Pelvic Organ Prolapse

Pelvic Organ Prolapse, or POP, is a symptom that affects many people but is not always openly discussed. It occurs when one or more pelvic organs—such as the bladder, bowel, or uterus—shift from their normal position and descend, often resting against the vaginal wall. While some degree of movement is considered normal, a prolapse is diagnosed when symptoms are present.
What Does POP Feel Like?
People with POP often describe a sense of heaviness or dragging in the pelvis. Others may notice a bulge in or outside the vagina, discomfort during daily activities, or a feeling that something is “coming down.” POP can also affect bladder and bowel function, leading to symptoms like incomplete emptying or frequent urgency.
What Increases the Risk of POP?
The most significant risk factor for developing POP is vaginal childbirth. However, it's not just childbirth itself, but certain factors around the delivery that play a role:
- Birth weight over 4kg
- Pushing for less than 20 minutes or more than 2 hours
- Obstructed labour or instrumental delivery (forceps, vacuum)
Other contributing lifestyle factors include:
- Chronic constipation or long-term straining
- Persistent coughing (e.g., due to asthma or smoking)
- Heavy lifting over extended periods
- Family history of prolapse
- Menopause, due to hormonal changes affecting tissue support
Conservative Treatment Options
For many people, POP can be managed conservatively without surgery. Treatment may include:
- Pelvic Floor Muscle Training: Strengthening these muscles improves the support they provide to pelvic organs.
- Horizontal Rest: Lying down throughout the day can help reduce the sensation of heaviness and give your body time to recover.
- Hormonal Therapies: Your doctor may prescribe topical oestrogen to help strengthen vaginal tissues, particularly after menopause.
- Pessary Use: A pessary is a small silicone device inserted into the vagina to provide internal support for the organs.
- Lifestyle Modifications: Addressing chronic constipation or cough and avoiding unsafe repetitive heavy lifting can reduce strain on the pelvic floor.
For personalised guidance, it’s important to consult a qualified pelvic health physiotherapist who can tailor your treatment to your specific needs and goals.
When Is Surgery Considered?
In more severe cases of prolapse, or when conservative measures do not relieve symptoms, surgery may be recommended. If this is the case, your healthcare provider will refer you to a specialist for a comprehensive assessment and to discuss your surgical options.
Conclusion
Pelvic Organ Prolapse is common, but with the right support and management strategies, it doesn’t have to limit your quality of life. Early intervention through physiotherapy and lifestyle changes can significantly improve symptoms and help you feel confident in your body again.
If you're experiencing symptoms or want to know more, reach out to a pelvic health physiotherapist to explore your options.
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