Pelvic organ prolapse happens when the muscles and tissues that hold up the bladder, uterus, or rectum weaken, letting one or more of these organs sag down into the vagina. It is common, especially after childbirth or with age, and it is treatable. Many women live with it quietly because they feel embarrassed, but it is a medical condition, not something you caused or need to hide.
When to Get Care Right Away
Pelvic organ prolapse is usually not an emergency, but call your doctor promptly, or go to urgent care, if you notice any of the following:
- You cannot urinate at all, or you cannot empty your bladder even partway
- Tissue bulging outside your body looks discolored, is bleeding, or has an open sore
- You have new fever, chills, or foul-smelling discharge along with the bulge
- You have sudden, severe pelvic pain
Medical Disclaimer: This article is for general education only. It is not medical advice, diagnosis, or treatment, and reading it does not create a provider-patient relationship. Talk with a licensed healthcare provider about your specific situation. If you are having a medical emergency, call 911 or go to the nearest emergency room. See our full Medical Disclaimer.
What Causes Pelvic Organ Prolapse?
The pelvic floor is a sling of muscles and connective tissue that supports your pelvic organs. Anything that repeatedly stretches or weakens that sling can raise your chance of prolapse. Common contributors include:
- Pregnancy and vaginal childbirth, especially with a long labor, a large baby, or an assisted delivery
- Getting older, since tissue support naturally loses some strength over time
- Menopause, which can reduce tissue elasticity
- Chronic conditions that raise pressure in the abdomen, such as long-term coughing, constipation, or obesity
- Prior hysterectomy or other pelvic surgery
- Repeated heavy lifting
- Connective tissue disorders that run in some families
Often more than one factor plays a role. Having a risk factor does not mean prolapse is certain, and having none does not rule it out.
Points to verify for Pelvic Organ Prolapse
Some women with pelvic organ prolapse have no symptoms at all, and it is found only during a routine exam. When symptoms do appear, they often include:
- A feeling of pressure, heaviness, or fullness in the vagina or pelvis
- Seeing or feeling a bulge at or near the vaginal opening
- A dull ache in the lower back that eases when you lie down
- Urinary changes, such as leaking, urgency, frequent urination, or trouble fully emptying the bladder
- Bowel changes, such as constipation or a feeling of incomplete emptying
- Discomfort during sex
- Symptoms that feel worse by the end of the day or after standing a long time, and better after lying down
If any of these sound familiar, it is worth bringing up with your provider, even if the symptoms feel minor.
How Doctors Stage Pelvic Organ Prolapse
Prolapse is not all-or-nothing. Doctors describe it in stages based on how far the tissue has descended, from very mild support loss that isn’t noticeable to prolapse that extends outside the vaginal opening. Staging is done during a pelvic exam, sometimes with you standing or bearing down, since prolapse can look different lying flat versus upright. Your specific stage, and which organ or organs are involved, guides what treatment options make sense for you. Only an exam by a qualified clinician can tell you your stage — this article cannot and should not be used to self-diagnose.
Non-Surgical Treatment Options
Many women manage prolapse well without surgery, particularly with mild to moderate symptoms. Options a provider may discuss include:
- Pelvic floor physical therapy: Targeted exercises, often called Kegels, to strengthen the muscles that support pelvic organs
- A pessary: A removable device fitted by a provider and worn in the vagina to hold organs in place
- Lifestyle changes: Managing constipation, treating a chronic cough, reaching or maintaining a healthy weight, and avoiding repeated heavy lifting
These approaches can reduce symptoms and, for some women, are the only treatment ever needed.
Surgical Treatment Options
Surgery may be considered when symptoms are significant or non-surgical options haven’t helped enough. Broad categories include:
- Reconstructive surgery: Repairs support to the vagina and pelvic organs using the body’s own tissue or, in select cases, surgical mesh, so that normal vaginal function is preserved
- Obliterative surgery: Narrows or closes off part of the vaginal canal to provide strong support; this ends the ability to have vaginal intercourse, so it is generally reserved for women who don’t plan to have penetrative vaginal sex in the future
- Hysterectomy: Sometimes performed along with a repair when the uterus is involved
The right procedure, if any, depends on which organs are affected, your stage, your overall health, and your personal goals, including whether you may want future pregnancies. Ask your surgeon directly about the risks, recovery, and success expectations for your specific case, since these vary by procedure and patient.
Putting Pelvic Organ Prolapse information into practice
- Describe your symptoms fully to your provider, including bladder, bowel, and sexual symptoms, even if they feel awkward to mention.
- Ask for a pelvic exam to identify which organs are involved and your stage.
- Ask what non-surgical options fit your stage and lifestyle before discussing surgery.
- If surgery comes up, ask how each option could affect future pregnancy plans and sexual function.
- Ask about expected recovery time and what follow-up care looks like.
Where current knowledge about Pelvic Organ Prolapse stops
Women who hope to become pregnant in the future need a treatment plan that accounts for that goal, since some surgical repairs can be affected by a later pregnancy and delivery. Women considering obliterative surgery should discuss the permanent effect on vaginal intercourse beforehand. This article does not cover every prolapse type, every surgical technique, or personal cost and insurance questions, which vary by diagnosis, provider, and location. It is a general overview, not a personalized treatment plan.
Common questions about Pelvic Organ Prolapse
Is pelvic organ prolapse dangerous?
For most women, it is uncomfortable rather than dangerous, and it is not usually an emergency. See the warning signs above for situations that need prompt medical attention.
Can pelvic organ prolapse get better on its own?
Mild prolapse can sometimes stay stable or improve somewhat with pelvic floor exercises and lifestyle changes, but it does not typically reverse on its own the way a healed injury might. A provider can tell you what to expect for your specific situation.
Do I need surgery if I have pelvic organ prolapse?
Not necessarily. Many women are managed successfully with a pessary or pelvic floor therapy. Surgery is one option among several, not an automatic next step.
Will pelvic organ prolapse affect my ability to have children?
It depends on your individual situation and any treatment you’ve had. If future pregnancy matters to you, tell your provider before choosing a treatment, since it can affect which options make sense.
Educational Disclaimer
This article is for general educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. It does not recommend any specific treatment for any individual and does not cover costs, insurance coverage, or success rates, which vary by provider, treatment, and location. Always consult a qualified health care provider about your specific diagnosis and treatment options.