Purpose
Accommodators are sometimes used to help “stretch” vaginal tissue in order that the insertion/removal of a pessary becomes more tolerable.
Common Conditions
Accommodators are useful in situations where the tissue:
- has less elasticity/compliance to stretch
- has a decreased estrogen supply (post-partum/post-menopausal/post-total hysterectomy)
- has decreased blood supply
- is atrophic
Tips before You Start
- Some women may require topical creams (non-hormonal, OTC vaginal moisturizers such as Replens, Repagyn, or Gynatrof, or the use of a prescribed estrogen such as Vagifem, a vaginal suppository, or Premarin, a topical estrogen cream) to assist with their accommodator practice.
- Do not use the accommodators if you have or suspect you have an active vaginal infection or have unusual symptoms. Stop using if you have pain that does not subside after using the accommodators.
Using Accommodators
When I prescribe accommodator use before pessary use, I give my clients a specific protocol to follow, indicating how many times a week they should use their accommodators, length of time, exercises to do, etc. Below is an excerpt from the first step of the protocol.
Instructions:
- Position yourself in a comfortable semi-reclined or lying down position. Start with calm breathing, pelvic floor relaxation techniques, or visualization.
- Apply lubricant to the smallest accommodator in your kit and vaginal opening.
- Gently place the accommodator at the vaginal opening and start to slowly insert. Stop at the first sign of pain and use your breathing/relaxation techniques. (For example, deep breathing with reverse kegels, body scan for muscle tension, visualization, or contract/relax of pelvic floor muscles). When the pain subsides, continue insertion. (Low grade discomfort is ok to continue through if you feel able to do so. For example, 2-3/10 where 10 = extreme pain and 0 = no pain.)
- Once the accommodator is in fully, rest with the accommodator in for 10 minutes, allowing the brain and tissues to experience the fullness and stretch associated with penetration. Then remove the accommodator.
If you think using accommodators would be helpful either before pessary use or for another reason, give us a call to discuss your symptoms and goals!
The information in this blog is provided as an information resource only and should not be used as a substitute for seeking personalized direction from your overseeing physician. Please consult your healthcare team before making any decisions about your pessary treatment plan, which is unique to you and your overall health. Toronto Pessary Clinic expressly disclaims responsibility, and shall have no liability, for any damages, loss, injury, or liability whatsoever suffered as a result of your reliance on the information contained in this blog.
