Pelvic Organ Prolapse

Nov 10

Let's Talk About What's Going On Down There

Have you ever felt heaviness, pressure, or a strange bulging sensation in your vagina? Maybe you've noticed something feels different when you're exercising, lifting your kids, going to the bathroom, or even wiping.

Let's talk about something that affects many women but isn't discussed nearly enough: pelvic organ prolapse (POP).

Prolapse happens when the muscles, ligaments, and connective tissues supporting your pelvic organs become stretched or weakened, allowing one or more organs to shift downward and bulge into the vaginal walls or toward the vaginal opening.

This does not automatically mean surgery is in your future.

There are effective, conservative ways to manage symptoms, improve support, and help you feel more comfortable and confident.

Meet the Three Main Types of Pelvic Organ Prolapse

1. Cystocele aka Bladder Prolapse

A cystocele occurs when the bladder drops downward and bulges into the front wall of the vagina.

You might notice:

Vaginal pressure or heaviness
A feeling that something is falling out
Difficulty emptying your bladder completely
Urinary leakage or increased urgency

2. Rectocele aka Posterior Vaginal Wall Prolapse

A rectocele happens when the rectum bulges into the back wall of the vagina.

You might notice:

Difficulty completely emptying your bowels
A sensation of stool getting stuck
Needing to press on the vaginal wall or perineum to help have a bowel movement
Vaginal heaviness or pressure

3. Uterine Prolapse aka Uterus Descending

Uterine prolapse occurs when the uterus descends into the vaginal canal because its supporting structures are no longer providing adequate support.

You might notice:

A dragging or heavy sensation in the pelvis
A visible or palpable vaginal bulge
Pressure that worsens after prolonged standing
Discomfort during certain activities

Here's the important part: These conditions can occur individually or together, and symptoms don't always match the severity of the prolapse.

What Can Pelvic Floor Physical Therapy Do for Prolapse?

You Have Options Beyond "Just Do Kegels"

Pelvic floor physical therapy is about much more than strengthening muscles.

At PhysioCore, we look at the whole picture: how your pelvic floor coordinates with your breathing, abdominal muscles, posture, movement patterns, and everyday activities.

Depending on your individual needs, treatment may include:

Improving pelvic floor strength, endurance, and coordination. Learning how to properly activate and relax your pelvic floor muscles.
Managing abdominal pressure. Understanding how breathing and movement affect pressure on your pelvic organs during lifting, exercise, and everyday activities.
Addressing constipation and straining. Learning bowel habits and strategies that reduce unnecessary pressure during bowel movements.
Building confidence with movement. Finding ways to return to activities you enjoy, including strength training and exercise.
Exploring additional conservative options. Discussing support devices, such as vaginal pessaries, when appropriate, in coordination with your medical provider.

The goal isn't always to make prolapse disappear. It's to reduce symptoms, improve function, and help you get back to doing the things you love.

And yes, many women with prolapse can continue to exercise, lift weights, run, and live active lives with individualized guidance.

Does Having Prolapse Mean You Need to Stop Exercising?

One of the biggest misconceptions I hear is that a prolapse diagnosis means you need to stop exercising or avoid lifting anything heavy.

That simply isn't true for everyone.

Your pelvic floor needs to be able to respond to the demands of everyday life. With the right assessment, education, and treatment plan, we can work toward helping you move with confidence rather than fear.

You deserve answers, not just restrictions.