Understanding Pelvic Organ Prolpase: Effective Treatments and Solutions for Relief.
Pelvic organ prolapse is more common than you might think—affecting about 1 in 3 women. Some experience pressure or heaviness in the vagina, others notice a bulge or discomfort, but many struggle to talk openly about what they’re feeling. If this sounds familiar, you're not alone—and more importantly, there are ways to feel better.
In this blog, we’ll break down what pelvic organ prolapse actually is, why it happens, and the most common symptoms women report. We’ll also walk through treatment options—from conservative approaches like pelvic floor physical therapy to surgical solutions—so you can feel informed and confident in your next steps.
Whether you're navigating symptoms yourself or learning how to support someone you care about, this guide is here to help. Relief is possible—and it starts with understanding your body.
what is pelvic organ prolapse (POP)
Pelvic organ prolapse (POP) happens when one or more of the pelvic organs—like the bladder, uterus, rectum, or small intestine—shift out of their usual position and start to press against the walls of the vagina. It’s actually pretty common, especially in women who’ve had children, but it can happen to anyone. Even though it’s so common, a lot of people don’t know much about it, or they feel too embarrassed to bring it up—so it often goes untreated or ignored.
The severity of prolapse can vary a lot. Sometimes, it’s so mild you don’t even know it’s there until it’s found during a routine pelvic exam. In more noticeable cases, the prolapsed organ can drop down into the vaginal canal—or even come out of the vaginal opening—which can be really uncomfortable and start to affect daily life.
Prolapse is typically graded from stage 1 (mild) to stage 4 (severe), depending on how far the organ has dropped. But here’s the important part: the stage doesn’t always match how you feel. You can have a stage 3 prolapse and feel totally fine, or have a stage 1 and deal with a bunch of annoying symptoms. Everyone’s body is different, and how you experience prolapse doesn’t always line up with what it looks like on paper.
causes and risk factors for pelvic organ prolapse
Pelvic organ prolapse usually happens because of a mix of things that put extra pressure on the pelvic floor muscles and the tissues that support them. One of the biggest risk factors? Childbirth—especially vaginal deliveries. During labor, there's a ton of pressure pushing down into the pelvis, and the pelvic floor muscles have to stretch a lot to make room for the baby. That stretching can lead to some wear and tear. And if you’ve had more than one baby—especially pregnancies that were close together—that risk can go up even more.
Getting older also plays a role. As we age, our estrogen levels drop, which can lead to a loss of muscle tone and elasticity in the pelvic floor. So, it’s pretty common to see prolapse show up later in life, even if someone didn’t have symptoms earlier on.
Chronic constipation is another sneaky culprit. All that straining during bowel movements can put a lot of pressure on the pelvic floor over time, which doesn’t do it any favors.
And then there's how we manage pressure in our core—whether that's lifting heavy things at work, working out, or just going about daily life. If the body isn’t managing that pressure well, it can lead to extra strain on the pelvic floor and, over time, weaken the support structures down there.
Knowing what can contribute to prolapse is super helpful—not just for understanding why it happens, but also for figuring out how to prevent it or manage it if it's already there.
symptoms of pelvic organ prolapse
The symptoms of pelvic organ prolapse can really vary depending on which organ is involved and how far things have shifted. One of the most common things people notice is a feeling of pressure or heaviness in the pelvic area—almost like everything’s just dropping down. This feeling tends to get worse as the day goes on, especially if you've been on your feet a lot. Some people describe it as feeling like there’s a tampon in when there isn’t, or like something is “falling out.” In some cases, you might even see or feel a bulge near the vaginal opening, which can be super unsettling and mess with your day-to-day confidence.
Bladder symptoms are also common—especially if the bladder itself is part of the prolapse. You might notice leaking (urinary incontinence), trouble starting or finishing a pee, feeling like you constantly have to go, or like your bladder never fully empties. On the flip side, some people actually have trouble peeing at all and feel like everything is getting backed up. It’s frustrating, and it can really affect your daily life.
Bowel issues can show up too. Things like constipation, straining, or feeling like you haven’t quite emptied everything—even after a bowel movement—are common. Some people even have to press on the vaginal wall to help things along, which can feel confusing or alarming if you don’t know what’s going on.
Sex can also feel different. Prolapse can cause discomfort or even pain during intimacy, which can make relationships feel a little more complicated.
If any of this sounds familiar, you’re not alone—and none of it is something you just have to “deal with.” Recognizing the symptoms is the first step toward getting the right support and treatment.
how pelvic organ prolpase is diagnosed
Diagnosing pelvic organ prolapse usually starts with a good chat about your medical history and what you’ve been feeling, followed by a physical exam. During the exam, your provider will take a look at how your pelvic floor is doing and may ask you to bear down (kind of like you're trying to have a bowel movement) or give a little cough. This helps them see if anything is shifting or bulging, and how much.
