Evelyn, a forty something Scottish lass presented to my clinic for a pessary fitting for procidentia. Now those are two big names for one big trouble. Procidentia is a type of pelvic organ prolapse when the entire uterus or bladder falls out from a woman’s vagina. A woman with procidentia may experience discomfort or pain, sexual pain, may have difficulty sitting, working or exercising and may have bladder troubles. A pessary is a small device inserted into a woman’s vagina to support the prolapse.

Evelyn was on a surgical waitlist however that meant it would be at least one year till the surgery would take place. As with all of my patients, I ask them if they are sexually active, Evelyn said that she was but less so lately as her prolapse was becoming more prominent recently. The reason I asked Evelyn if she was sexually active was because the one type of pessary, a Gelhorn, that works best is the one that precludes a woman from having vaginal sex.

Tears streamed down Evelyn’s face as I told her about her options. She understood the implications immediately and to my surprise, said, “well my husband will need to take another woman.” I said, no not necessarily. She said yes, he would as he would not be able to go without sex for one whole year.

Men’s needs are very different to women’s when it comes to sex. Evelyn was the first woman I had come across in a long time who truly understood, the biological need men have with regard to sex. For men, sex is a biological need and Evelyn understood this only too well. Evelyn did not want to risk ending her sex life with her husband.

Fortunately for Evelyn, I was able to fit her with a large ring type pessary with support. The pessary was comfortable as she walked about the clinic up and down stairs supporting her procidentia. The pessary did not fall out when she squatted or bore down. She was able to void and and perhaps the most important aspect was that Evelyn would be able to engage in vaginal sex with her husband. Her tears quickly turned to a smile knowing she and her husband could still be intimate even though she would need to wear a pessary for a year.

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