Some months back, Poise debuted a new internal “bladder support” called Impressa®. It’s made of flexible silicone and easily inserts via a tube similar to that of a tampon. Once expanded, it looks like a slightly smooshed hourglass timer or a miniature strapless ball gown (Perhaps these are weird analogies; it’s smaller on top, larger on bottom). As far as I know, the Impressa is the first over-the-counter, disposable pessary on the market, at least in the U.S. I consider this progress, a sign that our society is taking women’s health issues more seriously. Oddly, not everyone feels this way.
Some Not so Helpful Trainers Rail Against the Impressa
Why I am talking about the Impressa? I’m not a paid shill (Seriously, I’m not. No moolah or free products coming to this vagina). Rather, I want to toss some accolades as a counterpoint to foolish knee jerk criticism that accompanied the Impressa’s release. The Impressa’s ad campaign got some personal trainers in a tizzy. They yelled “for shame!” at Poise, accusing the company of peddling a bandaid for the pelvic floor. They argued that women should be offered “real solutions” in the form of physical therapy and personal trainers, apparently not realizing that physical therapists regularly recommend, wait for it, PESSARIES.
I’m not exaggerating the response. One trainer even wrote on her Facebook page:
Public Health PSA: If you’re having issues with leakage, do not use this. It will not help the issue, only put a bandaid over it.
This trainer then sent her readers to self-proclaimed women’s fitness and pelvic floor health experts. Amazingly, some of these “experts” actually AGREED with the misguided PSA. Keep in mind, none of the Poise haters were actually qualified to make statements like “it will not help leakage” (Side-note: It totally helps leakage). I also suspect none of the Poise haters know much about prolapse.
When all this was happening, I wrote some weak defenses of Poise, mostly because I like pessaries. I hadn’t actually tried the Impressa, so I tempered my frustration, mildly reminding these trainers that many women are MORE active when they use a vaginal support and that exercise can only do so much.
However, I really wanted to yell, “Gawd! You aren’t helping women by railing against Poise, you Dunning Krugerites!!!” I didn’t say that because decorum and stuff. Plus, the women criticizing Poise actually seem pretty cool and offer great advice on other topics, just not so much on the nitty gritty of pelvic floor issues. Some seem to believe that breathing a certain way, contracting the TvA, and aligning the pelvis will cure all ails. That would be nice, but no.
My Experience with the Impressa
In the meantime, I’ve actually tried the Poise Impressa. All the fuss made me curious. I already use a ring pessary with support for exercise and wanted to see how the Impressa compared. Drumroll…I love it. It’s awesome sauce.
Therefore, let me be clear. INTERNAL VAGINAL SUPPORTS ARE NOT BAND-AIDS! THEY ARE VALUABLE TOOLS! I used caps, which means I really believe that.
We should laud, not criticize, a company innovating a new and helpful product. Again, I’m NOT affiliated with Poise. I have not received any Poise products for free (But, hey, any in the Poise world, size 1 in case you are wondering…). I gain nothing by recommending this particular product (other than like 30 cents if you buy via this Amazon link).
Instead, I mention the Impressa by name because
1) It got some odd pushback
2) The design is awesome
3) It has some advantages over traditional pessaries
Let’s Talk Pessaries
Before explaining why the Impressa is so awesome, let’s talk pessaries.
What is a pessary? It is something you insert into your vagina to help prop up things that need to be propped up, as in prolapsing organs.
Many women use pessaries as they wait for surgery, but lots of other women use pessaries as a conservative treatment alternative to surgery. I’ve also heard from some physical therapists who personally use pessaries as a preventative device even though they don’t have prolapse but just want extra support when doing higher intensity exercise. That might be overkill, or it might be a smart idea. I don’t know. Regardless, I don’t think women talk about pessaries enough.
Last year I wrote a newsletter post detailing my foray into pessary usage. Click here if you want to read it (and don’t forget to sign up for the free newsletter). I got a few emails from other women telling me that they use pessaries, but are too embarrassed to tell anyone. I get the embarrassment, so I want to break the ice and announce “My name is Meredith. I use a pessary, and I like it.”
