Everything you need to know about pelvic organ prolapse

Question: How common is pelvic organ prolapse?

Answer: About 50% of women will experience some degree of pelvic organ prolapse (POP) in their lifetime. If surgery is needed, there is a 30% chance of recurrence.

Question: What causes prolapse?

Answer: Pelvic organ prolapse occurs when the pelvic floor muscles and connective tissues weaken, allowing organs such as the bladder, uterus, or rectum to press into the vaginal wall. Common causes include:

● Pregnancy and Childbirth: Especially with multiple or difficult deliveries.
● Aging and Menopause: Lower estrogen levels affect tissue support.
● Chronic Constipation or Heavy Lifting: Repeated straining increases pressure on the pelvic floor.
● Genetics and Connective Tissue Disorders: Some women may be more prone to prolapse due to differences in collagen and tissue integrity.

Question: What are the symptoms of prolapse?

Answer: Symptoms can vary, but may include:

● Vaginal bulging or pressure. This can present itself as a feeling of something falling out.
● Urinary issues, including leakage, frequent urges to go to the bathroom and difficulty emptying the bladder.
● Bowel issues, including straining, incomplete emptying and needing to press on the vagina to have a bowel movement.
● Pelvic discomfort that worsens after standing or activity.

Question: Do I need surgery for prolapse?

Answer: Not always! Many women manage prolapse successfully without surgery by using:

● Pelvic Floor Physical Therapy: Strengthening the pelvic muscles for better support.
● Lifestyle Changes: Avoiding heavy lifting, managing constipation, and maintaining a healthy weight.
● Pessaries: Small supportive devices placed in the vagina to help lift and support organs. If symptoms are severe and impact daily life, surgery may be an option. However, because prolapse can recur, a comprehensive plan (including rehabilitation and prevention) is important for long-term success.

Question: Can prolapse be prevented or improved naturally?

Answer: While some factors (such as genetics) can’t be changed, you can take steps to improve your pelvic floor health:

● Strengthen Your Pelvic Floor: Learn proper Kegel exercises (but don’t overdo them!).
● Practice Good Bowel Habits: Avoid straining, eat fiber, and stay hydrated.
● Use Proper Lifting Mechanics: Exhale and engage your core when lifting.
● Maintain a Healthy Weight: Excess weight can increase pelvic pressure.
● Manage Chronic Coughing: Treat allergies and quit smoking if necessary.

Question: Does lifting weights make prolapse worse?

Answer: Not necessarily! The way you breathe and engage your core during exercise is more important than the exercise itself.

● Jumping, coughing, and sneezing often create more pressure than lifting weights does. However, improper lifting, when you hold your breath or strain, can add stress to the pelvic floor.
● Learning how to breathe through movements and activating your deep core correctly can help you lift safely while protecting your pelvic floor. A pelvic health therapist can guide you on proper form.

Question: What is a pessary, and how does it work?

Answer: A pessary is a small, removable device placed inside the vagina to support the pelvic organs. It helps relieve pressure and improve symptoms without the need for surgery. There are different types of pessaries, and a healthcare provider can help you find the right fit.

Question: Does having prolapse mean I can’t exercise?

Answer: Not at all! Exercise is important for overall health, but improper pressure management during some movements, like heavy lifting or high-impact exercises, may need modifications. A pelvic floor therapist can help you create a safe and effective exercise plan that supports your core without worsening prolapse symptoms.

Lynn Sanford is passionate about partnering with patients to uncover the root of dysfunction and restore movement and strength—empowering individuals on their journey to healing and lasting recovery.