middle aged women walking through a field


She felt growing pressure “down there” for the last couple days, but thought nothing of it. She was busy with work and traveling nearly every weekend. But one afternoon, the pressure was intense. She was taking a shower when she felt something bulging out of her vagina. It was about the size of a golf ball.

Rachel panicked—the last time something came out of her vagina, it was a baby. But this, this was different. Rachel is a smart, educated and rational woman, in her mid-50s, but was thinking, “what is going on!?”

Shaking, she used her hand to feel her vagina. Rachel froze—terrified. She felt something smooth, soft yet firm pressing down through her vagina. She had no idea what was happening to her. Or, what was coming out of her body—her bladder.

Panicking, she googled her symptoms and saw, with some relief, what it was: pelvic organ prolapse.


What is it?

In short, pelvic organ prolapse (POP) happens when your pelvic organs drop down because your pelvic floor muscles can’t support them anymore. Your pelvic floor muscles keep your pelvic organs, (the uterus, rectum and bladder), where they belong. These muscles aren’t talked about a lot, but pelvic floor muscles truly matter.

Over time, the pelvic floor muscles weaken, causing the organs they support to drop down towards the vagina. Rachel was experiencing cystocele prolapse (bladder), but there are two other kinds of prolapse as well— uterine (uterus) and rectocele (rectum).

POP is also categorized as symptomatic and asymptomatic. Since Rachel felt her bladder coming out of her vagina, she had symptomatic POP, and a severe case. Most women experience asymptotic POP, when your pelvic muscles are weak, but your pelvic organs aren’t dropping down all the way into the vaginal opening.

This is not a life-threatening condition, and luckily there are effect treatments. But it’s uncomfortable, awkward, and embarrassing to talk about. It can also be scary if you don’t know what is happening with your body.

Somewhere between 25 and 45 percent [of women] experience symptoms, only about a quarter of women bring it up with a healthcare professional. And doctors don’t bring it up with women,” Dr. Yael Swica, Clinical Assistant Professor of Family Medicine at Columbia University, told the Huffington Post.

According to Harvard Women’s Health Watch, symptoms of POP include:

  • Pain or pressure in the pelvis, the lower back, or both
  • Urinary problems, like urine leaking or the feeling that you need to constantly urinate
  • Constipation
  • Painful sex

If you are experiencing one of the symptoms above, please seek medical care and a proper evaluation, by contacting your practitioner and thoroughly discussing treatment options.



Treatment depends on which type of prolapse you have, and the level of severity. The goal with all treatment is to strengthen the pelvic floor muscles so your pelvic organs will (hopefully) sit back where they belong.

“Women think this is part of aging, because no one talks about it. Don’t let it go and let it get worse, because all this is treatable—very treatable,” Dr. Yael Swica said.

Some common, noninvasive treatments include physical therapy, Kegels, a diaphragm, or a pessary, (a device inserted into the vagina, made of silicone, that provides structural support). Sometimes, prolapse surgery is needed. In prolapse surgery, the surgeon works to repair the connective tissue and ligaments that hold your muscles together.

Pelvic organ prolapse can happen to a woman if she has a regular menstrual cycle, in menopause or in perimenopause. However, risk factors for POP include: vaginal childbirth, urinary or fecal incontinence, and obesity.



One of the best ways to prevent pelvic organ prolapse is to build your pelvic floor muscles. POP and other pelvic floor disorders are the result of weakened pelvic muscles. It does not develop overnight. Symptoms like those mentioned above, are precursors to a more serious case of POP. Prevention and education are key!

  • Talk to your doctor if you are experiencing urinary incontinence (bladder leakage), fecal incontinence (bowel leakage), or any pelvic pain or pressure.
  • Share what you know with other women. It can be a sensitive topic to bring up, but it is necessary to talk about it and educate others.
  • Find a way to build and strengthen your pelvic floor muscles.

You don’t wait until you have cavities or a root canal to start taking care of your teeth, do you? Neither should you wait for POP symptoms to show before you begin building your pelvic floor muscles. Regular pelvic floor exercise can become part of your everyday life. But, it’s hard to begin when you don’t know where to start.

Learn more about how to strengthen your pelvic floor muscles through Kegels 2.0.

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