Pelvic Organ Prolapse has been defined as the the descent of one of more of the anterior vaginal wall, the posterior vaginal wall, the uterus or the apex of the vagina. Physiotherapy can help with diagnosing and managing the symptoms of Pelvic Organ Prolapse.


This downward movement of the pelvic organs may be accompanied by symptoms and these are the symptoms that lead women to  look for an assessment and treatment:

A feeling of pressure or fullness in your vagina/ rectum or both, worsening as the day goes on

A vaginal bulge

Difficulty emptying your bowels, chronic constipation

Urinary Issues e.g incontinence of frequency

Lower Back Pain

Difficulty retaining a tampon

The most common groups of people to experience Pelvic Organ Prolapse are those who are pregnant/have just had a baby/ recently returned to exercise after having had a baby and women during menopause. If you are feeling some of the above symptoms and are worried that you may have a prolapse go to see your GP, Gynae or Chartered Physiotherapist who is specialised in Women’s Health.


1. Don’t worry. Make sure you have a check-up first to make sure that you actually do have prolapse and make sure that you ask the person who diagnosed you for a referral to a Chartered Physiotherapist.Make sure you ask them to explain their findings to you. Don’t spend too much on Google.

2. Think about your day. Most people with a Pelvic Organ Prolapse will report that their symptoms are worse as the day goes on so see if there are things that you are doing that are aggravating your symptoms. These are usually activities that involved loading your pelvis and pelvic floor e.g lifting, walking, running, pushing buggies, putting babies’ car seats into the car, hoovering, housework and high intensity exercise. Try to identify the activities or daily patterns that make your symptoms worse or better.

3. Try to aim for a symptom free day by reducing activities such as those listed above. This may mean avoiding all housework, exercise, lifting etc for a few days. If you can do this it shows that your Pelvic Organs know where to be, but they are not able for extra strain at present. A little bit like a sports injury your pelvic organs may have become overloaded with lots of different loading factors and may needed a rest. Start your pelvic Floor exercises to build up the support under your pelvic floor organs and as your symptoms improve increase your core strengthening, very gradually increase your daily strains but only as your symptoms allow. If your aim is to return to high intensity exercise make sure you get good advice about returning to exercise from a professional with experience in Women’s Health

4. When I say start your pelvic Floor Exercises, I mean start doing them properly! It will never be a bad idea to get your pelvic Floor checked by a Chartered Physiotherapist, at any point in your adult life. It will mean that the exercises that you are doing are of good quality and it will lead to better decision-making when decide down the line whether the exercises worked for you or not.

5.Avoid Constipation and Straining to pass stools. Follow a balanced diet that suits you. Try to keep regular, drink plenty of water, eat a balanced diet and try to avoid pushing and straining when you are sitting on the toilet. Lean forwards on the toilet or use a foot stool for a good emptying position. Avoiding Constipation is one of the most important parts of Prolapse management. 


Sometimes Pelvic Organ Prolapse can be managed long-term by identifying the activities that allow you personally to get through your day without symptoms and modifying these activities. However, there are different stages of Pelvic Organ Prolapse and not all Prolapse can be managed by Pelvic Floor Exercises, lifestyle modification and core strenthening. You may need to use a pessary support. Currently it is mostly GP’s and Gynaecologists who assess and fit pessaries; however some Chartered Physiotherapists are providing this service also. If the physiotherapist you are attending does not fit pessaries she will refer you to a professional who does. A pessary is a supporting device that is inserted vaginal and that acts like a little shelf or extra support to keep your pelvic organs lifted. This can allow you to do your daily tasks and exercises without fear of symptoms. There are so many different types of pessaries, it is mind-boggling! However, with trial and error many people find the perfect pessary for them.





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