Pelvic Organ Prolapse

Pelvic organ prolapse is a common condition that affects many women, particularly following pregnancy, childbirth and during the menopause. Although it can feel worrying, a prolapse does not always become worse, and many women are able to successfully manage their symptoms with pelvic health physiotherapy and simple lifestyle strategies.

Many women first notice prolapse symptoms as a feeling of heaviness, pressure or a vaginal bulge, particularly after standing for long periods, exercising or towards the end of the day.

What is Pelvic Organ Prolapse?

Pelvic organ prolapse occurs when one or more of the pelvic organs, such as the bladder, uterus (womb) or bowel, descend and push against the walls of the vagina due to changes in the support provided by the pelvic floor muscles, ligaments and connective tissues. There are different types of prolapse, such as an anterior prolapse/cystocele, a uterine or vault prolapse, or a posterior prolapse/rectocele.

This can create a feeling of heaviness or pressure at the vagina, or a vaginal bulge.

Some women notice symptoms only during exercise or towards the end of the day, while others may have no symptoms at all.

Although prolapse is common, it is important to remember that symptoms do not always reflect the degree of prolapse. Many women are able to successfully manage their symptoms and continue to lead active lives with the right support and rehabilitation.

How can Pelvic Health Physiotherapy Help?

Pelvic health physiotherapy is recommended as a first-line treatment for many women with pelvic organ prolapse.

Following a thorough assessment, your treatment plan may include:

Pelvic floor muscle rehabilitation
Education about prolapse and symptom management
Advice on bowel and bladder habits (especially managing constipation!)
Breathing, lifting and pressure management strategies
Guidance on returning to exercise safely
Lifestyle advice to reduce unnecessary strain on the pelvic floor
A personalised rehabilitation programme tailored to your goals

The aim is not simply to strengthen the pelvic floor, but to help you feel confident managing your symptoms and returning to the activities that are important to you.

Pelvic organ prolapse is assessed and treated as part of my Women's Health Physiotherapy service.

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FAQ:

What does a prolapse feel like?

Many women describe a feeling of heaviness, dragging, bulging or a sensation that something is "coming down" into the vagina. Symptoms often become more noticeable after prolonged standing, exercise or at the end of the day.

Can physiotherapy help a prolapse?

Yes. Pelvic health physiotherapy is recommended as a first-line treatment for many women with prolapse and can help improve symptoms, pelvic floor function and confidence in returning to everyday activities.

Will I need surgery for my prolapse?

Not necessarily. Many women successfully manage their symptoms with pelvic health physiotherapy, lifestyle advice and pelvic floor rehabilitation. Surgery is usually considered only when symptoms remain troublesome despite conservative treatment.

Can I exercise if I have a prolapse?

In most cases, yes. Exercise remains important for your overall health, and a pelvic health physiotherapist can help you adapt activities where needed and guide you back to exercise safely and confidently.

Can a prolapse improve?

While the anatomy itself may not always completely return to its previous position, many women experience a significant improvement in their symptoms and quality of life with the right assessment, pelvic floor rehabilitation and lifestyle advice.

Why is there a bulge at the opening of my vagina/ down below?

Why does it feel like something is coming down my vagina?

A bulge at the vaginal opening can be a sign of pelvic organ prolapse, where one or more of the pelvic organs are pushing against the walls of the vagina. If you've noticed a new bulge or are concerned about your symptoms, it's worth having an assessment with a pelvic health physiotherapist or your GP.