Pelvic Organ Prolapse

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.

Find out more

NHS England: surgical treatments for pelvic organ prolapse

Vaginal mesh surgery

Surgery to treat pelvic organ prolapse by putting a supportive mesh inside the vagina is no longer done on the NHS, unless there's no alternative.

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.

Do

maintain a healthy weight
eat more fibre, drink plenty of water and do gentle exercise like walking regularly to avoid constipation
avoid physical activities that put a lot of strain on the pelvic floor, like heavy lifting, running and trampolining
do regular pelvic floor exercises

Don't

do not smoke - stopping smoking means you're less likely to have a persistent cough that can put pressure on your pelvic floor

Video: How to do pelvic floor exercises

In this video, a physiotherapist explains how to do pelvic floor exercises.

Media last reviewed: 20 October 2023
Media review due: 20 October 2026

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:

Help and support for pelvic organ prolapse

If you have pelvic organ prolapse, you'll be supported by your doctor or specialist. You may also find it helpful to get support online.

There are national charities that can offer support and information about pelvic organ prolapse.

Bladder and Bowel UK

Information and support for anyone affected by bladder or bowel problems.

Website: www.bbuk.org.uk
Helpline: 0161 214 4591
Bladder and Bowel UK: Just Can't Wait card (for help with toilet access in public spaces)
Bladder and Bowel UK private Facebook group

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