Pelvic Organ Prolapse: Symptoms, Causes, Stages, and Treatment Options

Pelvic organ prolapse happens when weakened pelvic floor muscles and supporting tissues allow one or more pelvic organs to drop from their normal position. Symptoms can range from pelvic pressure and a vaginal bulge to bladder or bowel changes. Treatment depends on the type and severity of prolapse and may include pelvic floor strengthening, pessaries, lifestyle changes, or surgery.

Updated: August 15, 2026
Author: Elidah Medical Staff

Pelvic organ prolapse pelvic prolapse

Most women who’ve given birth know about basic pelvic floor health and the wonders Kegels can do, but pelvic organ prolapse (POP) may not be as familiar a term. Even though up to 40% of women develop some form of pelvic prolapse, many do not discuss prolapse with their clinicians until symptoms are well developed.

Types of pelvic organ prolapse

Table of Contents

What Is Pelvic Organ Prolapse?

Pelvic organ prolapse (POP) occurs when the muscles and connective tissues that support the pelvic organs weaken or stretch, allowing one or more organs to descend toward or into the vagina.

The pelvic floor acts like a supportive hammock beneath the bladder, uterus, rectum, and other pelvic structures. When that support system weakens, these organs can shift downward and create pressure, a bulging sensation, or changes in bladder and bowel function.

Pelvic organ prolapse is common, particularly after childbirth and with aging. Some women have mild prolapse without noticeable symptoms, while others experience discomfort that interferes with exercise, bladder control, bowel movements, or daily activities.

Types of Pelvic Organ Prolapse

Pelvic organ prolapse can involve different organs depending on which area of support has weakened.

  • Cystocele or bladder prolapse: The bladder pushes into the front wall of the vagina.
  • Rectocele: The rectum bulges into the back wall of the vagina.
  • Uterine prolapse: The uterus descends into the vaginal canal.
  • Vaginal vault prolapse: The top of the vagina loses support, sometimes after hysterectomy.
  • Enterocele: The small intestine pushes downward into the upper vaginal wall.

A woman can also have more than one type of prolapse at the same time.

Symptoms and Stages of Pelvic Organ Prolapse

Symptoms often depend on how far the organ has descended and which structures are involved. Common signs include:

  • A feeling of pressure, heaviness, or fullness in the pelvis
  • A bulge or sensation of something coming down into the vagina
  • Visible tissue at the vaginal opening
  • Difficulty emptying the bladder completely
  • Urinary urgency or frequency
  • Urine leakage
  • Constipation or difficulty with bowel movements
  • Discomfort during sex
  • Symptoms that worsen after standing for long periods or physical activity

Clinicians generally describe prolapse in stages based on how far the affected organ has descended. Mild prolapse remains higher in the vaginal canal, while more advanced prolapse may reach or extend beyond the vaginal opening.

What Causes Pelvic Organ Prolapse?

Pelvic organ prolapse usually develops from a combination of weakened support tissues and repeated pressure on the pelvic floor.

Common risk factors include:

  • Pregnancy and vaginal childbirth: Delivery can stretch and injure muscles and connective tissues that support the pelvic organs.
  • Aging and menopause: Changes in muscle and connective tissue can reduce pelvic support over time.
  • Chronic constipation: Repeated straining places pressure on the pelvic floor.
  • Chronic coughing: Frequent coughing can repeatedly increase abdominal pressure.
  • Higher body weight: Additional abdominal pressure may increase strain on pelvic support structures.
  • Heavy lifting: Repeated increases in abdominal pressure can contribute in susceptible women.
  • Pelvic surgery: Procedures such as hysterectomy can alter the structures that support the pelvic organs.

If you are noticing other signs of weak pelvic support, see Weak Pelvic Floor Symptoms for more about how pelvic floor weakness can affect bladder control and everyday function.

How Pelvic Organ Prolapse Is Diagnosed

Pelvic organ prolapse is usually diagnosed with a medical history and pelvic examination. