Pelvic organ prolapse is when the bladder, uterus or bowel drops down and presses into the vagina, often causing heaviness, dragging or a bulge. See a pelvic floor physiotherapist if you notice these symptoms, especially after childbirth. A large randomized trial found that one-to-one pelvic floor muscle training reduced prolapse symptoms compared with advice alone.
Key Takeaways
- Prolapse happens when pelvic organs drop and press into the vaginal walls, usually because the supporting tissues and muscles have weakened.
- Common signs are heaviness or dragging in the pelvis, a bulge, and symptoms that get worse at the end of the day.
- It is strongly associated with childbirth and increasing age, and it is common.
- In the POPPY trial, women who had one-to-one pelvic floor muscle training reported fewer prolapse symptoms at 12 months than women who received a lifestyle advice leaflet alone.
- A pelvic floor physiotherapist assesses your muscles and builds an individual plan, including how to lift and exercise safely.
In This Article
Pelvic organ prolapse is when the bladder, uterus or bowel drops down and presses into the vaginal walls, often causing heaviness, dragging or a bulge. If you notice those symptoms, especially after having a baby, it is time to book a pelvic floor physiotherapist.
Prolapse is common and treatable, and the earlier you get it assessed, the more options you have.
What Pelvic Organ Prolapse Is
Your pelvic organs are held in place by a hammock of muscles, ligaments and connective tissue. When that support weakens, one or more organs can slip down into the vagina. There are three main types:
- Front wall (bladder): the bladder presses into the front of the vagina.
- Back wall (bowel): the rectum presses into the back of the vagina.
- Top (uterus): the uterus moves down into the vaginal canal.
The POPPY trial authors open their paper with a plain summary: "Pelvic organ prolapse is common and is strongly associated with childbirth and increasing age." Heavy lifting, long-term constipation and a chronic cough can also add strain over time.
Signs It's Time to See a Pelvic Floor Physio
Book an assessment if you notice any of these:
- a feeling of heaviness, dragging or pressure in the vagina or pelvis
- a bulge or "something coming down", sometimes felt or seen when you wipe
- symptoms that are worse at the end of the day or after standing for a long time
- trouble emptying your bladder or bowel fully
- leaking when you cough, sneeze or exercise
- discomfort during sex, or feeling looser than before
Some people only notice symptoms when they return to running or lifting after birth. Others feel them during pregnancy or later in life. Either way, the next step is the same: get it assessed rather than wait.
See your doctor promptly if you have bleeding, you cannot pass urine, or you have a bulge that will not go back in.
What the Research Says About Pelvic Floor Training
The POPPY trial, published in The Lancet in 2014, randomly assigned 447 women with newly diagnosed, symptomatic prolapse to either an individualised programme of pelvic floor muscle training or a prolapse lifestyle advice leaflet. At 12 months, the women who had one-to-one training reported fewer prolapse symptoms. The authors concluded that "one-to-one pelvic floor muscle training for prolapse is effective for improvement of prolapse symptoms."
The key word is individualised. A generic list of exercises is not the same as a plan built from an assessment of your own muscles.
What Pelvic Floor Physiotherapy for Prolapse Involves
Your first appointment is private and unhurried. It usually covers:
- A conversation. Your symptoms, pregnancies and births, bladder and bowel habits, and the activities you want to get back to.
- An assessment. How your pelvic floor muscles contract, relax and coordinate with your breathing. An internal exam gives the clearest picture, but it is always explained first and only done with your consent.
- A plan. Pelvic floor muscle training matched to what the assessment found, plus practical changes to daily life.
Those practical changes often matter as much as the exercises: how to breathe and brace when you lift a car seat or a laundry basket, how to manage constipation, and how to build exercise back up without making symptoms worse. If a support device called a pessary might help, your physiotherapist can refer you to your doctor to discuss it.
Prolapse and Getting Back to Exercise
A prolapse diagnosis does not have to mean giving up exercise. Many people keep training with changes to load, breathing and technique, and build up from there. If leaking is your main symptom, our guide to stress incontinence and pelvic floor physiotherapy covers that side.
After birth, a rehab-first program like GROWCO postnatal rehab is a good bridge between physiotherapy and group classes. When you are ready, a class built for moms such as Fit Mom Club lets you train with your kids nearby.
Pelvic Floor Physiotherapy at Anchor in Keswick
Pelvic floor physiotherapy at Anchor Health & Fitness offers private, compassionate care for prolapse, incontinence, pelvic pain and postpartum recovery. You do not need a referral to book, and physiotherapy is covered by most extended health benefit plans, with direct billing where possible.
Contact us or call (905) 535-4449 to book an assessment. We are on The Queensway South in Keswick, a short drive from Sutton, Jackson's Point and Pefferlaw.
References
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No referral needed. Most extended health benefit plans provide coverage, and we direct bill where possible.