3 Key Takeaways:
- Pelvic organ prolapse affects up to 50% of women over 50, making it one of the most common women’s health conditions, yet many suffer in silence due to embarrassment or lack of awareness.
- The primary causes include childbirth trauma and hormonal changes during menopause, with additional risk factors like obesity, chronic coughing, and heavy lifting contributing to the weakening of pelvic support structures.
- Early recognition and treatment can significantly improve quality of life, as symptoms typically worsen over time without intervention, but various effective treatments from conservative therapy to surgical options are available.
If you’ve been experiencing a feeling of pressure in your pelvis, a sensation that something is “falling out,” or you’ve noticed a bulge in your vaginal area, you might be dealing with what is pelvic organ prolapse—a surprisingly common condition that affects millions of women worldwide. Despite its prevalence, many women feel embarrassed or confused about this condition, often suffering in silence when effective treatments are readily available.
Pelvic organ prolapse occurs when the muscles, ligaments, and tissues that support your pelvic organs become weakened, causing one or more organs to shift from their normal position. At St. Pete Urology, our experienced urologists understand that learning about this condition can feel overwhelming, but knowledge is the first step toward finding relief and improving your quality of life.
What Is Pelvic Organ Prolapse? Understanding the Basics
Pelvic organ prolapse causes a descent of one or more pelvic organs—including your bladder, uterus, rectum, or vaginal apex—into or beyond the vaginal canal. Think of your pelvic floor as a supportive hammock made of muscles, ligaments, and connective tissue that holds your pelvic organs in their proper positions. When this support system weakens, gravity takes over, and organs can shift downward.
There are several types of pelvic organ prolapse:
- Cystocele (Anterior Prolapse): When the bladder drops and bulges into the front wall of the vagina
- Rectocele (Posterior Prolapse): When the rectum pushes against the back wall of the vagina
- Uterine Prolapse: When the uterus descends into the vaginal canal
- Vaginal Vault Prolapse: When the top of the vagina drops after a hysterectomy
- Enterocele: When the small intestine pushes against the vaginal wall
The severity ranges from mild cases where organs drop slightly to severe cases where tissues extend outside the vagina.
Pelvic Organ Prolapse Causes: Understanding Why It Happens
Research shows that up to 50% of women over age 50 experience some degree of pelvic organ prolapse, making it far more common than most people realize. The primary causes include:
Childbirth and Pregnancy Vaginal delivery is the leading cause of pelvic organ prolapse. Studies indicate that 21% to 36% of women experience levator ani muscle injuries after vaginal delivery, which directly correlates with prolapse development. Factors that increase risk during childbirth include:
- Large birth weight babies (over 8.5 pounds)
- Prolonged second stage of labor
- Use of forceps or vacuum delivery
- Multiple pregnancies and deliveries
Hormonal Changes Menopause significantly increases prolapse risk as declining estrogen levels weaken the supportive tissues. Estrogen helps maintain the strength and elasticity of pelvic floor muscles and connective tissue.
Other Contributing Factors
- Chronic coughing or constipation
- Repeated heavy lifting
- Obesity (increases intra-abdominal pressure)
- Previous pelvic surgery, including hysterectomy
- Genetic predisposition to weak connective tissue
- Aging process
Pelvic Prolapse Symptoms: What to Watch For
Many women with mild pelvic organ prolapse experience no symptoms, but as the condition progresses, pelvic prolapse symptoms become more noticeable. The most common signs include:
Physical Sensations
- Feeling of pelvic pressure or heaviness
- Sensation that something is “falling out” of the vagina
- Visible or palpable bulge in the vaginal area
- Lower back pain that worsens throughout the day
Urinary Symptoms
- Difficulty starting urination
- Incomplete bladder emptying
- Urinary incontinence or leakage
- Frequent urination
Bowel and Sexual Health Issues
- Difficulty with bowel movements
- Need to manually support the perineum during defecation (splinting)
- Pain or discomfort during sexual intercourse
- Difficulty inserting tampons
When Symptoms Worsen Most women notice that symptoms are worse at the end of the day, after prolonged standing, or during physical activity. Symptoms typically improve when lying down or resting.
Understanding Your Risk Factors
While pelvic organ prolapse can affect women of all ages, certain factors significantly increase your likelihood of developing this condition:
Age and Life Stage
- Prevalence increases with age, peaking at 5% in women aged 60-69
- Menopausal and postmenopausal women face higher risks
- Risk continues to increase until menopause, then stabilizes
Reproductive History
- Women who have given birth vaginally face the highest risk
- Risk increases with each subsequent delivery
- Even women who have never given birth can develop prolapse (17% of cases)
Lifestyle and Health Factors
- Obesity significantly increases risk (obese women are 2.9 times more likely to experience progression)
- Chronic medical conditions causing increased abdominal pressure
- Occupations requiring heavy lifting
- Genetic predisposition to connective tissue weakness
Demographic Considerations
- White and Hispanic women experience higher rates than other ethnic groups
- Socioeconomic factors may influence both risk and access to treatment
Taking Control of Your Pelvic Health
Understanding what is pelvic organ prolapse is the first step toward addressing this common but treatable condition. If you’re experiencing symptoms of pelvic pressure, vaginal bulging, or urinary difficulties, know that you’re not alone—and more importantly, effective treatments are available.
At St. Pete Urology, our experienced urologists specialize in comprehensive pelvic health care, offering both conservative treatments like pelvic floor physical therapy and pessaries, as well as advanced surgical options when appropriate. We understand that discussing these symptoms can feel uncomfortable, but our compassionate providers create a supportive environment where you can feel confident seeking the care you need.
Don’t let pelvic organ prolapse limit your quality of life. Early intervention often leads to better outcomes and can prevent progression of symptoms. Contact St. Pete Urology today at (727) 478-1172 to schedule a consultation with one of our pelvic health specialists and take the first step toward reclaiming your comfort and confidence.
References:
- American College of Obstetricians and Gynecologists. (2017). Pelvic organ prolapse. American Family Physician, 96(3), 179-185. https://www.aafp.org/pubs/afp/issues/2017/0801/p179.html
- Nygaard, I., Barber, M. D., Burgio, K. L., Kenton, K., Meikle, S., Schaffer, J., … & Pelvic Floor Disorders Network. (2008). Prevalence of symptomatic pelvic floor disorders in US women. JAMA, 300(11), 1311-1316. https://jamanetwork.com/journals/jama/fullarticle/182572
- Wu, J. M., Hundley, A. F., Fulton, R. G., & Myers, E. R. (2009). Forecasting the prevalence of pelvic floor disorders in US women: 2010 to 2050. Obstetrics & Gynecology, 114(6), 1278-1283. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9521163/
- Barber, M. D., & Maher, C. (2013). Epidemiology and outcome assessment of pelvic organ prolapse. International Urogynecology Journal, 24(11), 1783-1790. https://www.mayoclinicproceedings.org/article/S0025-6196(21)00699-6/fulltext
