Pelvic Organ Prolapse

What it is: Pelvic organ prolapse occurs when the layers of connective tissue called the fascia and muscles can no longer support the pelvic organs. The internal organs drop downward as a result of the muscles and fascia being stretched or weakened. If this occurs, a bulge can be felt inside of your vagina, or for more severe cases the organs may protrude from the vaginal opening. Pelvic organ prolapsed can be caused by injury to the muscles during childbirth or otherwise, constipation, chronic coughing, heavy lifting, menopause, and aging.

Causes: The tissues and muscles that hold up the uterus weaken.

Physiotherapist pressing patients pelvis

It can happen:

  • After one or more vaginal births
  • After delivery of a large baby (more than 9 pounds)
  • After hard labor and delivery
  • With normal aging
  • With reduction in estrogen
  • Obesity and chronic coughing or straining can also weaken the muscles and raise a woman’s chances of having this condition.


  • A feeling of heaviness or pulling in the pelvis
  • A feeling like you’re sitting on a small ball
  • Painful sex
  • Low back pain
  • Feeling an urgent need to urinate
  • Leaking urine
  • Painful bowel movements (BM)
  • Constipation


  • A pelvic exam


  • Inserting an object into the vagina to hold the uterus in place
  • Surgery
  • Kegel exercises (squeezing your pelvic muscles as if you’re trying to stop the flow of urine)
  • Estrogen therapy