Understanding Pelvic Organ Prolapse – Types, Symptoms, and Causes

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By jm

July 13, 2025

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Pelvic organ prolapse (POP) can sound intimidating, but you’re not alone if you’re dealing with it. POP is actually a common condition – studies estimate that between about 3% to 11% of women experience a pelvic organ prolapse in their lifetime^[1]. It often affects women after childbirth or later in life, and while it isn’t life-threatening, it can impact your comfort and daily activities. The good news is prolapse is treatable, and there are many ways to manage it and feel better.

What Is Pelvic Organ Prolapse?

Pelvic organ prolapse means that one or more pelvic organs have dropped from their normal position due to weakened support structures in the pelvis^[1]. In other words, the muscles and connective tissues of your pelvic floor (which act like a supportive sling or hammock for your bladder, uterus, and rectum) have become too weak or stretched out to hold those organs in place. When that support gives way, an organ can sag or bulge into the vagina. In mild cases, you might not even notice it. In more advanced cases, you might feel or see a bulge at the vaginal opening.

Prolapse is basically like a hernia in the vaginal area – women often describe feeling a fullness or pressure, as if something is “falling out” of the vagina^[2]. It may be unsettling, but remember that prolapse is very common and treatable. It’s also usually not dangerous – so while it can cause discomfort, it’s not going to turn into a life-threatening emergency. Still, you don’t have to just live with it; there are ways to improve it and help you feel more comfortable.

Types of Pelvic Organ Prolapse

There are several types of pelvic organ prolapse, depending on which organ is drooping and where the support is weak^[1]:

Bladder prolapse (Cystocele) – Weakened support at the front wall of the vagina can allow the bladder to bulge into the vagina. This is the most common type of prolapse.
Uterine prolapse – If the uterus loses support, it can descend down into the vaginal canal. In severe cases, the uterus can protrude partway out of the vaginal opening.
Rectocele (Posterior wall prolapse) – Weakness between the vagina and rectum can cause the rectum to bulge into the back wall of the vagina.
Small intestine prolapse (Enterocele) – In some cases, the small intestine can push into the vagina (usually the upper part) if the support is weakened.
Vaginal vault prolapse – In women who have had a hysterectomy, the top of the vaginal canal itself can drop if its supports weaken.

You might hear different terms from your doctor – cystocele, rectocele, enterocele – but they all fall under the umbrella of pelvic organ prolapse. Sometimes people also refer to “dropped bladder” or “dropped uterus.” It’s helpful to know the type of prolapse you have, but all types are related and often share similar risk factors and treatment approaches.

What Causes Prolapse (and Who Gets It)?

The primary cause of POP is a weakening of the pelvic floor muscles and connective tissues. Think of these like the foundation or scaffolding that holds everything up. When they’re weakened or damaged, organs can shift out of place. Common causes and risk factors include:

Pregnancy and Childbirth: The strain of pregnancy and vaginal delivery is the number one risk factor for prolapse^[2].
Aging and Menopause: As we age, muscles naturally lose strength. After menopause, the body produces less estrogen, a hormone that helps keep pelvic tissues strong.
Chronic Pressure on the Abdomen: Chronic constipation, long-term coughing, or lifting heavy objects increase pressure inside the abdomen and can gradually overstretch the pelvic supports.
Genetics and Connective Tissue Strength: Some women may simply have genetically weaker connective tissues or conditions like Ehlers-Danlos syndrome.
Obesity: Carrying extra weight puts constant downward pressure on the pelvic floor, increasing prolapse risk^[2].
Other Factors: Previous pelvic surgeries, nerve damage, or connective tissue disorders may also contribute.

Common Symptoms to Watch For

Pelvic organ prolapse often develops gradually. In early stages, you might not notice much. As it progresses, symptoms can include^[2]:

Vaginal bulge or pressure: Feeling a bulge or “something coming down” in the vagina, especially when bearing down or after being on your feet all day.
Pelvic heaviness or aching: A general sense of pressure or dull ache in the pelvic region or lower back.
Urinary problems: Leakage with coughing or difficulty emptying your bladder.
Bowel issues: Constipation or the sensation of incomplete bowel movements.
Discomfort during sex: Prolapse can sometimes make intercourse uncomfortable or painful.
Improvement when lying down: Bulge and pressure often feel better when off your feet.

Not everyone with a prolapse has all these symptoms – some have just a mild sense of pressure, while others have more pronounced bulging and discomfort. If you suspect you have prolapse or you’re feeling any of these symptoms, it’s wise to talk to a healthcare provider. They can do a simple exam to tell you for sure.

Why You Don’t Need to Be Embarrassed (and Treatment Options Ahead)

It’s common to feel embarrassed or anxious about prolapse symptoms. Many women suffer in silence, thinking it’s just a part of aging or something they have to “live with.” In fact, prolapse is very common and nothing to be ashamed of – and most importantly, it’s fixable.

There are both non-surgical and surgical treatments available for pelvic organ prolapse. Many women with mild-to-moderate prolapse find relief through conservative measures such as pelvic floor exercises, physical therapy, or using a supportive device called a pessary^[3]. In more severe cases, or if conservative treatments aren’t enough, there are effective surgeries to repair the prolapse.

In our next posts, we’ll delve into how pelvic floor physical therapy can help prolapse and share some empowering self-care tips and exercises. Remember, prolapse may be a common hitch in the journey, but with the right knowledge and support, you can absolutely take control and continue living your life to the fullest.