Pelvic organ prolapse
Pelvic organ prolapse is when your womb, bladder or bowel bulge into the vagina. Treatments and lifestyle changes can help manage it.
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Pelvic organ prolapse is when your womb, bladder or bowel bulge into the vagina. Treatments and lifestyle changes can help manage it.
Symptoms of pelvic organ prolapse
Pelvic organ prolapse is common in women over 50. It can affect anyone with a vagina.
It may not cause symptoms, but if you do have symptoms they can include:
- a feeling of heaviness, discomfort or pressure in your lower tummy or vagina
- feeling or seeing a bulge or lump inside (or coming out of) your vagina
- pain, discomfort or numbness during sex
- problems pooing, such as constipation
- problems peeing, such as feeling like your bladder is not emptying fully, needing to go to the toilet more often, or leaking a small amount of pee when you cough, sneeze or exercise
Sometimes pelvic organ prolapse may only be found during tests done for another reason, such as cervical screening.
See a GP if:
- you have a lump in or around your vagina
- you have any other symptoms of pelvic organ prolapse
What happens at your appointment
If you have symptoms that could be caused by pelvic organ prolapse, a GP will ask about your symptoms and examine you. For this you'll need to undress from the waist down.
Let them know if you'd like someone else to be in the room with you (a chaperone) – this could be someone you know, a nurse or a trained member of staff. You can ask for this examination to be done by a female doctor if you prefer.
You may be asked to lie on your side with your knees pulled up towards your chest or you may be examined standing up.
The doctor will feel for any lumps in your pelvic area and inside your vagina.
They may gently put a smooth, tube-shaped tool called a speculum into your vagina so they can see if there's a prolapse.
If you have problems with your bladder, the GP may refer you to hospital for further tests.
If you're diagnosed with a prolapse, it may be given a number from 1 to 4 depending on how severe it is, with 4 being a severe prolapse.
Treatment for pelvic organ prolapse
Treatment for pelvic organ prolapse depends on which organs have prolapsed and how severely. Your doctor will also consider your age, overall health, and if you're planning to have children in the future.
If you do not have any symptoms, or the prolapse is not bothering you, you may not need medical treatment.
If the prolapse is more severe or your symptoms are affecting your daily life, treatment options may include:
- hormone treatment – a cream applied to the vagina, or tablets or a hormone-releasing ring inserted into the vagina
- vaginal support pessaries – a plastic or silicone device inserted into the vagina help support the pelvic organs
- physiotherapy and pelvic floor muscle training, usually with a specialist women's health physiotherapist
- surgery – if the prolapse is severe, surgery to lift and support the pelvic organs may be an option
You and your doctor will decide together what's the best option for you.
Vaginal mesh surgery
If you have previously had vaginal mesh inserted and think it might be causing problems, speak to a GP or your surgeon.
Things you can do to help with pelvic organ prolapse
There are things you can do yourself to help with pelvic organ prolapse.
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Do
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maintain a healthy weight
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eat more fibre, drink plenty of water and do gentle exercise like walking regularly to avoid constipation
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avoid physical activities that put a lot of strain on the pelvic floor, like heavy lifting, running and trampolining
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do regular pelvic floor exercises
Don’t
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do not smoke – stopping smoking means you're less likely to have a persistent cough that can put pressure on your pelvic floor
Causes of pelvic organ prolapse
Pelvic organ prolapse can happen when the pelvic floor muscles weaken.
It's more common as you get older, particularly after the menopause.
It can be caused by:
- pregnancy and childbirth
- being overweight
- long-term constipation and straining
- persistent coughing
- pelvic surgery, such as a hysterectomy
Some health conditions can also make a prolapse more likely, including:
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