What every woman should know about pelvic organ prolapse

Women's Health

by Casey Kinman, MD

Jan 19, 2022

Talking about gynecologic issues, including pelvic organ prolapse, can be a bit uncomfortable for many women. Some of you may be tempted to stop reading right about now—but stick with me and allow me to help educate you about why this topic is so important for women of all ages.

Pelvic organ prolapse, explained

First of all, what is “prolapse?” Simply put, the word prolapse means to slip down or fall. A group of muscles, known as the pelvic floor, help support your pelvic organs and keep them in place. But over time, after childbirth or certain surgical procedures, as you age and your estrogen levels decrease, your pelvic floor muscles may become weakened or strained. This can cause your pelvic organs to begin to prolapse.

Many women describe prolapse as a feeling of pressure in the vagina and some say it feels like exactly what it is—the sensation that something is falling out. Some women may also experience incontinence, constipation or incomplete bladder emptying along with prolapse.

Other symptoms of pelvic organ prolapse include:

  • Seeing or feeling a bulge or “something coming out” of the vagina
  • A feeling of pressure, discomfort, aching or fullness in the pelvis
  • Pelvic pressure that gets worse with standing or coughing or as the day goes on
  • Difficulty emptying the bladder or having a bowel movement
  • Problems inserting tampons

If you are having any of these symptoms, make an appointment with your Ob-Gyn for an evaluation.

Why does pelvic organ prolapse happen?

The most common risk factors for pelvic organ prolapse include:

  • Vaginal childbirth. However, you can get pelvic organ prolapse even if you’ve never delivered a child or delivered via C-section. The risk is even greater if you have given birth to a large baby or had a forceps or vacuum-assisted delivery.
  • Long-term pressure on your abdomen, including pressure from obesity, chronic coughing or straining often during bowel movement.
  • Advanced age
  • Genetic predisposition
  • Connective tissue disorders

Treatment options for pelvic organ prolapse

Before we dive into treatment options, it’s important to know which parts of the pelvis make up the pelvic organs:

  • Bladder
  • Urethra
  • Uterus
  • Vagina
  • Small bowel
  • Rectum

Let’s focus on the most common areas that can experience prolapse: the bladder, uterus, vaginal walls, and rectum. Your treatment will depend on the type of prolapse you have, your symptoms, age and other health problems.

The good news is that prolapse can often be treated with non-surgical options, but sometimes surgery is the best option. Your Ob-Gyn will be able to talk through the treatment options with you to help you choose the best approach for you. It may be a combination of lifestyle modification, surgery, pessary use or pelvic floor physical therapy.

Treatment options for pelvic organ prolapse include:

  • Observation or doing nothing for the time being
  • Activity modification: Avoid lifting heavy objects.
  • Pelvic floor exercises or physical therapy
  • Pessary: A removable device that can be placed inside the vagina to help hold the bladder in place.
  • Surgical repair of the prolapse

What to do if you think you have pelvic organ prolapse

If you’re experiencing symptoms of pelvic organ prolapse, talk to your Ob-Gyn about what you’re feeling. Don’t be embarrassed to bring up these symptoms—we talk about this stuff all day long, trust me. You shouldn’t have to live with uncomfortable symptoms.

Don’t have an Ob-Gyn? Find one near you today or learn more about treatment for pelvic organ prolapse.

About the Author

Casey Kinman, MD, is an obstetrician-gynecologist specializing in female pelvic medicine and reconstructive surgery on the medical staff at Baylor University Medical Center. She is passionate about improving the lives of women with pelvic floor disorders, including pelvic organ prolapse, urinary and fecal incontinence, pelvic pain and sexual dysfunction. Connect with Dr. Kinman today.

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