Pelvic organ prolapse is when 1 or more of the organs in your pelvis move down from their normal position and bulge into your vagina.
It can happen to your womb (uterus), bowel, bladder or top of the vagina (cervix).
A pelvic organ prolapse can cause pain and discomfort, but it is not life threatening.
Pelvic floor exercises and lifestyle changes can help improve the symptoms of prolapse. Sometimes medical treatment is needed.
Symptoms of pelvic organ prolapse
Pelvic organ prolapse symptoms include:
- a feeling of heaviness around your lower abdomen (tummy) and vagina
- a dragging feeling inside your vagina
- feeling like there's something coming down into your vagina - it may feel like sitting on a small ball
- feeling or seeing a bulge or lump in or coming out of your vagina
- discomfort or numbness during sex
- problems peeing - such as feeling like your bladder is not emptying fully or needing to go to the toilet more often
Sometimes pelvic organ prolapse has no symptoms. Your GP or nurse may find it during a routine internal exam, such as when you go for cervical screening.
Non-urgent advice: Go to your GP if:
- you have any of the symptoms of a prolapse
- you notice a lump in or around your vagina
Diagnosing pelvic organ prolapse
Your GP will ask if they can do an internal pelvic exam.
You can ask for a female doctor to do the exam, if you prefer. You can bring someone with you for support, or ask your GP for a chaperone (observer, often a nurse).
The doctor will explain what they are doing as they do it and you can ask them to stop at any time.
They will ask you to undress from the waist down and lie on the exam bed. They will then feel for any lumps in your pelvic area and inside your vagina.
They may put an instrument called a speculum into your vagina. This is to hold the walls of your vagina open so they can see if there's a prolapse.
If you have problems with your bladder, your GP may refer you to hospital for further tests.
These may include:
- a test to check your pee for an infection
- putting a small tube into your bladder to look for any problems
Types of prolapse
The 4 main types of prolapse are the:
- bladder bulging into the front wall of the vagina (anterior prolapse)
- womb bulging or hanging down into the vagina (uterine prolapse)
- top of the vagina sagging down - this happens to some women after they have had surgery to remove their womb
- bowel bulging forward into the back wall of the vagina (posterior wall prolapse)
It's possible to have more than 1 of these at the same time.
Causes of pelvic organ prolapse
Pelvic organ prolapse happens when the pelvic floor becomes weakened and cannot hold the organs in place. The pelvic floor is the group of muscles and tissues that support the pelvic organs.
Things that can cause weakness or damage to the muscles include:
- overweight and obesity
- chronic cough
- heavy lifting
- ageing and menopause
Some rare health conditions can also make a prolapse more likely, including:
- joint hypermobility syndrome
- Marfan syndrome
- Ehlers-Danlos syndromes