A feeling of pressure or heaviness in the vagina, discomfort during everyday activities or noticing a bulge can be concerning. These changes may be signs of vaginal prolapse, a condition in which one or more pelvic organs move downwards from their usual position.
This condition falls under the broader term pelvic organ prolapse. It can affect women differently. Some may have mild changes with few or no symptoms, while others may experience symptoms that interfere with daily activities, bladder or bowel function or sexual comfort.
Having a prolapse does not automatically mean that surgery is needed. Treatment depends on the type of prolapse, the symptoms it causes and how much they affect your daily life. Understanding the condition can help you know what treatment options may be available.
The pelvic floor is made up of muscles and supporting tissues that help hold organs such as the bladder, uterus and rectum in their normal positions. When these supporting structures weaken or stretch, one or more pelvic organs can move downwards and create a bulge into or through the vagina.
This is known as pelvic organ prolapse. The type of prolapse depends on which organ or part of the vaginal wall has lost support. The degree of prolapse can also vary, and not everyone with prolapse experiences troublesome symptoms.
Pelvic organ prolapse can involve different structures, and more than one type may occur at the same time.
A cystocele, also called anterior vaginal wall prolapse, occurs when the bladder bulges into the front wall of the vagina because the supporting tissues have weakened.
Uterine prolapse occurs when the uterus descends from its usual position towards or into the vagina as its supporting structures weaken.
A rectocele, or posterior vaginal wall prolapse, occurs when the rectum bulges into the back wall of the vagina. This is different from rectal prolapse, in which part of the rectum protrudes through the anus.
Vaginal vault prolapse can occur after a hysterectomy when the upper part of the vagina loses support and descends towards or into the vaginal canal.
Identifying the type and extent of prolapse helps your gynaecologist understand which structures are affected and consider the most appropriate management options.
Some women with pelvic organ prolapse have few or no symptoms, particularly when the prolapse is mild. When symptoms occur, they can vary depending on the type and extent of prolapse.
Possible vaginal prolapse symptoms may include:
● A feeling of pressure, heaviness or dragging in the vagina or pelvis
● Feeling or seeing a bulge in or around the vaginal opening
● Discomfort during sex
● Difficulty emptying the bladder or other urinary problems
● Difficulty with bowel movements
Symptoms may become more noticeable after prolonged standing or physical activity. Symptom presence or severity does not always match the extent of prolapse, which is why an examination helps identify the cause.
Women often have questions about vaginal prolapse causes, particularly whether childbirth, ageing or other changes to the pelvic floor may have contributed.
Several factors can weaken or stretch the structures that support the pelvic organs. These may include:
● Pregnancy and vaginal childbirth
● Ageing and changes associated with menopause
● Chronic constipation and repeated straining
● Persistent coughing
● Increased pressure within the abdomen
● Previous pelvic surgery
● Differences in connective-tissue strength
Having one or more of these factors does not mean that prolapse will necessarily develop. Each factor affects people differently, and several may contribute over time.
Diagnosis usually begins with a discussion of your symptoms, medical history, and how the changes affect your daily life. Your gynaecologist will also usually perform a pelvic examination to assess which pelvic organs are involved and the extent of the prolapse.
During the evaluation, you may be asked about bladder or bowel difficulties if they relate to your symptoms. Further tests are not necessary for everyone but may be recommended when additional information is needed to understand particular urinary, bowel or other pelvic concerns.
Yes. Surgery isn't always necessary, especially when symptoms are mild or can be managed effectively with non-surgical approaches. The best option depends on the type and extent of prolapse, your symptoms, and how much they affect your daily life.
Non-surgical vaginal prolapse treatment may include:
● Pelvic floor muscle training: Exercises guided by an appropriately trained healthcare professional can help strengthen the muscles that support the pelvic organs and may improve some symptoms.
● Vaginal pessary: A removable device placed inside the vagina can provide support to the prolapsed organs and help manage symptoms without surgery.
● Managing contributing factors: Addressing constipation, repeated straining or persistent coughing, where relevant, may help reduce additional pressure on the pelvic floor.
Regular follow-up may be recommended depending on the treatment being used and how your symptoms change over time.
Surgery may be considered when prolapse symptoms are significant, interfere with daily activities or have not improved sufficiently with non-surgical treatment. The decision is based on how the prolapse affects you, not its extent alone.
If you are considering surgery, your gynaecologist will assess the type and extent of prolapse, the structures involved, your overall health, and your individual needs and preferences. Different surgical procedures are available depending on which organs require additional support.
Surgery is therefore not automatically required for pelvic organ prolapse. Discuss the potential benefits, risks, and expected outcomes before deciding whether surgery is appropriate.
Vaginal prolapse treatment can involve different approaches, and there is no single option that is appropriate for everyone. Treatment generally aims to relieve troublesome symptoms and improve day-to-day comfort and function.
Your gynaecologist can discuss the benefits and limitations of the available options based on the type of prolapse, your symptoms, overall health and what matters most to you. Treatment may also change over time if your symptoms or needs change.
Vaginal prolapse can affect women in different ways, and having prolapse does not necessarily mean that treatment or surgery is immediately required.
If symptoms affect your comfort or daily activities, a gynaecological evaluation can clarify what is happening and guide you toward an appropriate management approach.
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Vaginal prolapse is usually caused by weakened or stretched pelvic floor muscles and supporting tissues. Factors such as pregnancy and vaginal childbirth, ageing, menopause, chronic constipation, repeated straining, persistent coughing and previous pelvic surgery may contribute. Prolapse often develops due to a combination of factors rather than one specific cause.
Common vaginal prolapse symptoms may include pelvic or vaginal pressure or heaviness, a feeling or visible bulge around the vaginal opening, discomfort during sex and difficulties with bladder or bowel function. Some women with mild prolapse may have few or no symptoms.
Yes. Depending on the symptoms and type of prolapse, non-surgical treatment may include pelvic floor muscle training or a vaginal pessary. Addressing contributing factors such as constipation or persistent coughing may also be helpful. Surgery is not necessary for everyone with prolapse.
Surgery may be considered when symptoms are troublesome, affect daily activities or have not improved sufficiently with non-surgical treatment. The decision also considers the type and extent of prolapse, overall health, and individual needs and preferences.
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