Vaginal prolapse, also known as pelvic organ prolapse, occurs when one or more of the pelvic organs drop down towards the vaginal wall. Vaginal prolapse is named based on the organ that has dropped down. This includes the bladder, uterus, rectum, and/or small intestine. The degree of vaginal prolapse is based on the level of downward movement for each particular organ.

The degree of vaginal prolapse is staged from stage 1 (mild) to stage 4 (severe). There is much controversy over whether or not stage 1 prolapse should even be considered prolapse. This is because up to 50% of normal, healthy, 20 years olds that have never had children, technically have stage 1 prolapse.

It is important to understand that just because one has vaginal prolapse does not mean that there is anything wrong with the organ itself. It is simply that the ligaments supporting the organ are not functioning properly.

Vaginal prolapse can be accompanied by any of the following symptoms:

• Vaginal bulge

• Pelvic or vaginal pressure or heaviness

• Need to use support from your hand to either urinate or have a bowel movement

• Pain with deep penetration during sexual intercourse

• Low back ache or pain

• Increased bleeding, discharge, or infections

Typically, the vaginal prolapse doesn’t cause sharp pain. It is more of a feeling of heaviness or general discomfort. There are several risk factors that can put one at more of an increased risk of developing or worsening prolapse.

Risk factors for developing prolapse include:

• Consistent, repetitive heavy lifting

• Reoccurring cough or respiratory illness

• Forceps delivery

• Pelvic floor muscle weakness

• Pregnancy

• Collagen deficiency conditions such as ehlers danlos syndrome

• Obesity

It is important to note that the degree of symptoms doesn’t always correlate with worsening of the vaginal prolapse. For example, if you have severe heaviness, it doesn’t mean that your prolapse is more severe.

Treatment for vaginal prolapse should always involve a pelvic floor physical therapist. Your pelvic floor physical therapist can help determine the degree of vaginal prolapse, and help you determine some of the factors that might be contributing to it.

Treatment will differ depending on your individual risk factors and symptoms. For example, a patient who experienced worsening of symptoms after a forceps delivery typically has a different type of prolapse than someone who experienced prolapse as a result of pregnancy.

If you are struggling with prolapse, please give us a call. We’d be happy to help walk you through your options.

More resources for prolapse:

• What Is Prolapse? A Guide to Understanding Prolapse, Causes and Treatment