Pelvic Organ Prolapse:
You're Not Alone and There Is Help
By Kathy Reid-Shirley, BSc, RN | Urogynecology Specialist Nurse
Pelvic organ prolapse happens when your bladder, uterus, or bowel drops down into your vagina—and it's far more common than you think.
I see at least 100 women with pelvic organ prolapse every single month. Women who have felt the bulge, the pressure, the heaviness, the dragging feeling. They know their body changed after childbirth or menopause, but they waited before coming to see me.
Why? Because they put their family first, thought it would get better on its own, felt embarrassed, or didn't know help was available.
This condition is very common. You are not alone. And there is help.
Quick Summary
- Your pelvic organs (bladder, uterus, bowel) drop into your vagina when supporting muscles and tissues weaken
- Prolapse affects up to 40% of women—you're not alone and it's not your fault
- You don't need surgery—most women manage successfully with pelvic floor exercises, pessaries, and vaginal oestrogen
- Don't wait years to get help—early treatment means more options and better outcomes
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What Is Pelvic Organ Prolapse?
Pelvic organ prolapse (POP) happens when one or more of your pelvic organs—your bladder, uterus, or bowel—drop from their usual position and push into (or sometimes out of) the vagina.
Think of your pelvic floor like a hammock of muscles, ligaments, and tissue that supports all your pelvic organs. When that support weakens or stretches, the organs can shift downward.
Recent research shows up to 40% of women have some degree of prolapse when examined.¹ That means if you gathered 10 women in a room, 4 would likely have some form of prolapse. There are three main types: bladder prolapse (cystocele), where the bladder drops into the front vaginal wall; uterine prolapse, where the womb descends into the vagina; and bowel prolapse (rectocele), where the rectum bulges into the back vaginal wall. Many women have more than one type at the same time.
💡 Up to 40% of women have some degree of prolapse. You are absolutely not alone in this.
Why Does Prolapse Happen?
Prolapse occurs when your pelvic floor becomes weakened or stretched—most often due to factors beyond your control:
- Childbirth: Vaginal delivery—especially large babies, multiple births, or difficult labours—stretches and weakens pelvic floor muscles. The more children you've had, the higher your risk.
- Ageing and menopause: Muscles and tissues naturally weaken with age. After menopause, falling oestrogen levels cause pelvic tissues to lose strength and elasticity.
- Genetics: Some women are born with naturally weaker connective tissue. If your mother or sisters have prolapse, your risk is higher.
- Chronic straining: Long-term constipation, persistent coughing, or heavy lifting repeatedly increases pressure on the pelvic floor.
- Previous pelvic surgery: Hysterectomy or other pelvic surgeries can weaken support structures.
What Does Prolapse Feel Like?
The most common symptoms women describe:
- A bulge or lump you can see or feel in or coming out of your vagina
- Heaviness, pressure, or dragging in your pelvis or lower back—often worse at the end of the day
- Difficulty emptying your bladder completely, or a slow flow of urine
- Trouble with bowel movements, or needing to press on your vagina to help
- Discomfort or pressure during sex
- Lower back pain that improves when you lie down
When prolapse extends beyond the vaginal opening, the tissue can become dry and irritated from rubbing against underwear.
Symptoms don't always match severity. I see women with mild prolapse who are deeply distressed, and women with more advanced prolapse who are coping. Your personal experience matters, regardless of the stage.
⚠️ Prolapse is a medical condition caused by factors mostly beyond your control.
This is not something you did wrong.
How Is Prolapse Treated?
The best approach usually involves multiple treatments working together:
Pelvic floor exercises
These strengthen the muscles supporting your pelvic organs. When done correctly and consistently, they significantly improve symptoms. A women's health physiotherapist can ensure you're doing them right.
Low-dose vaginal oestrogen
This replaces what's lost after menopause, keeping vaginal tissue healthy and strong. Available as a cream, tablet, or ring—it's safe, local, and very effective.
Pessaries
Soft silicone devices that sit in your vagina to support your prolapsed organs. Non-surgical, removable, and often a long-term solution—many women get immediate relief without surgery. Simple pessaries can be fitted by a GP for mild prolapse; more complex cases require a specialist.
Surgery
Surgery lifts and supports the organs and is an option when other treatments haven't helped or prolapse severely affects your quality of life. However, it's not a permanent cure. Research shows prolapse can recur after surgical repair,³ and it comes with risks and recovery time. This is why many women choose non-surgical management first—and succeed with it.
✅ Many women manage prolapse successfully WITHOUT surgery using pelvic floor exercises, pessaries, and vaginal oestrogen working together.
Advocating for Yourself at the GP
Many women tell me they tried to raise prolapse with their GP and felt dismissed. You have the right to specialist care.
How to advocate for yourself:
- Be specific. Don't say "I have some women's health issues." Say "I can feel a bulge in my vagina" or "I have difficulty emptying my bladder."
- Explain the impact. "I can't exercise," "I'm avoiding sex," "I can't lift my grandchildren"—these things matter.
- Ask directly. Ask for a referral to a urogynaecology specialist or pelvic health physiotherapist.
- Don't accept "wait and see". If you've had symptoms for months or years, waiting longer isn't the answer.
If your GP dismisses you: request an examination, ask to see a different GP, ask that your concerns be documented in your notes, or change practices if necessary. Your health matters
What I Want Every Woman to Know
- This condition is common and you are not alone. Help is available—from pelvic floor exercises to pessaries to surgery. You do not have to just live with it.
- Prioritise your health. The sooner you address prolapse, the more options you have and the better your outcomes. Waiting doesn't make it better—it often makes treatment harder.
- Advocate for yourself. Earlier treatment means more options. Don't wait until things get worse.
— Kathy Reid-Shirley, BSc, RN, Urogynaecology Specialist Nurse
A Quick Note: Everything shared here is for educational purposes based on professional experience and current research. It is not medical advice tailored to your specific situation. If you are experiencing symptoms, please see a healthcare provider for assessment.
References
- Hadizadeh-Talasaz Z et al. Iranian Journal of Public Health. 2024;53(6):1228–1240
- Karabuga B et al. Journal of Clinical Medicine. 2025;14(20):7313
- Mudalige MDTK et al. BJUI Compass. 2024