred to use KY Jelly and she said whatever I was was happy using.
Anyhow if a pessary is not for you there is the V2 belt which some of the ladies on this forum use and are quite happy with. It gives external support. Type v2 belt in the search at the left of the forum and it should take you to these posts.
Ask your doctor why he or the nurse can't teach you how to remove and insert the pessary yourself.
Whatever you decide I wish you the best of luck. Do keep us posted on your progress.
Flora

Hi,Help me figure this out ladies,please! I have been going back and forth on the surgery idea, and wonder if I'm going nuts! I got a donut pessary last fall and after the doctor inserted it, it was fine! Well when I tried, it is either painful, or goes flying every where! When I put the gel on it, it is too slippery to hold and squeeze to insert! I haven't tried it in months! Should I try another one, and what kind? I am also 63 and have learned a lot here but my family just doesn't understand why I am so reluctant to have the surgery! Nancy

There is definitely a 'knack' to insertion of these - My Dr kills you with agony yet the Gynae mums see's done it so swiftly and painlessly she doesnt evennotice

Mum has a ring pessary - Like a bracelet but smaller :)

I would definitely try different ones before doing anything you cannot step backwards and change...

I read somewhere that if you lie down on your back it is easier to put in- also you could wear some thin cotton gloves so it doesn't slip as much- also if you are going to the doctor to check out new pessaries- convience them to coach you through putting one in yourself with the checking the placement. and as to your family- maybe you could find some literature they could read-

Hi Nancy,
I have a donut pessary now and when I insert it I lie on my back with my head and back slightly raised on a pillow. I fold the pessary ready to put in and apply the KY Jelly to that end only. I keep a kleenex handy so I can wipe the KY Jelly off my hand. Once I have it in the proper position it will slip in on its own. It turns over once it is in place. I then stand and check to feel if it is in as far as it can comfortably go. You do need to be as relaxed as possible to get it to go in. I usually take several deep breaths once I am lying down before I start.
Hope this helps.
How are you doing otherwise?
Regards Flora

Hi again Nancy,
I have the fitting instructions for the health care professioal for the donut pessary. The instructions say; 1 Wear dry gloves. When necessary the entering end of the pessary can be coated with Trimosan or other suitable lubricant.
2 Use one finger to depress perineum. Hold donut pessary almost parallel to the introitus. Guide pessary into vaginal vault using a corkscrew motion.
3 Cervix should rest behind donut.
4 After fitting, the patient is told to sit,stand and bear down slightly. Examine patient while in standing position to ensure pessary has not shifted position. Patient should not feel pessary once it is in position. Pessary should not be too loose as it may turn or be expelled and should not be too tight as it may cause discomfort.
5 The health care professional should be able to sweep one finger between pessary and vaginal walls. if there is not enough space to do this, the next smallest size should be tried. If excessive space exists, the pessary may rotate or even be expelled.
6 it is sometimes necessary to refit the patient with different size or type of pesary after a period of time. Do not assume that a replacement will always be the same size as before. Check the fitting to ensure continued patient comfort and relief of symptoms. The use life of a pessary is limited. Examine frequently for signs of deterioration.
I don't know if this will help or not. One thing though I find that the pessary turns on its own once it is inserted and in Christine new book this is mentioned.
Take care. Regards Flora.

Hi Nancy

I remember you from a while back. This may not be an acceptable solution for you, but I can see two possibilities. The first is that your body has changed, and it really is different. The second is that the doctor or nurse has two hands in whatever position you like to control a slippery pessary, whereas the location of your vagina and the distance from your shoulders means that you just can't quite reach that far with your hands in appropriate positions. Don't beat up on yourself for not being built like a gorilla with arms four feet long - the mind boggles, but I reckon lady gorillas would have no trouble at all managing a pessary!!

Tampons sometimes come with an applicator, why not pessaries? Because you can't buy them retail and some types can only really be inserted by a second party. This means that they are a continuing $tream of income for the second party.

Hey, with that smart female brain of yours I bet you could come up with an applicator, so you could lube up the pessary, and put it in the applicator, then insert the applicator into the vagina, push the pessary out the end just like a tampon.

Something like a plastic tube (I'm thinking PVC water pipe and fittings), with a diameter about the same as a stout penis might work, with carefully smoothed leading edge. You could make an indentation in the edge on the trailing end and line the pessary up with it so you can orient it correctly in your vagina, and a line etched around it at the correct distance from the leading edge so you could feel it and know how far in to push it in before ejecting the pessary. You could have another, longer piece of tube slightly smaller in diameter with one end closed off that would fit inside the applicator. You would push the pessary out of the outer tube by pushing the inner tube up the outer tube, kind of like a syringe. You might be able to come up with a better design. Oh yes, and make sure you clean everything thoroughly before and after use. Getting the pessary out might not be so simple, and I guess it's a bit like driving a car. You have to know how to stop it before you learn how to start it!

DISCLAIMER: I don't use a pessary any more, and I don't know how precisely you could place it, but I can see that it could possibly work, but if you try it, be very careful that you don't injure your vagina in the process.

Actually, you could probably do better than that. If you have a partner or other trusted person, just teach them how to do it and get them to insert it for you. I am sure you could barter another personal service with them. Once again, the mind boggles.

Good luck, if you dare try either option. Let us know.

Cheers

Louise

ps. Where do you store such a device? Maybe in the kitchen in a container labelled "sausage maker". I am also thinking that the food pusher out of my Kenwood mincer would make a good plunger for the applicator. Oh dear, my imagination is getting a bit too fertile this morning. I had better stop right here. L

I read your post and started laughing so hard it set off a coughing fit.......if I blow out a 'cele it'll be due to the image of using a kenmore mincer to insert a pessary........oh no .........there I go again with the laughing.

good thing I wasn't drinking my tea as I was reading or it would be all over the screen

thanks for the laughs : )

Well- it is 2011 and I have a 3.5 inch donut in me upon which I am relying for relief from a grapefruit sized bulge. I took it out but the nurse quickly put it back in when she saw it covered with blood- the doctor did not think this too severe...
I know how bad the pressure was from the sag- I felt like I weighed a ton. Cannot imagine anymore surgery so have accepted that pessary must work... i just need to be able to reinsert it- taking it out was not a problem but will wait to remove until nearing doc visit. These comments are appreciated. I hope to become star pupil of donut use(more like a bagel haha

Well done Sammy. I do so hope this works for you.

(I can't see your crown. Where did you say you wore it???)

Louise ;-)