Pelvic Organ Prolapse: Causes, Symptoms & Treatment

What Are the Causes and Symptoms of Pelvic Organ Prolapse?

Pelvic organ prolapse (POP) occurs when the pelvic floor muscles and supporting tissues become weakened or stretched, reducing their ability to support the pelvic organs properly. As a result, one or more pelvic organs may shift from their normal position and bulge into the vagina or rectum, sometimes causing discomfort, pressure or pain.

In the early stages, a prolapse may cause few or no symptoms and is often first detected during a routine examination, such as a cervical smear test. However, without proper management and pelvic floor support, prolapse symptoms can worsen over time and may lead to bladder weakness and stress incontinence or bowel problems, discomfort during daily activities, vaginal bulging, bleeding or reduced quality of life.

Strengthening and maintaining your pelvic floor through regular pelvic floor exercises can help support the pelvic organs and may reduce the risk of prolapse worsening. It is also important to recognise early symptoms and seek advice if you notice changes in bladder control, pelvic pressure or vaginal heaviness.

As with many pelvic floor conditions, early support and treatment are important. Leaving a prolapse unmanaged for a long period of time may allow pelvic floor weakness and symptoms to worsen, which can affect bladder, bowel and pelvic support over time.

Seeking advice early and strengthening the pelvic floor can help support long-term pelvic health and may reduce the risk of symptoms progressing or recurring in the future. If you notice symptoms such as pelvic heaviness, vaginal bulging, bladder leaks or discomfort, it is important to speak to your doctor or pelvic health specialist.

Common Causes of a Pelvic Organ Prolapse

A vaginal prolapse happens as a consequence of a weakened pelvic floor. The main cause of this weakening in women is ageing and vaginal childbirth, which are largely unavoidable. The latter has a dramatic effect on the pelvic floor muscles and leads to around 1 in 3 women suffering from some sort of pelvic organ prolapse. Other common causes of the pelvic floor weakening include:

• ageing
• pregnancy and vaginal childbirth
• menopause - due to the reduction of the female hormone oestrogen
• body weight - over BMI 30
• genetics
• constipation and associated straining
• persistent coughing
• regular and improper heavy lifting
• strenuous activity
• previous pelvic surgeries, including most notably undergoing a hysterectomy

All pelvic organ prolapses are treatable, so if you’re reading this because you think you may have one, don’t worry. We’re here to put your mind at rest, but it’s crucial not to feel embarrassed or to ignore it. If it’s worrying you, or you think you may be in a later stage of prolapse, make an appointment to see your doctor.

Common Symptoms Associated With a Pelvic Organ Prolapse

Some women experience little or even no complaints about their prolapse, only becoming aware of it at a routine GP appointment such as a smear test. However, some women experience inconvenient symptoms and lots of discomfort. All of the symptoms below can be felt to varying degrees. You may feel a few, many or all of the following symptoms, depending on the organ that has prolapsed:

• a feeling of pressure inside the vagina, especially when sitting down
• a dragging feeling inside the vagina, and/or feeling that something is going to fall out
• a feeling like you’re sitting on a ball
• vaginal bleeding, outside of menstruation
• a gaping vagina - so much so that a tampon cannot stay in place
• noticeable tissue protruding from the vagina, that may also be painful and bleed
• discomfort or pain during sex
• pelvic or lower back pain
• pain that reduces when you lay down and increases when you stand for a long time
• persistent or frequent urinary tract infections (cystitis)
• urinary stress incontinence – the inability to hold in urine when you cough, sneeze, laugh, exercise or lift heavy objects
• a frequent need to urinate
• difficulty having a bowel movement – constipation and a feeling of not having fully emptied the bowel

If you think you may have a prolapse, the first step is to seek a proper medical diagnosis from your doctor or pelvic health specialist. Once you understand the type and severity of your prolapse, you can make informed decisions about the treatment options available to you.

While surgery may be recommended for some women, conservative treatment is often advised first, giving you time to strengthen and support your pelvic floor before considering more invasive procedures. Many women successfully manage their symptoms with pelvic floor exercises, pessaries, lifestyle changes and supportive garments.

Kegel8 can play an important role in conservative prolapse management by helping to strengthen weakened pelvic floor muscles, improve pelvic support and support long-term pelvic health. Combined with healthy bowel habits, weight management and reducing strain on the pelvic floor, these treatments may help reduce symptoms and slow prolapse progression.

Taking time to explore your options and support your pelvic floor early can help you feel more confident, informed and in control of your recovery journey.