Let’s get over the embarrassment about pessaries! It’s a device that makes lives better — kind of like contacts. No one would say, “Stop wearing contacts! They are just bandaids for your eyes. Instead, you should be doing eye exercises or eating carrots.” Actually, I’m sure if I Googled I could find someone who says that, but that person would be an idiot. Anyway, I digress. Back to pessaries.
I was never offered one. I had to ask my doctors. My first doctor said I wouldn’t like it and that was that. About a year later, I had a new, younger doctor, so I asked again, and she was all like “you’ll love it.” She was right.
Ladies, pessaries are not just for grandmas. I use mine mostly for exercise. I feel more supported, and it has allowed me to build up to higher impact activities. I’m still careful with my exercise selections. I don’t run marathons (not a real loss for me because I kinda hate running). I also don’t jump rope regularly, but I CAN jog a couple miles, lift weights, and do some plyometric stuff like box jumps.
I like analogies, so I’ll throw out another one. A pessary is like sunscreen. Sunscreen can help prevent burning, but most dermatologists remind us that it isn’t a free pass to spend all our time in the sun. We still need to wear hats and seek out shade. Similarly, pessaries can support some internal slack, but they aren’t a replacement for reasonable modifications or pelvic floor muscle strengthening.
Pessary Versus Impressa
Pessaries come in a lot of shapes and sizes. This is why a doctor needs to fit you. I like my ring pessary, but it’s not perfect, which is why I’m considering some other models in the future. The pessary options are plentiful. Furthermore, pessaries are cool because you can keep them in for a long time and they are, obviously, reusable. They are reasonably priced, but insurance often covers the cost anyway.
Conversely, an over-the-counter pessary like the Impressa can only be worn for 8 hours, comes in three generic sizes, and can be quite expensive if you wear one everyday. That’s the bad news.
But the good news is really good news. You don’t need to schedule a doctor’s appointment and go through all the fittings to try it out. Instead, you can buy this sizing pack. It is even easier to insert and remove than a traditional pessary (it has an applicator and string like a tampon). And, it’s lighter than other pessaries, allowing it to “inflate” and position itself easily. I felt more support when jogging with the Impressa than with the ring pessary, mostly because of the design differences. Also, it has another undiscussed benefit: If you, ahem, find certain inversions in Yoga or Pilates a bit embarrassing because of physics, the Impressa might help.
Back to that Criticism
I suspect those who initially criticized the Impressa have a misunderstanding of physical therapy and the role of exercise in rehabilitation, or, they have an overly simplified understanding of the postpartum body. Advice to avoid pessaries reeks of the classic either/or fallacy – viewing the solution to postpartum vagina issues as EITHER Poise products OR physical therapy and exercise. This is a false binary. It’s way more complicated than that.
I need to make the Motherfigure tagline “It’s complicated” because every topic I discuss circles back to this conclusion. Putting too much confidence in exercise and physical therapy does no woman any good. If she needs some vaginal support, then why should we shame a company for innovating an accessible and unique approach to this problem?
I don’t think the Impressa should be used as a way to push harder in exercise without thinking about progressions, modifications, or overall goals. I absolutely don’t think it should be used as an alternative to seeking medical care. But it can be used in conjunction with those things. And it can make women less afraid to move and live their lives.
Railing against the Impressa makes about as much sense as blaming the manufacturers of tampons for women menstruating. Poise didn’t invent prolapse or incontinence. They provide products to help manage those things. If you find yourself needing the Impressa, but you haven’t been to a doctor, go to the doctor…AND still use the Impressa. Pessaries are great tools, not shameful unmentionables.
Therefore, I’m Impressa-ed (Don’t tell me you weren’t waiting for that pun). Now, I’m off to run 26 miles — oh wait, that’s not right. I meant 2.6 miles.