Pelvic organ prolapse is what occurs when the muscles and ligaments that support a woman’s pelvic organs weaken; causing them to slip out of place (prolapse). The organs that can be involved when a pelvic prolapse occurs include: the bladder, urethra, uterus, vagina, small bowel and rectum.

Pelvic organ prolapse most often occurs due to stretching and weakening of the muscles from childbirth or surgery. There are different types of pelvic organ prolapse: anterior prolapsed, posterior prolapse, uterine prolapse and small bowel prolapse.

The condition can worsen over time and usually surgical removal of the uterus (hysterectomy) is recommended as a treatment option. However, removal of the uterus can sometimes leave other organs in the pelvic with less support.



Signs and symptoms of pelvic organ prolapse include:

  • Pressure against the vaginal wall
  • Feeling as if something is falling out of the vagina
  • Bloating
  • Lower back pain
  • Pain during sexual intercourse
  • Frequent urination
  • Constipation





Pelvic organ prolapse is often caused by damage to muscles and ligaments that support the pelvic organs. Weakening and stretching of these tissues allows the organs to move out of their normal positions and causes them to press against the inside walls of the vagina. One major cause of pelvic organ prolapse is childbirth. Giving birth can cause loss of support of the structures in the pelvic area. Another cause of reduced support in the pelvis is lower levels of the hormone estrogen. Estrogen is a protein that helps the pelvic connective tissues stretch and return to their normal positions. The lowering of estrogen levels typically occurs during and after menopause.

Pelvic organ prolapse can also occur due to:

  • Having had surgical removal of the uterus (Hysterectomy)
  • Being overweight
  • Being a smoker
  • Conditions affecting the spinal cord (muscular dystrophy, multiple sclerosis)


Certain conditions can also cause the tissues in the body to weaken, making a prolapse more likely, including:

  • Joint hypermobility syndrome: A type of syndrome that involves loose joints
  • Marfan syndrome : An inherited condition that affects the blood vessels, eyes and skeleton
  • Ehlers-Danlos syndrome: A group of inherited conditions that affect collagen proteins in the body


Risk factors

There are several factors that can increase the risk of developing pelvic organ prolapse. These factors contribute to the weakening and stretching of tissues that support the pelvic organs. They include:

  • Obesity (increased pressure on the abdomen)
  • Smoking and lung conditions
  • Chronic constipation
  • Repeated heavy lifting
  • Diseases of the nervous system
  • Pelvic surgery (hysterectomy)
  • Family history of pelvic organ prolapse



In mild cases of pelvic organ prolapse, lifestyle changes such as weight loss and pelvic floor exercises are recommended. In more severe cases where symptoms require attention, treatment options can include:


  • Vaginal Pessary: Insertion of a device into the vagina to help hold the prolapsed organ in place
  • Hysterectomy: Surgical removal of the uterus




Although there is no sure way to prevent damage to the pelvic organs caused by childbearing, there are certain lifestyle changes that can help reduce the risk of prolapse. These include:

  • Staying at a healthy weight
  • Eating a healthy diet
  • Doing regular pelvic strengthening exercises
  • Avoiding smoking
  • Avoiding heavy lifting and jumping
  • Avoiding constipation and straining when going to the toilet