The effect of pessaries on the vaginal microenvironment

Objective The objective of the study was to evaluate the differences in vaginal culture, microscopy, and Gram stain between postmenopausal women who wear pessaries and those who do not to explain pessary-related, bothersome vaginal discharge. Study Design Postmenopausal women not using exogenous estrogen who had either been wearing a pessary for at least 3 months or who were undergoing their first pessary fittings were approached for enrollment. Symptoms were assessed, and vaginal fluid was collected for culture, microscopy, and Gram stain. A cross-sectional analysis was performed, comparing the new and return pessary wearers. The new pessary users were also sampled at 2 weeks, 3 months, and 6 months after fitting. Results Women who wore pessaries were more likely to be bothered by discharge (30.0% vs 2.1%, P Conclusion Pessary-related, bothersome vaginal discharge develops early and may be due to an inflammatory process in the vagina.