Living with pelvic organ prolapse can have a significant impact on many activities often taken for granted – exercising without worry, getting through a long day on your feet, feeling confident during intimacy, or simply not thinking about your body all day long. It's a genuinely common condition, but that doesn't make it any less disruptive to live with. Dr Mandana Master will help you understand exactly what's happening and the range of effective treatments available, so you can get back to feeling comfortable and confident in your own body.
Pelvic organ prolapse occurs when the muscles and ligaments that normally support the pelvic organs weaken or stretch, allowing one or more organs to descend and press against, or bulge into, the vaginal walls. It’s an extremely common condition, particularly among women who have given birth, and becomes more common with age and after menopause.
Prolapse exists on a spectrum, from mild and barely noticeable to more advanced, where a bulge may be visible or felt at or beyond the vaginal opening. It isn’t dangerous in the way some other gynaecological conditions can be, but it can meaningfully affect comfort, bladder and bowel function, and quality of life.
Some women with mild prolapse have no symptoms at all, while others notice:
Symptoms often ease when lying down and worsen with prolonged standing, lifting, or straining, which can be a helpful clue that prolapse may be the underlying cause.
Pelvic organ prolapse develops when the connective tissue and muscles supporting the pelvic organs are weakened or overstretched. Common contributing factors include:
Particularly multiple births, the delivery of a larger baby, assisted births, or a prolonged second stage of labour, all of which place strain on the pelvic floor.
The decline in oestrogen affects the strength and elasticity of pelvic tissue, which is why prolapse often becomes more noticeable around this time.
Including long-term constipation, a persistent cough, or heavy lifting, all of which place repeated pressure on the pelvic floor over time.
Pelvic floor support naturally weakens to some degree over time due to musculoskeletal changes, independent of other factors.
Some women have a natural predisposition toward weaker connective tissue, making prolapse more likely even without other risk factors.
Including hysterectomy, which can sometimes affect the support structures of the upper vagina.
Treatment depends on the type and severity of prolapse, your symptoms, and your personal preferences, and doesn’t always require surgery. Options may include:
Management with a physiotherapist who specialises in pelvic floor disorders is often the first line of treatment for mild to moderate prolapse. Targeted exercises can help to strengthen and support the pelvic floor muscles.
A pessary is a removable device fitted inside the vagina to support the pelvic organs, offering a non-surgical option that suits many women. These devices must be fitted by an experienced clinician, whether a gynaecologist or pelvic floor physiotherapist, to be effective. Some women choose to wear the pessary throughout the day while others use it only when participating in certain activities.
Lifestyle changes include managing constipation, modifying heavy lifting, and addressing any chronic cough, all of which can reduce ongoing strain on the pelvic floor.
Surgical prolapse repair is recommended for more significant prolapse or where non-surgical options haven’t provided enough relief. Several different surgical approaches are available depending on which structures are affected, including minimally invasive techniques such as laparoscopy.
Dr Mandana will talk you through which combination of these is likely to suit your specific situation. There’s rarely a need to rush into surgery before trying more conservative options first, unless your circumstances suggest otherwise.
You deserve a gynaecologist who listens carefully, explains things clearly, and treats your concerns with evidence-based, patient-centred management strategies. Get in touch with Dr Mandana Master at Embrace Fertility today to arrange a consultation.
