What Pelvic Organ Prolapse Feels Like—and How To Treat It

I thought my bladder issue was just a normal post-pregnancy symptom. Turns out I had POP. It sounds scary, but it's manageable. Here's what you need to know.

When I was pregnant, fellow parents warned me about the standard things like never sleeping again, sore nipples, and the "you're going to poop on the table" thing.

My son was a behemoth of a baby, and he was delivered via C-section. No pooping on the table for me. My milk never came in, so my nipples were salvaged. I lost the battle when it came to sleep, but I figured two out of three isn't so bad.

Fast-forward to when the floor literally went right out from underneath me—my pelvic floor, that is— when I received a diagnosis of pelvic organ prolapse (POP). Potential damage to my pelvic floor from pregnancy and delivery was something no one ever warned me about, so when I experienced symptoms, I didn't realize anything was wrong at first.

pelvic prolapse
Yeji Kim

My initial symptom was feeling that I wasn't quite emptying my bladder. I dismissed it at first as a post-pregnancy bladder. Then it got to be persistent, irritatingly and insanely persistent. It didn't hurt to go to the bathroom, but I just wasn't going either. A pelvic ultrasound, CAT scan, misdiagnosis of urinary tract infection (UTI) and then overactive bladder, two unnecessary prescriptions, two urologists, and so many trips to the bathroom later, a urologist said to me, "I think you have a prolapse."

And that's when my journey through pelvic organ prolapse began.

What Is Pelvic Organ Prolapse?

Pelvic organ prolapse (POP) occurs when there is a drop in the pelvic organs caused by the loss of normal muscular support of the vagina. The pelvic organs include the vagina, cervix, uterus, bladder, urethra, intestines, and rectum.

All these organs are supported and held in place by the muscles of the pelvic floor. When those muscles become weakened, stretched, and fail to tighten back up—like they sometimes do during and after pregnancy—that's when a problem may arise.

For me, it felt like my prolapse came on rather suddenly. But, according to Daun Hooley-Miller, NP, a women's health nurse practitioner at Ascension St. Vincent in Carmel, Indiana, there really isn't anything sudden about it. "Many [people] suddenly feel symptoms, but it usually takes months or years to work its way to where you notice," says Hooley-Miller. People don't become symptomatic till the organs come near the vaginal opening, she explains.

Symptoms will look and feel different from person to person, stage to stage, and may vary based on the type of prolapse they are experiencing, adds Hooley-Miller.

Types of Pelvic Organ Prolapse

Pelvic organ prolapse can also happen in males but it is much more common in females. About 50% of females have prolapse to some degree, but do not let that frighten you. While prolapses can be uncomfortable, upsetting, and frustrating, they shouldn't hurt and are not life-threatening.

According to the American College of Obstetricians and Gynecologists (ACOG), there are several types of pelvic organ prolapse in females:

  • Cystocele: The bladder drops into the vagina
  • Enterocele: The small intestine bulges into the vagina
  • Rectocele: The rectum bulges into the vagina
  • Uterine prolapse: The uterus drops into the vagina
  • Vaginal vault prolapse: The top of the vagina loses its support and drops (the most severe form of POP)

Causes of Pelvic Organ Prolapse

There are a number of things that can cause a prolapse, but childbirth is the leading contributor to pelvic organ prolapse, according to Hooley-Miller. That said, prolapse can happen for other reasons, such as:

  • Constipation
  • Straining to urinate or defecate
  • Coughing
  • Genetics
  • Repetitive heavy lifting

"People who have never been pregnant can have pelvic floor prolapse," says Hooley-Miller. For instance, any motion that puts pressure on your pelvic floor can cause problems in some people. "Squatting when lifting may be good for your back, but not your pelvic floor," adds Hooley-Miller.

Symptoms of Pelvic Organ Prolapse

There are a variety of symptoms that may come along with POP, says Bri Grogan, PT, DPT, a physical therapist and founder of Vibrant Pelvic Health.

Some of the most common symptoms of POP include:

  • Feeling pressure or "heaviness" in your pelvis
  • Seeing or feeling a "bulge" sticking out of the vagina
  • Urine leaking
  • Feeling like you have to urinate all the time
  • Feeling like you can't fully empty your bladder

"Some [people] complain of feeling a golf ball in their vagina," says Dr. Grogan. "There is also sometimes pressure or heaviness in the pelvis. Anytime you bear down for any reason, you will notice it. Or you will notice it after you have been lifting things, such as your baby, all day. You may also feel pressure on the bladder, a feeling that you always have to go."

