Have you ever felt a weird fullness or pressure in your vagina? Like something had slipped out of place, perhaps?

You might be experiencing pelvic organ prolapse (POP), a condition where one or more of your pelvic organs (vagina, uterus, bladder, or rectum) drops from its typical position. This occurs when your pelvic floor, which consists of the muscles, ligaments, and tissues that support your pelvic organs, is too weak to hold your organs in place.

While POP can be embarrassing for some people, know that you are not alone: “About 40% of women worldwide will experience pelvic organ prolapse, and with the aging population, this number is expected to increase,” says Dr. Lauren Dickerman, a pelvic floor therapist with over a decade of experience caring for individuals with POP.

The more people understand what POP is, why it happens, and what treatments are available, the more likely the stigma around pelvic organ conditions will decrease.

Pelvic organ prolapse symptoms: How to spot POP

In addition to possibly feeling a fullness or pressure in your vagina, Dr. Dickerman notes that POP-related pressure “can present with or without an observed bulge.” She says other symptoms include potential changes in sexual, urinary, and bowel function:

  • Urinary changes could include incontinence (leakage of urine), urgency, difficulty emptying your bladder, and incomplete bladder emptying
  • Bowel changes could include difficulty passing a bowel movement, straining, incomplete bowel emptying, or splinting (using a hand to help reduce a rectocele, which is a form of POP where the rectum bulges into the vaginal wall)
  • Sexual changes could include pain and/or urinary leakage during sexual activity

If you’re experiencing any of the above symptoms, the next step is to make an appointment with your healthcare provider (preferably a gynecologist or OB/GYN). Your doctor will “take a thorough history, then do a physical assessment or a pelvic exam, where they will observe and feel your pelvic function,” explains Dr. Dickerman. “If they observe a prolapse, they might perform a POP-Q, which is an objective measurement that quantifies the stage or severity of the organ descent.”

The POP-Q uses a “simple measuring stick” to measure “the amount of movement of the suspected organ when a patient bears down in distance towards or beyond the hymen,” continues Dr. Dickerman. Stage 0 means there is no prolapse. Stage 4 (the highest) means “the organ has completely descended out of the vagina.” However, Dr. Dickerman reiterates that one’s prolapse stage “doesn’t necessarily determine presence/level of bother or intensity of your symptoms.”

Once a POP diagnosis is made, Dr. Dickerman says you may be referred to other medical specialists, such as a urogynecologist. She also recommends “advocating for a referral to a pelvic floor physical therapist/occupational therapist.” Dr. Dickerman emphasizes that a “comprehensive care team is helpful for individuals experiencing prolapse to address the physical, functional, and emotional toll that a person may experience.”

What causes pelvic organ prolapse?

Several factors can weaken the muscles and connective tissues that support the internal organs. According to Dr. Dickerman, they include:

  • Pregnancy (“risk increases with increasing number of pregnancies and being pregnant with multiples”)
  • Childbirth (“more significantly vaginal delivery”)
  • Aging
  • Obesity
  • Menopause status
  • Chronic constipation
  • Connective tissue disorders
  • Chronic coughing
  • Pelvic surgery

How to prevent pelvic organ prolapse

While POP “is not entirely preventable,” says Dr. Dickerman, she mentions several ways to lower your risk. In essence, it’s a good idea to adopt specific strategies for protecting your pelvic floor and your overall health. They include:

  • Maximizing your deep core function to protect your pelvic floor
  • Learning how to manage constipation
  • Learning proper toileting strategies to encourage normal bladder and bowel emptying
  • Lifestyle and behavioral strategies to manage your weight
  • Connecting with a pelvic floor specialist for birth prep to ensure readiness for labor and delivery
  • Seeking out medical guidance to maximize hormonal health
  • Being aware of your medical history (such as the presence of connective tissue issues or a change in pulmonary health) to help your healthcare team find strategies to decrease your risk
  • Keeping up with regular medical assessments and finding ways to maximize fitness and wellness to support normal aging

Pelvic organ prolapse treatments

As with many other medical conditions, POP can get worse if left untreated. First of all, says Dr. Dickerman, “the staging of the prolapse could change, e.g., the amount of organ descent.” Also, there’s a potential for “increased pain/discomfort, increased bladder and bowel symptoms, worsening of sexual health, a decrease in [everyday] function, and worsening mental health (from emotional stress, which could impact significant relationships, like being able to be intimate with a partner).

Treatment usually begins with “thorough conservative management,” says Dr. Dickerman. Working with a pelvic floor specialist (either a physical therapist or an occupational therapist) is an excellent first step in this process. These clinicians are “experts in connecting the dots between multiple bodily systems and uniquely skilled in identifying functional causes of prolapse,” says Dr. Dickerman.

Your pelvic floor specialist will begin by performing “a thorough history and physical exam.” Then, continues Dr. Dickerman, they “will tailor a program specific to you, which will include education, lifestyle modifications (such as recommendations to improve bladder, bowel, and sexual function), and specific exercises.”

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Additional treatment options include weight management and the use of a pessary, an intravaginal device that supports your pelvic organs. Pelvic floor specialists can assist with pessary fittings, as well as connect you with nutritionists and/or dietitians.

“If conservative management isn’t enough,” says Dr. Dickerman, “surgery might be indicated and sometimes medications to address hormonal contributors.”

You don’t have to suffer in silence

“There are so many treatment strategies that are available to treat POP,” assures Dr. Dickerman. “Women deserve to be armed with the education and the ability to connect with a highly skilled care team.” So speak with your healthcare provider about connecting with a skilled pelvic floor specialist. “There are so many ways to improve function, quality of life, and overall well-being,” says Dr. Dickerman.

Understandably, a pelvic floor prolapse diagnosis can cause women to feel shame or embarrassment. But by educating ourselves about this condition – and by talking about it more – we can help eliminate its “taboo” status.

Sarene Leeds holds an M.S. in Professional Writing from NYU, and is a seasoned journalist dedicated to reporting on women's health, parenting, mental health, TV, and pop culture. Her work has appeared in HuffPost, Rolling Stone, The Wall Street Journal, Vulture, SheKnows, and numerous other outlets. Subscribe to her Substack, the Critical Communicator, and follow her on Instagram, BlueSky, or Threads.