One thing we always recommend? Getting checked in standing too. A lot of symptoms show up when you're upright and going about your day—not lying down on an exam table. Gravity, muscle activation, and how your body functions can all change when you're standing, so it gives us a much better idea of what's actually going on and how it’s affecting you.
conservative treatment for pelvic organ prolpase
For a lot of people with pelvic organ prolapse, you don’t have to jump straight to surgery. There are some really effective non-surgical (or conservative) treatment options that can help relieve symptoms and improve how you feel day to day.
One common option is a pessary—a small, removable device that sits inside the vagina and helps support the pelvic organs. They come in different shapes and sizes, and a healthcare provider can help fit the right one for you. Pessaries are a great choice if you’re not ready for surgery or just prefer a less invasive approach. And yes—you can still be active and live your life with one in.
Another incredibly helpful approach (I may be a little biased!) is pelvic floor physical therapy. Even if you’re considering surgery, pelvic floor PT is worth doing either way. Not everyone has prolapse for the same reasons, and working with a pelvic floor PT can help figure out what’s actually contributing to your symptoms. Some key areas we often work on include:
Pressure management – This is a big one. If your body can’t manage pressure well—like when lifting, sneezing, or even just breathing through certain movements—your pelvic floor can end up taking on too much strain. Learning how to control that pressure helps protect the area and prevent things from getting worse.
Pelvic floor mobility – Your pelvic floor isn’t just about strength. It needs to move well and respond quickly to daily tasks. We work on mobility so your pelvic floor can adapt and support your organs when you need it most.
Hip and core strength – Strengthening the right muscles around your pelvis—especially the hips and abdominals—gives the pelvic floor the backup it needs. When those areas are doing their job, your pelvic floor doesn’t have to overwork.
Functional movement training – Sometimes, just changing how you lift, carry, or move through your day can make a big difference. Little tweaks can reduce the strain on your pelvic floor and help you feel more in control.
Lifestyle changes also play a role, especially if constipation is one of your triggers. Staying hydrated, eating fiber-rich foods, and working on bowel habits can all help reduce straining—because pushing hard during bowel movements increases pressure on your pelvic organs and can make prolapse worse.
For some people, conservative treatments are all that’s needed to manage prolapse. Others may eventually need surgery—and that’s okay too. But we really encourage starting with the options above. If you go straight to surgery without addressing the underlying pressure and movement patterns, the same strain that contributed to the prolapse in the first place could affect the success of the repair over time.
surgical treatment for pelvic organ prolpase
If your prolapse is more severe or just isn’t improving with conservative treatments, surgery can be a really valid option. For some people, the symptoms just get in the way of daily life too much, and no amount of pressure management or pelvic floor exercises can quite get things where they need to be—and that’s okay.
There are several types of surgical procedures available, and the right one depends on which organ is involved, how severe the prolapse is, your goals, and your overall health. But in general, the goal of surgery is to restore the organs to a more supported, lifted position and improve your symptoms—whether that’s pressure, bulging, bladder or bowel issues, or discomfort with activity.
Some procedures use your own tissues to create support, while others might use surgical mesh (which your surgeon will talk through with you in detail if it’s part of your plan). Some surgeries preserve the uterus, and others may involve a hysterectomy—again, all depending on what’s going on in your body and what your preferences are.
What I always like to remind people is that surgery doesn’t “fix” the pelvic floor muscles—it addresses the position of the organs, but the muscles, pressure systems, and movement patterns still need love and attention. That’s why we usually recommend doing pelvic floor PT before and after surgery. It helps you prep your body for better outcomes and supports healing in the long run.
At the end of the day, choosing surgery is a personal decision. You deserve to feel confident, informed, and supported no matter which path you choose.
Pelvic organ prolapse can feel overwhelming, especially if you're just starting to learn about it—but you're not alone, and there are options. Whether you manage it with pelvic floor therapy, lifestyle changes, a pessary, or surgery, there is support out there to help you feel more like yourself again. The most important thing is knowing that your symptoms are real, they matter, and you deserve care that listens and helps you move forward with confidence.
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Hi! We are Dr.Aimee and Dr. Lauren
We are the owners of Empower Physical Therapy and Wellness. We are pelvic floor physical therapists who specialize in helping women from pregnancy, into postpartum and through perimenopause, menopause and then beyond! We believe all women deserve to do all of the things they love without symptoms!
You can contact us via our website, email at hello@weempowerpt.com or social media!
The information provided in this blog is for educational and informational purposes only and is not intended as medical advice. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or symptoms. Never disregard professional medical advice or delay in seeking it because of something you have read on this blog.
If you think you may have a medical emergency, call your doctor, go to the emergency department, or call 911 immediately. The opinions expressed in this blog are those of the author and do not necessarily reflect the views of any medical or healthcare institutions.