Some may not even notice their prolapse, while others will experience a range in symptoms and severity depending on the stage. Stages 1 and 2 are considered mild to moderate, while stages 3 and 4 lean toward a more severe prolapse.

Treatment for Pelvic Organ Prolapse

There are some things you can do to try to prevent pelvic organ prolapse from happening in the first place, especially during pregnancy. For instance, it can help to avoid constipation and straining, not pushing to urinate, and always using proper lifting mechanics. But sometimes even the fittest people who have done everything to prevent prolapse can still experience it.

In other words, if you do experience pelvic organ prolapse, it's not your fault. You should not be ashamed to talk to a health care provider about your symptoms and seek help and treatment. And that's the good news: pelvic organ prolapse is treatable.

Severe cases of prolapse may require surgery. In other cases, some opt for pessaries, a device inserted non-surgically into the body to support the vaginal tissues. In other instances, there are ways to ease the symptoms. "We can do management," says Hooley-Miller. "We try to avoid things that will make the prolapse worse."

Here are a few ways to treat and manage pelvic organ prolapse.

Lifestyle changes

Lifestyle changes can go a long way in addressing the symptoms of prolapse, says Dr. Grogan. A treatment plan for prolapse will often include suggestions for lifestyle changes that can help reduce prolapse symptoms, such as:

  • Learning how to properly transition from sitting to standing
  • Eating a high-fiber diet
  • Practicing appropriate exercises
  • Losing weight
  • Quitting smoking
  • Taking your time to use the bathroom

Kegel exercises

Health care providers commonly recommend Kegel exercises to strengthen weakened pelvic floor muscles. Dr. Grogan also notes the benefits of Kegels but endorses them with a hint of caution. "They have to be done right, gradually, progressively, and done by people who know how to release their pelvic floor muscles," she says.

Before you begin the process of bulking up those muscles, Dr. Grogan encourages patients first to give them a much-deserved breather. "You can't go wrong with pelvic floor relaxation," says Dr. Grogan. "Learn how to relax the muscles of the pelvic floor so that you can know when you are truly contracting them."

See a pelvic floor physical therapist

The best thing you can do to treat and manage pelvic organ prolapse is to see a professional pelvic floor physical therapist. A pelvic floor therapist treats dysfunctions in the pelvic floor by addressing weaknesses and pain through therapeutic exercise to strengthen or relax the pelvic floor muscles. It's not easy to figure out how to fix prolapse on your own, but a therapist trained in the condition can help assess your exact condition and guide you through exercises to help.

Even better, most insurances cover pelvic floor therapy, so all you may need is a referral from your OB-GYN or primary care physician. Most private and public insurance will cover a pelvic floor therapist, but check your insurance to be certain.

Exercises to avoid if you have a prolapse

For those who do not have coverage or do not have a pelvic floor physical therapist in your area, there are some helpful pelvic floor workout videos available on YouTube, such as those on Dr. Grogan's channel.

Your doctor or pelvic floor therapist will likely suggest exercises to help build your pelvic muscles, which may include Kegels. But there are also some exercises you should avoid when you have pelvic organ prolapse, including:

  • Jumping
  • High-intensity workouts
  • Aerobics
  • Running
  • Lifting weights

Of course, physical activity is important to other aspects of your health, so talk to your doctor before engaging in any exercises—including Kegels—to ensure that the movements are safe for the type and severity of your prolapse.

Key Takeaway

Pelvic organ prolapse is common in people who have been pregnant and given birth. Symptoms of pelvic organ prolapse include feeling like your bladder is not emptying correctly, feeling pressure or a "bulge" in your pelvis, and sometimes, leaking urine. The condition is very treatable, so if you have any symptoms or suspect you have prolapse, talk to your doctor.

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Sources
Parents uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Pelvic organ prolapse. Office on Women’s Health. 2021.

  2. Demystifying pelvic organ prolapse. UChicagoMedicine. 2019.

  3. Surgery for Pelvic Organ Prolapse. American College of Obstetricians and Gynecologists. 2022.

  4. Pelvic Organ Prolapse. StatPearls Publishing. 2023.

  5. Pelvic organ prolapse. Yale Medicine. 2023.

  6. Pelvic Organ Prolapse Quantification System (POP-Q) - a new era in pelvic prolapse staging. J Med Life. 2011.

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