Better Me

What Is Pelvic Organ Prolapse and What You Can Do About It

Do you feel pressure down below when you jog, run or do jumping jacks? Do you even cross your legs when you sneeze or cough for fear you’ll tinkle a little?

This isn’t something you commonly talk about with your friends over coffee, but pelvic organ prolapse, or POP, is an uncomfortable type of pelvic floor disorder that affects about one third of people in their lifetime. While it doesn’t usually pose a major health issue, POP can be embarrassing for some and hinder quality of life.

Don’t suffer in silence. Read on to learn more about POP and a variety of solutions and treatments that can help.

What is pelvic organ prolapse?

POP is a type of pelvic floor disorder that occurs when one or more of your pelvic organs drop from their normal position in your pelvic cavity.

“The pelvic floor consists of sheets of muscles that form a bowl-shaped structure that directly supports the pelvic organs, which include the uterus, ovaries, bladder and rectum, and provides indirect support for other abdominal organs such as the small and large intestines,” said John Heusinkveld, MD, an OBGYN and urogynecologist with Banner Health in Arizona. “When these muscles are damaged, these organs may bulge into the vagina or another organ.”

What are the symptoms of pelvic organ prolapse?

Your symptoms often depend on the organ affected by the prolapse. The three different types of POP are:

  • Cystocele, also known as an anterior vaginal prolapse, occurs when the bladder bulges into the vagina. This is the most common form of prolapse.
  • Rectocele occurs when the rectum protrudes through the back wall of the vagina.
  • Uterine prolapse occurs when the uterus drops into the vagina.

“When your bladder prolapses, for instance, you may experience urinary incontinence, loss of bladder control, or leakage of urine when you laugh, cough, sneeze or run,” Dr. Heusinkveld said. “You may also feel a sensation of something bulging at the entrance of your vagina.”

Other symptoms of POP include:

  • Bladder pain
  • Pain during sex
  • Pressure and/or pain in the lower back, lower belly and groin

What causes pelvic organ prolapse?

For some people, POP is the result of carrying babies for nine months. Pregnancy places considerable strain on the pelvic floor because of the growing size and weight of the uterus.

“During vaginal birth, the birth canal stretches and may tear,” Dr. Heusinkveld said. “Damage to the nerves that control the muscles of the pelvic floor may also occur during the birth process. The combination can lead to protrusions of pelvic organs.”

However, if you’ve never given birth, you can have POP too. It runs in families and can be caused by many factors, including:

  • Obesity
  • Getting older
  • Menopause
  • Pelvic organ cancers
  • Conditions or habits that strain the pelvic floor, such as ongoing constipation and high-impact exercise or jobs that require heavy lifting

What treatment options are available for pelvic organ prolapse?

If your symptoms are mild, your health care provider may recommend you start with conservative treatment, such as physical therapy and Kegel exercises.

“Physical therapy can improve the tone and strength of the pelvic floor muscles and reduce both incontinence and prolapse symptoms” Dr. Heusinkveld said.

Your provider may also recommend you try a small device called a pessary, a device worn inside the vagina to support the pelvic organs. Pessaries are made from silicone and come in different shapes. They are usually fitted to you and are removable.

If you’ve exhausted all conservative treatment options and/or symptoms worsen and affect your quality of life, you may need surgery. “About one in seven in the U.S. will undergo surgery for prolapse at some time in a lifetime,” Dr. Heusinkveld said. “Many patients who have surgery have no further problems.”

The type of surgery you receive will depend on the organ or organ affected. If you have a uterine prolapse, often a hysterectomy is recommended.

Can I prevent a pelvic organ prolapse?

There’s no single way to prevent POP, but there are lifestyle choices that might help reduce your risk of developing it.

To decrease your risk, with the following:

  • Maintain a healthy weight
  • Drink plenty of fluids and include fruits, vegetables, whole grains and other high-fiber foods in your diet. A diet with plenty of fiber and fluids helps to maintain regular bowel movements and decrease risk for constipation and straining.
  • Avoid heavy lifting when possible and try to lift with your legs, instead of your waist or back.
  • Get early treatment for a chronic cough or bronchitis
  • Perform Kegel exercises

Bottom line

You don’t have to live with pelvic organ prolapse or the discomfort that can come with it. Schedule an appointment with your health care provider and explore options to get you back to feeling well.

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