As a women’s health physiotherapist, my goal is to make sure women are informed of the changes that can occur with their bodies in the hope that I can help prevent or reduce their symptoms.

What is pelvic prolapse?

One common problem that I come across is pelvic organ prolapse (POP). This is when either the bladder (cystocele), bowel (rectocele) or uterus (uterine) drops down and pushes into the vaginal wall. As many as 50% of women at some point in their lifetime will have a prolapse.

There are many reasons why women suffer POP. In this article I will explain the symptoms and the lifestyle changes you can make to help reduce them or in turn reduce the likelihood of a prolapse even occurring.

What causes a pelvic organ prolapse?

The pelvic organs are supported by ligaments and the pelvic floor muscles. The pelvic floor muscles sit underneath the pelvic organs, they act like a buoyancy aid and help keep the organs in place. The ligaments then act as an anchor for the uterus.

Certain activities can weaken and lengthen the pelvic floor muscles and ligaments thus allowing the pelvic organs to move down into the vaginal wall.

Activities that weaken the pelvic floor muscles

  • Heavy lifting
  • Being on your feet all day
  • Pregnancy and child birth
  • Anything that makes you have to strain or hold your breath to lift, including constipation
  • Over strenuous abdominal exercises and high impact exercises
  • It is important to reduce the frequency of the above activities especially if you are experiencing any of the POP symptoms.

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Symptoms of pelvic organ prolapse

  • The feeling of pressure or dragging sensation in the vagina.
  • Sensation that something is there for example a misplaced tampon feeling
  • Feeling of incomplete bladder emptying
  • Difficulty emptying your bowels
  • Urinary leaking or urgency

5 ways to lower your risk of pelvic prolapse

Heavy lifting

Make sure you squeeze your pelvic floor muscles before you lift and avoid prolonged periods of lifting, even with lighter weight items.

Being on your feet all day

As the day goes on your pelvic floor muscles get tired and weaker and are less supportive. If you can, have a rest and lie down in the day for 30 minutes to ‘recharge’ your pelvic floor muscles.

Pregnancy and childbirth

A combination of the weight of the baby pushing on the pelvic floor muscles and the hormone ‘relaxin’ lengthening the ligaments means there is no substitute for doing pelvic floor muscle exercises in preparation. Please see an earlier article on how to do these: Your Pelvic Floor is for Life, Not Just for Pregnancy: Must-Have Tips to Avoid Weak Muscles

Straining and constipation

  • Go when you get the urge to go
  • Try get your knees above your hips when you sit down
  • Keep hydrated
  • Seeded fruits such as apricots and nectarines are really good for preventing constipation

Over strenuous abdominal exercises and high impact exercises

  • Planks and certain abdominal exercises such as double table tops with leg reaches can create intra-abdominal pressure which in turn pushes down on the organs, these should be avoided.
  • If you are concerned see a physiotherapist who can make sure you are doing the correct tailored exercises.
  • Running and jumping increases forces going through the PFM and ligaments so try short bursts at a time or low impact cardio work instead especially if you have any symptoms.
  • If you think you may have a prolapse then go to your GP and ask for a referral to a specialist Women’s health physiotherapist where they can examine you.

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By Jenny Constable, Specialist Women’s And Men’s Health Physiotherapist at Six Physio.

Have more questions? Email Jenny:


About The Author

Specialist Physiotherapist

Since qualifying from the University of Hertfordshire in 2007, Jenny has had a wealth of experience treating a wide variety of musculoskeletal, Women's Health and Men's Health conditions. After Qualifying Jenny worked at The Imperial College Healthcare Trust in London for 6 years. This meant working across a variety of settings with some of the leading experts in physiotherapy. It was while working at St Mary's Hospital that her passion for Women's health started. She then spent the next 3 years working at Queen Charlottes and Chelsea Hospital specialising in Women's Health. Women's Health Physiotherapy focuses on ante natal, post natal musculoskeletal conditions and pelvic floor muscle dysfunctions such as prolapse and urinary incontinence. Jenny joined SIX in 2014 where she built up our women's health service at our Harley street clinic. We have now moved to our brand new clinic in Fitzrovia and she is working to build on our women's and now men's health service there. Jenny is passionate to help men and women with conditions that impact their quality of life such as incontinence, pelvic pain and sexual dysfunction. She loves to see their lives change after education, exercise and manual treatments. Jenny has undertaken many postgraduate courses to help further her skills and enable her to choose the best possible treatment for her patients. Some of the courses she has a special interest in are; Pilates, acupuncture and advanced manual therapy for pelvic floor muscle dysfunctions. When not at SIX physio Jenny is kept busy by her 4 year old daughter Abigail and Maddie her 9 month old, oh and don't forget the 3 ponies pixie, Frankie and Mayfair.

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