Pelvic Organ Prolapse

Pelvic organ prolapse is a common condition happens in about half of all women at some point in their life. It occurs when the muscles and tissues supporting the pelvic organs become weakened or stretched. This allows one or more organs (such as the bladder, uterus, or rectum) to drop into or press against the vaginal wall.

Though prolapse is not life-threatening, it can cause discomfort, pressure, and changes in bladder or bowel function. Thankfully, it’s also treatable. With the right care, you can manage symptoms and restore comfort and confidence.

What Is Pelvic Organ Prolapse?

Pelvic organ prolapse happens when the pelvic floor loses its strength or integrity. As a result, one or more organs may shift out of their normal position.

Types of prolapse include:

  • Cystocele (bladder prolapse): The bladder bulges into the front wall of the vagina
  • Rectocele (rectal prolapse): The rectum presses into the back wall of the vagina
  • Uterine prolapse: The uterus descends into the vaginal canal
  • Vaginal vault prolapse: The top of the vagina drops (typically after hysterectomy)
  • Enterocele: The small intestine pushes into the upper vaginal wall

Some people experience a combination of these types.

Common Symptoms

Pelvic organ prolapse symptoms vary depending on the type and severity. You may notice:

  • A feeling of pressure or heaviness in the pelvis
  • A bulge or protrusion in the vaginal area
  • A sensation of “something falling out” of the vagina
  • Urinary leakage or difficulty completely emptying the bladder
  • Frequent urinary tract infections
  • Constipation or incomplete bowel movements
  • Discomfort or pain with intercourse
  • Lower back pain or pelvic aching

Symptoms often worsen when standing, lifting, or at the end of the day and improve when lying down.

Causes and Risk Factors

Pelvic organ prolapse is often caused by a combination of pressure and weakening of pelvic floor support. Risk factors include:

  • Vaginal childbirth, especially with large babies or difficult/multiple deliveries
  • Aging and menopause, due to decreased estrogen and tissue elasticity
  • Chronic coughing, constipation, or heavy lifting
  • Obesity
  • Genetic predisposition
  • Previous pelvic surgery, including hysterectomy

While prolapse becomes more common with age, it’s not an inevitable part of aging. Treatment can help at any stage.

When to See a Provider

You should schedule a visit if you:

  • Notice a bulge or pressure in your vaginal area
  • Experience urinary or bowel changes
  • Feel discomfort during intimacy
  • Have a family history of prolapse and are experiencing symptoms

An early diagnosis can lead to better outcomes and more treatment options.

Diagnosis

Your provider will begin with a pelvic exam to assess the location and severity of prolapse. In some cases, additional tests may be recommended, including:

  • Urinalysis or bladder function testing
  • Pelvic ultrasound
  • MRI (in complex cases or surgical planning)

You’ll also be asked about your symptoms, lifestyle, and goals to help guide treatment. Be sure to share when your symptoms began, and if the symptoms have worsened over time.

Treatment Options

Treatment depends on the type and severity of prolapse, your symptoms, and whether you plan to have children in the future.

Conservative (nonsurgical) options:

  • Pelvic floor physical therapy to strengthen muscles and improve support
  • Pessary device – a removable insert that supports the pelvic organs
  • Lifestyle changes – including weight management, avoiding heavy lifting, and treating chronic cough or constipation
  • Topical vaginal estrogen – to improve tissue strength and elasticity in postmenopausal women

Surgical options (if needed):

  • Vaginal or laparoscopic repair of the affected organ
  • Uterine suspension or hysterectomy, if uterine prolapse is present
  • Mesh procedures (used selectively and with informed consent based on current guidelines and risks)

We’ll help you choose the best approach based on your comfort, preferences, and health history.

You Don’t Have to Live With Prolapse

Pelvic organ prolapse is common and treatable. Whether your symptoms are new or something you’ve lived with for years, there are solutions that can help you feel better, move more freely, and enjoy life without discomfort.

Schedule an appointment today to learn more about your options and take the first step toward lasting relief.