Inside Out: What Can Be Done About Pelvic Organ Prolapse?

While you may not be familiar with the term, pelvic organ prolapse is actually fairly common. Over 3 million women in the United States are affected by this condition, which occurs when the muscles and ligaments of the pelvic floor are unable to support the weight of the organs above. 

Understanding this condition — its causes and symptoms, along with treatment options — may help you feel more comfortable about seeking help. 

Why Pelvic Organs Fall 

The group of muscles and ligaments found in your pelvis is known as the pelvic floor. When these muscles and ligaments are weakened and/or torn, they can no longer support the weight of the organs pressing down on them. These organs include the bladder, rectum, uterus and intestines, which put about 20 to 30 pounds of downward pressure on your pelvic floor. 

Pelvic organ prolapse occurs when the pelvic organs drop down and press into the vaginal wall and often protrude out of the vagina. 

The main types of pelvic organ prolapse are: 

• Dropped bladder (cystocele), when the bladder drops into or out of the vagina 

• Rectocele, when the rectum bulges into or out of the vagina 

• Dropped uterus (uterine prolapse), when the uterus bulges into or out of the vagina 

• Enterocele, when the small intestines push the vaginal walls down, creating a bulge in or out of the vagina 

Why Does Pelvic Organ Prolapse Happen? 

Certain factors can increase a woman’s risk of pelvic organ prolapse. The most common one is vaginal childbirth, which can strain and stretch the muscles, ligaments and connective tissue of the pelvic floor.  

Other risk factors include: 

• Persistent pressure on the abdomen, which can be caused by obesity, chronic coughing and frequent straining during bowel movements 

• Family history of pelvic floor disorders 

How To Know If You Pelvic Floor Is Failing 

Many women with pelvic organ prolapse feel or see a bulge in (or coming out of) the vagina. Some other signs of pelvic organ prolapse are: 

• Pressure or a feeling of fullness in the vaginal region 

• Urine leakage (incontinence) or inability to fully empty bladder 

• Constipation and need to assist with fingers to aid stool evacuation 

• Trouble inserting and keeping in tampons 

If you are experiencing any of these symptoms, let your primary care physician or OB-GYN know. Pelvic organ prolapse doesn’t occur quickly, but many women don’t realize what’s happening until they see or feel a bulge. They may go for years knowing something isn’t quite right “down there” before they decide to see someone. 

Therapy and Surgery Treat Pelvic Organ Prolapse 

There are many treatment options for pelvic organ prolapse. When the condition is caught early (before the organs start to protrude), physical therapy can help. A removable device called a pessary that supports the pelvic organs can also be useful, especially in the short term. 

Surgery is another option for treating pelvic organ prolapse. Many of these procedures are minimally invasive. A urogynecologist can work with you to find the right treatment option based on the severity of your condition and your lifestyle.