Pelvic organ prolapse (POP) is more common than many women realize. It often goes undiscussed due to embarrassment or lack of awareness. But understanding the condition, its causes, symptoms, and treatments can empower women—especially those who are pregnant, postpartum, or managing pelvic health through physiotherapy or yoga—to take charge of their well-being.
Pelvic organ prolapse occurs when the muscles and connective tissues that support your pelvic organs weaken, allowing one or more organs (bladder, uterus, vagina, rectum, or small intestine) to drop from their normal position. This descent often creates a bulge in the vaginal area and can lead to discomfort, pressure, or even visible protrusion.
Think of your pelvic floor as a hammock holding everything in place. When that support is compromised—due to childbirth, aging, or other factors—the organs may shift and sag.
Depending on the severity, some women might feel a minor pressure, while others may notice a bulge or something “falling out” of the vagina.
Pelvic organ prolapse isn’t a one-size-fits-all diagnosis. There are several types, depending on which organ is affected:
When the bladder descends into the vaginal wall, causing pelvic pressure or urinary issues. You may feel a heaviness that worsens as the day progresses.
The rectum pushes into the vagina, making bowel movements difficult or incomplete. Constipation and rectal pressure are common symptoms.
The uterus drops into the vaginal canal. In severe cases, it may protrude outside the vagina.
This involves the small intestine falling into the vaginal space, often after a hysterectomy.
Occurs when the top of the vagina descends, especially after the uterus has been surgically removed.
These types may occur separately or together and vary from mild to severe.
Several risk factors contribute to weakening the pelvic floor:
Vaginal deliveries, particularly those involving prolonged labor, large babies, or assisted tools (forceps/vacuum), stretch or tear pelvic tissues.
With age, muscle tone decreases, especially after menopause due to reduced estrogen, which supports connective tissue health.
Extra weight increases abdominal pressure, placing more strain on the pelvic floor.
Long-term constipation, heavy lifting, or chronic coughing can overstress pelvic muscles.
Some women have genetically weaker connective tissues, making them more susceptible to prolapse.
Removing the uterus can disrupt the natural support system of pelvic organs.
Estrogen decline post-menopause weakens tissues, increasing prolapse risk.
Symptoms vary based on the type and severity but often include:
A feeling of pelvic pressure or fullness, like something is “falling out”
Visible or palpable bulge in or outside the vagina
Urinary incontinence or trouble fully emptying the bladder
Bowel movement issues, like constipation or straining
Pain during intercourse or decreased sensation
Lower back pain and groin discomfort
Difficulty using tampons or menstrual cups
These symptoms may worsen after standing, lifting, or a long day of physical activity.
Your healthcare provider will conduct a comprehensive evaluation:
They’ll ask about childbirth, surgical history, urinary or bowel problems, and sexual health concerns.
During this manual exam, you may be asked to cough or strain, revealing any bulging or descent. The POP-Q system is often used to measure and stage the prolapse.
Bladder function tests (urodynamics) for incontinence
Bowel studies for rectal involvement
Imaging (MRI or ultrasound) for complex or multi-organ prolapse
A complete diagnosis ensures a tailored treatment plan.
Treatment depends on your symptoms, prolapse severity, age, and personal goals (e.g., future pregnancies).
These are first-line interventions. They strengthen the pelvic muscles, improving mild symptoms and preventing worsening.
A silicone device inserted into the vagina to hold organs in place. Useful for those avoiding or not ready for surgery.
Weight loss
High-fiber diet to manage constipation
Avoid heavy lifting
Quit smoking to protect connective tissue and reduce coughing.
Restores normal organ placement. Can be done vaginally, laparoscopically, or abdominally.
Closes part of the vaginal canal, suitable for women not planning to remain sexually active.
May provide support in some cases but carries risks. Always discuss FDA warnings and alternatives with your surgeon.
While not 100% preventable, you can significantly reduce your risk with the following strategies:
1. Regular Kegel Exercises – Engage your pelvic muscles daily.
2. Maintain a Healthy Weight – Less pressure on your pelvic floor.
3. Avoid Heavy Lifting – Use proper techniques if necessary.
4. Manage Constipation – Eat fibre-rich foods and hydrate.
5. Treat Chronic Coughs – Avoid repeated strain on your core.
6. Quit Smoking – Smoking deteriorates tissue health.
7. Posture and Core Strength – Yoga and physiotherapy can support alignment and reduce stress on the pelvic region.
Living with POP means managing symptoms and making small but effective daily changes.
Kegels can make a big difference if done consistently and correctly (consult a pelvic floor therapist).
Eat fiber-rich meals and drink enough water to prevent straining.
Engage in low-impact exercises like yoga or walking.
Use supportive devices like pessaries when recommended.
Consider pelvic health physiotherapy for guided rehabilitation.
At Omansh, we advocate gentle, regular yoga and physiotherapy programs focused on pelvic health for long-term management.
Seek medical advice if:
You feel vaginal pressure or bulging
You struggle with urination or bowel movements
You experience sexual discomfort
Symptoms are affecting your lifestyle or mental health
Early intervention can prevent worsening, improve comfort, and expand your treatment options.
Expect your doctor to conduct a pelvic exam and may refer you to a urogynecologist, a specialist in female pelvic medicine.
No. Many women manage mild to moderate prolapse without surgery.
Surgery is considered when:
Conservative treatments aren’t enough
The prolapse is severe or interferes with daily life
There are complications like incontinence
Discuss all your options with your provider. Your choice should reflect your lifestyle, health status, and preferences.
A condition where pelvic organs drop into or outside the vagina due to weakened pelvic floor support.
Cystocele, rectocele, uterine prolapse, enterocele, and apical prolapse.
Childbirth, aging, obesity, chronic straining, and more.
Vaginal bulging, pressure, urinary or bowel issues, and sexual discomfort.
Via medical history, pelvic exams, and sometimes imaging or functional tests.
Pelvic floor exercises, pessaries, lifestyle changes, and surgery in severe cases.
Yes, through Kegels, weight management, avoiding heavy lifting, and more.
With lifestyle modifications, medical support, and pelvic floor strengthening.
When symptoms interfere with daily life or cause discomfort.
No. Many cases are managed non-surgically.
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