When pelvic muscles weaken, it can lead to a condition called pelvic organ prolapse (POP). With POP, one or more pelvic organs shift or press into the vagina due to inadequate support.

The type of pelvic organ prolapse depends on which organ is involved. Each type has its specific symptoms and effects:

• Cystocele. Also known as an anterior vaginal wall prolapse, this is the most common type. It occurs when the bladder shifts out of place and bulges into the vagina.
• Vaginal vault prolapse. This happens when the top part of the vagina drops down into the vaginal canal, often after a hysterectomy.
• Uterine prolapse. A uterine prolapse is when the uterus drops down into the vaginal canal.
• Urethrocele. This is when the urethra, the tube that carries urine from the bladder to the outside of the body, slips down.
• Rectocele. This happens when the muscles between the vagina and rectum weaken. This allows the rectum to bulge into the back wall of the vagina. This condition is also known as a posterior vaginal wall prolapse.
• Enterocele. An enterocele is when the small intestine bulges into the upper or back wall of the vagina.

POP tends to happen over time and can be influenced by several factors that strain the pelvic floor. Common causes include:

• Aging. As you get older, the loss of estrogen after menopause weakens the pelvic floor muscles.
• Childbirth. Vaginal deliveries, especially with large babies or long labors, are a significant risk factor.
• Chronic coughing. Conditions like asthma or chronic bronchitis can strain the pelvic floor over time.
• Regularly lifting heavy objects.
• Carrying extra body weight.
• A family history of prolapse may raise your risk of developing it.

POP can present a range of symptoms depending on which organ is affected and the severity of the prolapse. Common symptoms include:

• A noticeable bulge. In more severe cases, tissue may protrude from the vagina.
• A sense of pressure or heaviness in the pelvic area, particularly when standing for long periods.
• Pain or discomfort during sexual intercourse.
• Difficulty with bowel movements or constipation.
• Urinary incontinence or difficulty emptying the bladder.

To diagnose pelvic organ prolapse, your doctor will:

1. Take a detailed medical history.
2. Perform a physical exam, including a pelvic exam. This checks your pelvic muscle strength and the severity of the prolapse.

Depending on your symptoms, your doctor may recommend additional tests like:

• Ultrasound
• Urodynamics- a test that measures how well your bladder stores and releases urine.
• MRI

Treatment depends on the severity of your symptoms.

• Pelvic floor exercises (Kegels). Doing regular Kegel exercises can make a big difference. These exercises involve squeezing and relaxing the muscles that support your pelvic organs, like your bladder and uterus. Over time, this can help strengthen muscles and improve symptoms.
• Vaginal pessaries. A pessary is a small silicone or plastic device that your doctor can fit inside your vagina to help support prolapsed organs. It’s a good option if you’re not ready for surgery or prefer to avoid it.
• Weight loss. Carrying extra weight puts more pressure on your pelvic floor. Losing weight can help relieve some of that strain and reduce symptoms.
• Managing constipation. Straining during bowel movements because of constipation can worsen prolapse symptoms. Keeping things regular with a high-fiber diet, water, and staying active can help.
• Hormone therapy. For post-menopausal women, estrogen therapy may help. It may strengthen pelvic tissues and improve prolapse symptoms.
• Lifestyle changes. Making adjustments, such as being mindful of any physical activity that worsens symptoms, can help minimize pelvic floor strain.

For more severe cases where non-surgical treatments aren’t enough, surgery might be the best option. Surgery can repair or support prolapsed organs. Your doctor will assess your symptoms and advise on the best treatment options for your prolapse.

While not all cases of POP can be prevented, there are ways to reduce the risk:

• Engaging in daily pelvic floor exercises
• Managing body weight to avoid extra pressure
• A high-fiber diet and staying well-hydrated
• Avoiding activities that worsen symptoms

Many women live with varying degrees of prolapse, and it is a condition that is often manageable with the right combination of treatments.

It’s essential to seek medical evaluation as soon as you notice any concerning symptoms. Early intervention can mean more treatment options and quicker symptom relief.

1. What activities can make pelvic organ prolapse worse?

Certain activities can put extra strain on the pelvic floor and worsen prolapse symptoms. These include heavy lifting and high-impact exercises like running or jumping. It’s essential to void activities that aggravate your symptoms. Your doctor can help you find alternatives.

2. Can pelvic organ prolapse impact my bladder or bowel function?

Yes, depending on the type of prolapse, it can affect bladder and bowel function. Bladder issues like incontinence, frequent urination, or difficulty with bladder emptying can occur. Similarly, rectal prolapse may lead to constipation or trouble with bowel movements.