A pessary is a medical device or medical aid that is inserted into the vagina for therapeutic purposes (support pessary) or used for contraception (diaphragm, intrauterine device).

Vaginal support pessaries support the bladder, urethra and/or uterus from the vagina. They are mainly made of injection moulded silicone.

For decades different types of pessaries, especially cube, sieve cup, ring and urethra pessaries, have proven to be a non-surgical method of treatment for gynaecological clinical syndromes, such as descensus and its symptoms and stress urinary incontinence.

Restifem consists of tissue-compatible silicone. Allergies are not known. The vaginal skin should be intact and free of inflammation when using a pessary, otherwise pain, discharge or bleeding may occur. If this happens to you, have your treating doctor clarify this immediately and stop the therapy with restifem until you see your doctor. If the above-mentioned complaints occur during breastfeeding or after the menopause, they are usually caused by a sensitivity of the vaginal skin, which is a result of a hormone deficiency. In this case, your gynaecologist will inform you about the possibilities of local hormone therapy.

Restifem is available in the sizes small and medium.

The medium is considered the standard size. If you are less than 1,60m tall, the small size fits better. Please note that the vagina is still dilated a few weeks after birth and that the therapy is started with the medium size, but then changes to small as the tissue structures recover.

In principle, you can test yourself which pessary size is the correct one. No pain should be felt when wearing the pessary and no contact bleeding should occur. However, an initial feeling of pressure towards the uterus and behind the pubic bone is desirable, as the tissue structures in these areas should be relieved, i.e. supported.

If you are not sure which is the right size, either choose the set or consult your attending gynaecologist.

You can use restifem after the end of the puerperal period, i.e. about 6 weeks after birth. However, you should still start as early as possible. The recovery of the pelvic floor connective tissue and muscles takes about 6 to 12 months and also depends on the time of breastfeeding. Breastfeeding causes the oestrogen level in the body to be low, which delays recovery. The use of restifem is therefore recommended for the period of recovery.

In Germany, restifem can be prescribed by the gynaecologist/urologist with a corresponding diagnosis (e.g. descensus, stress urinary incontinence) by means of a prescription, either using a “Hilfsmittelrezept” or private prescription. The costs are usually covered by the statutory health insurance.

Other countries have different regulations. Please consult your attending physician or your health insurance company for more information.

Restifem is available without prescription in our online shop www.restifem-shop.com or by email: info@restifem.com. We ship the goods EU-wide.

If you would like to try one size first and order the second size later, we will give you a discount so that you do not pay more than the total price of the set. However, we charge the indicated shipping costs for each delivery (3 Euros within Germany, 7 Euros to foreign countries).

For reasons of hygiene and health protection, you cannot return the product after opening the foil bag. Restifem is only approved for use by one person. You can find more information on this in our right of withdrawal. However, you can return/exchange originally packed goods up to 30 days after purchase.

Professionals such as physiotherapists, midwives and doctors can order 2 pessary samples at a reduced price (30 Euros plus VAT) via our email address: info@restifem.com

Pregnancy and birth lead to overstretching of the pelvic floor muscles and pelvic floor connective tissue. For this reason, it has been established for years to go to postnatal exercise classes after giving birth. The recovery of the pelvic floor connective tissue, which has so far received little attention in medicine, can be supported by prophylactic wearing of a pessary (e.g. restifem). An optimal recovery can reduce the risk of later functional limitations of the pelvic floor.

The way restifem works can be explained as follows: If you sprain your ankle, you will feel pain and instability while running. A support bandage provides immediate stability, relieves pain and supports the regeneration of the retaining ligaments and joint capsule. A postnatal pessary therapy has a comparable effect. For example, the pessary pushes the uterus into the initial position, as it was before the pregnancy. The posterior ligament of the uterus is thus relieved and can regenerate optimally. In contrast to some other pessaries, restifem does not put additional strain on the pelvic floor muscles due to its retropubic support mechanism.

However, the preventive effect of postpartum pessary therapy over the course of a lifetime is scientifically difficult to demonstrate, because many factors contribute to the development of a descensus or urinary incontinence and the first symptoms often occur only after years or even decades. Above all, these factors are number of pregnancies, vaginal births, gynaecological operations, ageing processes (especially due to the hormonal changes in the menopause) but also obesity, lack of exercise, and heavy physical work.

By training the pelvic floor muscles, e.g. through postnatal exercise, you strengthen your pelvic floor and thus promote the recovery processes.

The following therapeutic approaches are available to support the recovery of the pelvic floor connective tissue (source: Beilecke (2019) Postpartum influence on the pelvic floor connective tissue – a therapeutic approach that has been neglected up to now. Gynaecologist: 505-507):

1. Pessary therapy e.g. restifem

2. Local oestrogen therapy – oestrogen promotes wound healing in the pelvic floor connective tissue by activating fibroblasts and thus the formation of new connective tissue. A doctor can prescribe vaginal hormone therapy with Estriol, provided there are no medical contraindications.

3. Neural therapy – injection with local anaesthetics helps to improve wound healing and relieve pain.

4. Vitamin D substitution – vitamin D has an anti-inflammatory and immunomodulating effect via its hormone. There is a correlation between the level of vitamin D and the strength of the pelvic floor muscles. In the systemic substitution of vitamin D from breastfeeding women, the transfer to the child must also be considered. The mother’s substitution should be carried out carefully and that of the child should be paused under certain circumstances.

5. Laser therapy – postnatal laser treatment promotes the regeneration of the connective tissue of the vaginal wall by activating fibroblasts and thus forming new connective tissue.

It makes sense to wear the pessary during pelvic floor exercises, as well as during other sports activities (e.g. jogging) and situations where you put your body under physical strain in everyday life (e.g. frequently carrying a child). The still weak pelvic floor after a birth is relieved by the pessary, respectively organs like the uterus and pelvic floor muscles and connective tissue are supported in the initial position as before the pregnancy. This way you have a better feeling for the pelvic floor and can train the muscles more effectively.

If restifem is correctly seated, you should hardly notice it. But if it slips too often or is even pushed out of the vagina, then it is either not the right size or the right pessary.

The cause is usually a more pronounced state of descensus, which may have been caused, for example, by birth injuries (levator tearing, etc.). The abdominal pressure on the pessary is then so great that it cannot anchor behind the pubic bone and is pressed out of the vagina again.

Each descensus is highly individual in terms of type (uterus and/or vaginal walls) and severity (minor to complete prolapse). Please consult your treating physician regarding pessary therapy. If necessary, other pessary forms (e.g. a cube pessary) can give better hold.

The recovery processes are supported by the female hormone oestrogen and since this is only present in the body in reduced amounts during breastfeeding, the time of recovery may be delayed by breastfeeding. The pressure in the abdominal cavity also has an influence on the development of symptoms due to descensus; physical activities and carrying a child are examples of this.

Postnatal symptoms of descensus or prolapse are often spontaneously reduced due to the postnatal recovery processes in the connective tissue and the muscles of the pelvic floor. It is possible that restifem® will hold better after a few weeks and can support the natural recovery processes in a preventive way.

Moderately pronounced descensus/prolapse and urinary incontinence problems can be alleviated or eliminated by restifem.