How to use vaginal pessaries – menopausal hormone therapy

On this page, you can find out how to use menopausal hormone therapy vaginal pessaries, including step-by-step instructions and tips for safe and effective use.
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  • Last updated:
    May 7 2026
  • Last reviewed:
    May 7 2026
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What are MHT vaginal pessaries?

Menopausal hormone therapy (MHT) is used to treat menopausal symptoms. There are different types of MHT, including MHT vaginal pessaries.

MHT vaginal pessaries are tablets or soft capsules that you insert in your vagina. They release a low-dose of oestrogen and are used to treat symptoms like vaginal dryness, itching, burning and painful sex.

They can be used alone or with other forms of MHT.

There are two types of pessaries:

  • with an applicator – a small device that helps you insert the pessary into your vagina
  • without an applicator – you insert the pessary into your vagina using your finger.

How to use MHT vaginal pessaries

Before you start

It’s important to know what dose you need. Your doctor will tell you how often you should use a pessary.

Usually, it’s one pessary every day for 3 weeks. Later, you may only need one pessary twice a week.

Inserting the pessary before bed will help it to stay in place and reduce leakage. But you can still expect a small amount of leakage. You can use a panty liner to protect your underwear.

1. Wash and dry your hands

2. Prepare the pessary

For pessaries with an applicator  – Remove the applicator from the packaging. The pessary is already loaded in the applicator.

For pessaries without an applicator – Remove one pessary from the blister pack.

3. Get into a comfortable position

For example, stand with one foot raised on a ledge, chair or toilet seat, or lie on your back with knees bent.

4. Insert the pessary

For pessaries with an applicator 

  • Gently insert the applicator into your vagina as far as it will comfortably go. Insert it at an angle, aiming slightly towards your lower back.
  • Slowly press the plunger all the way to release the pessary. You shouldn’t be able to feel the pessary, and it should stay in place.
  • Remove the applicator from your vagina.

For pessaries without an applicator

  • Using your finger, gently insert the pessary into your vagina as far as it will comfortably go. Aim slightly towards your lower back.
  • Insert the pessary deep enough so that it stays in place, and you don’t feel it.

5. Throw away the applicator

Place the applicator in household rubbish where children or pets can’t get it.

 

 

6. Wash your hands again

This information is based on commonly used medicines in Australia. Always follow medicine instructions and advice of your doctor, pharmacist or health professional.

Funded by the Australian Government through the Quality Use of Diagnostics, Therapeutics and Pathology Program.

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