The In's And Out's of Prolapse (Updated November 2025)
- jdimaggio1214
- 12 minutes ago
- 3 min read
It is estimated that 40% of women have some degree of pelvic organ prolapse, and is expected to increase with the aging population. Prolapse is more common with women who have given birth with rates up to 65% after multiple childbirths. But it does also occur in those who haven’t. Often times the initial symptoms of prolapse are extremely scary and seem to appear “out of nowhere.” Many women fear the worst - that organs are going to completely fall out. Most of this fear can be alleviated with an education and understanding of prolapse.
What is a pelvic organ prolapse? It is the descent of one or more organs, from the pelvis into, or in more severe cases out of the vaginal canal. The organs of the pelvic floor have several different support systems: ligamentous, fascia and pelvic floor muscles. The organs are tethered in the pelvis via ligaments. There is also a fascia layer around the organs that acts almost as glue to adhere them to each other. The final support system is the pelvic floor muscles that create support under the organs.
Signs and Symptoms
Symptoms of pelvic floor prolapse are most commonly reported as a pressure or heaviness in the vaginal canal, similar to a tampon that is falling out or not completely inserted. When assessed with a mirror, you may see a bulge at the opening of vagina. Other symptoms can include low back and abdominal pain. Often times, women will feel the symptoms worsening later in the day or with increased activity. This is because gravity and activities throughout the day effect the force through the pelvis. The more that you are upright or straining with activity, the more force or pressure created. When we rest at night, this is reduced and the prolapse will sometimes return to its resting position. This is also where Pelvic Floor PT can play a role in movement patterns and pressure management during activities and postures to reduce symptoms.
Stages and Types of Prolapse
When it is diagnosed, the practitioner will stage its severity with a grading system. Grade 1 is a smaller prolapse that remains higher inside the canal. A Grade 2 prolapse comes further down the canal to the opening. Stage 2 and 3 are prolapses that are out of the canal at different degrees.
Prolapse can occur to any organ in the pelvis; uterus, rectum, small bowel or most commonly the bladder. Depending on the support system that is creating the prolapse (ligamentous, fascia or muscle), pelvic floor PT can help to reduce the prolapse by up to 1 grade.
Do I Have to Stop Exercising?
No!!! Pelvic organ prolapse is a common concern for women over 50, particularly after menopause. This is the crucial time to prioritize your health by continuing to exercise regularly. Engaging in physical activity helps maintain bone density, muscle mass, and balance - all of which are essential as we age. Learning how to properly engage your pelvic floor and core for better support, as well as improving breathing and coordination patterns will allow you to continue exercise.
How Do I Keep It From Getting Worse?
There are many conservative treatment options for pelvic organ prolapse, including pelvic floor PT. Addressing breathing patterns and pressure management helps to reduce downward strain or force. Reviewing proper lifting mechanics and potential activity modifications will also reduce downward strain, and help you to continue with your fitness and daily activities. l also help to identify muscle imbalances and coordination in hip girdle, core and pelvic floor to improve symptoms and help to improve support pelvic organs. Constipation management also decreases additional strain to reduce symptoms during voiding.
Immediate Relief
When symptoms of pelvic floor dysfunction become overwhelming, finding relief at home is possible through simple positioning techniques. One effective method is to lie on your back while elevating your hips using pillows or cushions. This position helps to alleviate the strain of gravity on your pelvic organs, promoting a natural realignment of the prolapse. Additionally, you can use a clean or gloved finger to perform gentle manual "relocation", which will guide the prolapse back into place. Taking these steps can provide immediate comfort and create a sense of control over your symptoms.
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