Prolapse: What It Is and How to Prevent It

A Women’s Health Physio Perspective

Pelvic organ prolapse is a common condition that affects many women, particularly after childbirth or during and after menopause. It occurs when one or more pelvic organs—such as the bladder, uterus, or bowel—drop from their usual position due to a loss of support from the pelvic floor. The good news? There are simple, effective ways to prevent and manage prolapse.
As women’s health physiotherapists, we’re here to guide you through these strategies so you can stay active, strong, and confident.

Why Pregnancy and Menopause Increase Risk

Pregnancy and vaginal birth place significant strain on the pelvic floor muscles, ligaments, and connective tissues. The growing baby adds weight and pressure, and prolonged or assisted deliveries (forceps or vacuum) can further impact the pelvic floor.

Menopause, on the other hand, contributes to prolapse due to a drop in oestrogen levels. Oestrogen keeps pelvic tissues strong and elastic. With hormonal decline, tissues can weaken, making prolapse more likely or worsening existing symptoms.

What Are the Types of Prolapse?

There are several types of pelvic organ prolapse:

• Anterior vaginal wall prolapse: Bladder prolapse into the front vaginal wall
• Posterior vaginal wall prolapse: Bowel prolapse into the back vaginal wall
• Uterine prolapse: Uterus descending into the vaginal canal
• Vaginal vault prolapse: Vaginal top falling post-hysterectomy

How to Prevent Prolapse

1. Strengthen Your Pelvic Floor

Regular pelvic floor exercises are one of the best ways to prevent prolapse. These muscles are vital for supporting your pelvic organs. If you’re unsure whether you’re doing them correctly, book an appointment with a pelvic health physiotherapist for personalised guidance.

2. Avoid Excess Intra-Abdominal Pressure

Chronic straining from constipation, heavy lifting, or persistent coughing increases pressure on your pelvic floor. Support your body by:

• Managing constipation with fibre and fluid
• Learning proper lifting techniques
• Addressing underlying issues like chronic cough or allergies

3. Improve Posture and Core Control

Your posture and breathing impact how pressure is distributed through your core. A well-functioning core includes the diaphragm, deep abdominals, back muscles, and pelvic floor. We can help you:

• Use breathing techniques to reduce downward pressure
• Improve posture during daily tasks
• Move in a pelvic floor-friendly way

4. Maintain a Healthy Weight & Stay Active

Carrying extra weight increases pelvic pressure. A small weight reduction can relieve symptoms and reduce strain on your pelvic floor.
Staying active supports your pelvic health. Low-impact exercises like walking, swimming, cycling, Pilates, and yoga can be great options. These improve circulation, bowel function, muscle tone, and mental wellbeing.

Already Experiencing Symptoms?

If you’re noticing heaviness, bulging, or discomfort, there are several ways we can help. Treatment options range from conservative to surgical, depending on your symptoms and goals.

1. Do Nothing (“Watch and Wait”)

Yes, this is an option! Monitoring symptoms while staying active and making lifestyle changes can help. Continue pelvic floor-friendly movement like walking or Pilates, or choose other activities you enjoy.

2. Lifestyle Modifications

This is often the first line of treatment:

• Improve bowel health and toilet positioning
• Avoid heavy lifting or use safe techniques
• Manage chronic cough or smoking
• Practise correct breathing patterns
• Address bladder leakage or pelvic floor symptoms

These changes empower you to take control of your pelvic health.

3. Pessary Support

A pessary is a small, removable device inserted into the vagina to support the prolapsed organs. It can:

• Reduce symptoms like heaviness or leakage
• Be worn daily or during specific activities
• Be fitted and managed by your pelvic health physio

Pessaries are a safe, non-surgical option. We help you find the right size and teach you how to manage it confidently.

4. Surgery

Surgery may be appropriate if symptoms are severe or conservative treatments haven’t worked. It aims to restore support to the vaginal walls and pelvic organs.

Important to know:

• Surgery is not a quick fix and requires recovery
• Pre- and post-operative physio improves outcomes and reduces risk of recurrence

Final Thoughts

Prolapse is common, but it’s not something you just have to live with. Whether you want to prevent issues, manage early signs, or explore treatment, a women’s health physio can help.
We offer personalised care to support you at every stage. If you’re unsure where to begin, reach out. We’re here to help you feel strong, confident, and supported from the inside out.

Written by Sydney Rutty
Women’s Health Physiotherapist at PhysioFemina