Pelvic organ prolapse
Informed by recognized medical guidance
Overview
Pelvic organ prolapse is when one or more of the organs in the pelvic area — such as the bladder, uterus, or bowel — drop down from their normal position and bulge into the vagina. This happens because the muscles and tissues that support these organs become weak or stretched.
Key facts
- It is very common, especially after childbirth or menopause.
- It can range from mild to severe, and many people have no symptoms at all.
- Treatment options include lifestyle changes, pelvic floor exercises, and sometimes surgery.
Yes, pelvic organ prolapse is very common. It affects about 40% of women over 50, but many do not seek help because they feel embarrassed or think it's normal.
Pelvic organ prolapse mainly affects people with a uterus, especially after childbirth, during or after menopause, and those who have had multiple vaginal deliveries. It can also affect people who have had a hysterectomy or who are overweight.
Symptoms
- Sudden severe pain in the lower belly or pelvis
- Inability to pass urine at all (complete urinary retention)
- Heavy bleeding from the vagina not related to a period
- ⚠A bulge that suddenly becomes larger, more painful, or changes color
- ⚠Signs of infection such as fever, chills, or unusual discharge
- ⚠Difficulty having a bowel movement that doesn't improve with home care
Common symptoms
- A feeling of heaviness, fullness, or a bulge in the vagina
- A pulling or dragging sensation in the lower belly (abdomen)
- Lower backache that gets worse when you stand or lift
- Leakage of urine (stress incontinence) or difficulty emptying the bladder
- Constipation or a feeling that the bowel is not fully empty
- Discomfort during sex
Symptoms in children
- Pelvic organ prolapse is extremely rare in children. If it occurs, it may be linked to a congenital condition (present from birth) or a connective tissue disorder.
Symptoms in older adults
- Symptoms may include a sensation of something falling out of the vagina, difficulty inserting tampons or using the toilet, and urine or stool leakage. Older adults may also feel a greater impact on daily activities and quality of life.
Causes
Main causes
- Pregnancy and childbirth, especially vaginal delivery, can stretch and weaken the pelvic floor muscles and other supporting tissues.
- Aging and the natural decline in estrogen during menopause can reduce tissue strength.
- Chronic pressure on the pelvis from heavy lifting, obesity, or long-term constipation.
Risk factors
- Multiple vaginal deliveries
- Delivering a large baby or having a long second stage of labour
- Having a hysterectomy (removal of the uterus)
- Being overweight or obese
- Chronic coughing (e.g., from smoking, asthma, or COPD)
- Connective tissue disorders or family history of prolapse
When to see a doctor
See a doctor urgently if:
- If you have sudden severe pelvic pain or cannot urinate, see a doctor urgently or go to an emergency room.
Book a routine appointment if:
- If you notice a bulge in your vagina or feel a dragging sensation, make an appointment with your GP or a gynaecologist.
Diagnosis
Your doctor will ask about your symptoms and medical history, and do a pelvic exam to feel for a bulge and assess the strength of your pelvic floor muscles.
Tests that may be done
- Pelvic exam (manual check of the vagina and surrounding organs)
- You may be asked to cough or bear down to see how the prolapse changes
- In some cases, ultrasound or MRI to get a clearer picture
- Urine tests or bladder function tests if there are urinary symptoms
What to expect at your appointment
The exam is usually quick and not painful. You may have a full bladder for part of the test. The doctor will explain the type and severity of prolapse and talk with you about treatment options.
Treatment
Treatment depends on how bothersome your symptoms are, your age, and whether you plan to have more children. Many people manage well with lifestyle changes and exercises. Others may benefit from a pessary or surgery.
Self-care at home
- Do Kegel (pelvic floor) exercises regularly to strengthen the muscles
- Avoid heavy lifting or learn proper lifting techniques
- Maintain a healthy weight to reduce pressure on the pelvis
- Treat constipation by drinking plenty of water and eating high-fibre foods
- Stop smoking to prevent chronic coughing
Medical treatments
A doctor may recommend a vaginal pessary — a soft removable device that is inserted into the vagina to support the organs. Pessaries come in different shapes and sizes and need to be fitted by a healthcare professional. Some people use topical oestrogen cream (if appropriate and recommended by a doctor) to improve tissue strength. Pelvic floor physiotherapy with a specialist can also help.
When is surgery considered?
Surgery may be considered if symptoms are severe or do not improve with other treatments, or if the prolapse is causing problems with urination or bowel movements. The type of surgery depends on which organs are affected and whether you have had a hysterectomy. Common approaches include repairing the weakened tissues and, in some cases, using a sling or mesh. Discuss risks and benefits with your surgeon.
Living with this condition
Living with pelvic organ prolapse can be manageable. Many people learn to adjust their activities, do exercises, and use strategies like emptying the bladder regularly to stay comfortable. You may need to avoid heavy lifting or high-impact exercise.
Lifestyle tips
- Do pelvic floor exercises every day — aim for sets of 8-12 squeezes, several times a day
- Use good posture when sitting and standing to reduce strain on the pelvis
- Wear supportive clothing or a support belt if it helps
- Plan bathroom breaks so you empty your bladder before feeling an urgent need
Diet and exercise
Eat plenty of fruits, vegetables, and whole grains to prevent constipation. Stay active with low-impact activities like walking, swimming, or cycling. Avoid jumping, running, or heavy weightlifting unless you have built up your pelvic floor strength with professional guidance.
Mental health and emotional wellbeing
Prolapse can affect self-esteem, body image, and relationships. It is normal to feel frustrated, embarrassed, or anxious. Talking to a healthcare provider or a counsellor can help. You are not alone — many people have this condition.
Prevention
You can reduce your risk by keeping a healthy weight, doing pelvic floor exercises daily, avoiding constipation, and using correct lifting techniques. While you cannot fully prevent prolapse, these steps can help strengthen the pelvic floor and reduce strain.
Vaccines
There are no vaccines for pelvic organ prolapse.
Screening programmes
There is no routine screening test for prolapse. However, if you notice symptoms or have risk factors, talk to your doctor during a routine check-up.
Complications
If left untreated
- Pain or discomfort that worsens over time
- Difficulty completely emptying the bladder, leading to repeated urine infections
- Urine leakage (incontinence) or bowel problems
- Sores (ulcers) on the part of the prolapse in the vagina
Long-term outlook
Pelvic organ prolapse is not life-threatening, and many people live comfortably with it. With the right care — from simple exercises to a pessary or surgery — most people see improvement in their symptoms and quality of life.
Find support
International organisations
Local organisations
- NHS (UK) – Pelvic organ prolapse information ↗ · United Kingdom
External links open third-party websites. Ruqelo Health is not responsible for external content. Listing an organisation does not imply endorsement.
Always verify with your doctor
Health guidelines vary by country and region. The information in this article is based on international clinical guidelines but may not reflect the specific guidelines, medications, or practices in your country. Always discuss your health concerns with your own doctor or healthcare provider, and refer to your local national health guidelines where available.
Important notice This information is for educational purposes only. It does not replace professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider about your specific situation. If you are experiencing a medical emergency, call your local emergency services immediately.
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Sources and guidance
This article is educational and is prepared with reference to recognized health information and clinical guidance sources where available. Specific source links may vary by topic.
Last updated: July 18, 2026
Educational note: This information is for education only and is not a diagnosis.
Use it to support, not replace, advice from a licensed clinician.
If symptoms are severe, worsening, or urgent, call your local emergency number or seek emergency care.