Pelvic Organ Prolapse: What It Is, Why It Happens, and What You Can Do
- Amanda Simmons
- 4 days ago
- 3 min read
Hi friends, Dr. Amanda here 👋. Today we’re taking a deep dive into pelvic organ prolapse—a condition that sounds scary, but is actually more common (and more manageable) than you might think.
What Is Pelvic Organ Prolapse?
Pelvic organ prolapse happens when the muscles and tissues that support the vagina weaken, and one or more pelvic organs (like the bladder, uterus, or rectum) begin to descend downward.
A lot of women worry that prolapse means “my organs are going to fall out.” That’s not the case. The vagina is a closed system, attached at the top to the cervix. Nothing is literally “falling out”—instead, the vaginal walls and nearby organs may start to bulge downward.
Stages of Prolapse
Prolapse can range from very mild to more advanced:
Stage 0: No descent—everything is well supported.
Stage 1: A little bit of downward movement, but no bulge.
Stage 2: The cervix or vaginal wall reaches the opening, but doesn’t go past it.
Stage 3: A bulge is visible outside the vaginal opening.
Stage 4: The organ (often the uterus) fully descends past the vaginal opening.
👉 Most young, postpartum women experience Stage 1 or 2, while Stages 3–4 are more common after menopause.
Types of Prolapse
Depending on which organ is involved, prolapse can look different:
Cystocele: The bladder pushes into the vaginal wall.
Rectocele: The rectum pushes into the vaginal wall.
Uterine prolapse: The uterus and cervix descend downward.
Enterocele / Vaginal vault prolapse: More common after hysterectomy, when the space left behind allows other organs to shift downward.
How Common Is Prolapse?
About 50% of women show some degree of prolapse on exam.
But only 3–6% report symptoms—meaning many women don’t even know they have it!
Symptoms usually show up only if the prolapse is bothersome.
Common Symptoms
Pelvic organ prolapse can affect bladder, bowel, sexual function, and overall comfort. Symptoms may include:
Bladder issues → leaking with coughing/sneezing, frequency, urgency, weak stream, or incomplete emptying
Sexual symptoms → pain with sex, changes in orgasm, leaking during intimacy
Bowel issues → constipation, straining, incomplete emptying, or needing to use a finger to push the rectum or bladder back into place
Other symptoms → heaviness, pressure, pelvic pain, low back discomfort, or feeling a bulge
The Gold Standard Treatment
The first-line treatment for prolapse is pelvic floor muscle training. Strengthening and coordinating the pelvic floor can reduce symptoms, improve support, and even reverse mild prolapse.
Other options include:
Pessary: A medical device inserted into the vagina to support organs, especially helpful in later stages or while doing pelvic floor therapy.
Lifestyle adjustments: Pressure management, toileting strategies, and strength training (done correctly) can all help.
Surgery: Reserved for more advanced prolapse (Stages 3–4), and usually only if therapy and pessary use aren’t enough.
Lifestyle & Exercise Tips
Here’s where a lot of misinformation exists. Many women are told by their doctors to stop lifting, running, or jumping because those activities “make prolapse worse.” But this isn’t the case.
Most of the time, the problem isn’t the activity itself—it’s pressure mismanagement in the abdomen and bearing down during exercise. Once you learn how to brace and breathe correctly, lifting, running, and jumping are not only safe, they’re actually protective and help keep the pelvic floor strong and happy.
Other helpful tips include:
Positioning relief: Legs up the wall or supported bridges can ease heaviness.
Strength training: Research shows women who lift heavier weights with proper form actually have fewer symptoms than women lifting lighter loads.
Breathing & bracing: Exhale during the hardest part of a lift, keep ribs stacked over pelvis, and avoid bearing down.
Toileting habits: Breathe through bowel movements, avoid straining, and manage constipation.
The Bottom Line
Pelvic organ prolapse is common, and while the word itself can feel intimidating, there are effective, non-surgical ways to treat it. Many women see their symptoms reduce—or even resolve—with the right pelvic floor therapy.
👉 At Ascend Pelvic Health, I help women understand their prolapse, retrain their core + pelvic floor, and regain confidence in their bodies. If you’ve been experiencing heaviness, pressure, or bulging, the most important step is to get evaluated so we can uncover what’s really going on and create a personalized plan for you.
✨ You don’t have to stop running, lifting, or jumping. You don’t have to live with these symptoms. Let’s work together to get you moving with confidence again.
Reach out today to schedule a Free Discovery Call—I’d love to help you feel supported, strong, and back in control of your body.
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