What is a prolapse?

A vaginal prolapse is when an organ like a bladder, cervix or rectum is pushing against the walls of the vagina. A prolapse can progress from indenting the walls of the vagina to pushing it so much that if pushes out of the vagina. This is the most common form of prolapse.

Some people can also have a rectal prolapse where the rectum is falling into itself and can progress outside of the rectum.

Some people have no symptoms of having a prolapse but some symptoms of a prolapse can be feeling a dragging or heavy sensation in the vaginal region, a “ball” sensation in the vagina, lower back pain, difficulty emptying the bladder and/or bowel, slower or intermittent urine stream, frequent urinary tract infections, painful sexual intercourse

Pelvic-ProlapseWhat can cause a prolapse?

  • Menopause
  • Pregnancy/Birthing process
  • Chronic Constipation
  • Heavy Lifting
  • Excess weight
  • Chronic Cough

What Can You do about a Prolapse?

Minimise the pressures that transfer the pelvic floor. Such as losing weight, minimise heavy lifting. If possible, treat a chronic cough with medication or positioning yourself to minimise aggravating the cough, eg. sleep with pillows to elevate the body.

Manage your constipation. This can be done many ways. A GP can advise you what medication is appropriate. A women’s health physiotherapist can advise you on optimum techniques of performing a bowel motion to minimise the impact on the pelvic floor. They can also give you lifestyle choices or massage techniques to encourage the bowels to move better. They can also provide training on how to relax your pelvic floor muscles when going to the toilet as there is a percentage of the population that cannot relax their muscles on command or even contract their muscles when they are meant to be relaxing them.

When women go through menopause , they stop releasing oestrogen into their bodies. This can significantly change the quality of the vaginal tissues, including the tissues that are meant to be holding up your organs. Vaginal oestrogen can be prescribed by a medical officer like a GP or gynaecologist. This can often improve the blood supply to these tissues and can improve symptoms of not only prolapse but also stress incontinence, urge incontinence, vaginal atrophy and dryness.

A women’s health physiotherapist can also look at how strong your pelvic floor muscles are to help support your organs from coming down. A tailored pelvic floor muscle exercise program can be given to strengthen and co-ordinate these muscles to work optimally especially when you are lifting or coughing or sneezing for example.

She can also look at how you activate your abdominal muscles. When some people lift or load their bodies to do something, they have poor technique which can unnecessarily stretch their pelvic floor even more. This can then worsen their prolapse symptoms over time. A women’s health physiotherapist can assess this through real time ultrasound and see how these abdominal muscles are working and how they impact the pelvic floor.

They can also look at how you breathe. A lot of people hold their breaths when they move or lift. This can add to the pressures onto the pelvic floor and stretch it further. The physiotherapist can optimise how you breathe by minimising the overstreching of the pelvic floor.

Pessaries can be an option to mechanically support the prolapse through the vagina. Some women’s health physiotherapists, like at Inspired Physiotherapy, can do this and allow you to get back to what you want to do sooner like weightlifting or running or just simply walking without getting prolapse symptoms. There are potential side effects with this and this should be discussed with the physiotherapist and/or gynaecologist to see what is the best option for you.

Surgery is the other option that can help with a prolapse. Consultation with a good gynaecologist will help assist what are the best options for you. Surgery can still lead to the prolapse coming back again, so it is always important to discuss this with your doctor as well as going onto a pelvic floor exercise program.


Regardless of whether your choose surgery, a pessary or pelvic floor muscle training as the way to help with your pelvic organ prolapse, a women’s health physiotherapist can assist you in optimising how your pelvic floor works and minimise the overstretching of your pelvic floor. Come visit Inspired Physiotherapy for more advice and management.