Do you feel pelvic pressure or a vaginal bulge at the end of the day — or after you’ve been standing for a long time? Maybe you’re making frequent trips to the bathroom? These could be signs of a condition called pelvic organ prolapse (POP).
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What Is Pelvic Organ Prolapse?
POP is a pelvic floor disorder in women. It happens when the muscles and tissues that support the pelvic organs become weak and loose.
Normally, the muscles and tissues of the pelvic floor support the bladder, uterus, cervix, vagina, and rectum like a hammock. But when the pelvic floor becomes weak, the organs may slip down or press into the vagina. It’s not life-threatening, but POP can cause pain and discomfort.
According to the U.S. Department of Health and Human Services, almost 3% of American women suffer from POP.
Types of pelvic organ prolapse
There are three main types of POP. They are:
- Cystocele — when the bladder drops into the vagina. (This is the most common type of POP.)
- Uterine prolapse — when the uterus pushes into the vagina.
- Rectocele — when the rectum bulges into the vagina.
What causes pelvic organ prolapse?
Some women are more likely to have POP, but it can also affect anyone. Risk factors include:
- Genetics. Some people naturally have very loose, flexible connective tissue.
- Childbirth. Multiple vaginal deliveries or large babies can stretch the muscles and tissues of the pelvic area.
- Chronic pressure in the lower abdomen. Obesity, heavy lifting, chronic coughing, and constipation can weaken your pelvic floor.
- Age. As you get older, the muscles in your pelvic floor tend to weaken.
Pelvic Organ Prolapse Symptoms
POP typically has one or more symptoms. These include:
- Pressure or a heavy feeling in your pelvis.
- A feeling that something is falling out of your vagina.
- Feeling a bulge inside or outside your vagina.
- Feeling an increase in symptoms at the end of the day.
- Feeling an increase in symptoms after standing for a long time.
- An increase in urinary urgency (that “gotta go” feeling).
- Needing to urinate more often.
- Difficulty emptying your bladder completely.
- Dribbling urine.
Pelvic Organ Prolapse Treatment
To diagnose POP, your doctor will ask you questions about your health, symptoms, and past pregnancies. They will also do a pelvic exam. They may order other tests, such as an ultrasound.
Options for pelvic organ prolapse treatment
You may not be able to completely reverse POP. But if your condition is mild to moderate, you can reduce your symptoms by lifestyle changes. Try to:
- Maintain an ideal weight. Being overweight puts pressure on pelvic muscles.
- Avoid constipation. Straining during bowel movements can weaken your pelvic floor. To prevent constipation, exercise, drink more water, eat high fiber foods, and talk to your doctor about medication to soften stool.
- Treat chronic coughing. Long-term coughing puts pressure on pelvic muscles and weakens them. If you smoke, try to quit. If you have asthma or bronchitis, talk to your doctor about how to manage a chronic cough.
- Learn pelvic floor therapy. A physical therapist can explain how to do pelvic floor exercises called Kegels. By contracting and releasing your pelvic floor muscles, you strengthen the muscles that support the pelvic organs.
- Learn if Kegels are right for you. If you’re having pelvic pain (including pain during intercourse) along with urinary symptoms, they could make things worse. Check with your doctor before beginning pelvic floor exercises.
- Use proper technique when lifting. Lifting, pushing, or pulling heavy things puts excessive pressure on your pelvic floor. To avoid this, contract your abdominal muscles when lifting, pushing, or pulling.
If your condition is more severe, you might need medical treatment. Options include:
- Pessary. This is a medical device that a doctor initially inserts into your vagina. You can then remove and reinsert the pessary to clean it or to have sex. It supports and keeps the bladder, uterus, or rectum in its proper position.
- Surgery. Your doctor may use your own body tissue or synthetic mesh to repair the prolapse and build pelvic floor support. These surgeries can be done with or without a hysterectomy (removeal of the uterus) depending on a variety of factors.
Editor's Note: This article was originally published on , and was last reviewed on .
About UPMC Magee-Womens
Built upon our flagship, UPMC Magee-Womens Hospital in Pittsburgh, and its century-plus history of providing high-quality medical care for people at all stages of life, UPMC Magee-Womens is nationally renowned for its outstanding care for women and their families.
Our Magee-Womens network – from women’s imaging centers and specialty care to outpatient and hospital-based services – provides care throughout Pennsylvania, so the help you need is always close to home. More than 25,000 babies are born at our network hospitals each year, with 10,000 of those babies born at UPMC Magee in Pittsburgh, home to one of the largest NICUs in the country. The Department of Health and Human Services recognizes Magee in Pittsburgh as a National Center of Excellence in Women’s Health; U.S. News & World Report ranks Magee nationally in gynecology. The Magee-Womens Research Institute was the first and is the largest research institute in the U.S. devoted exclusively to women’s health and reproductive biology, with locations in Pittsburgh and Erie.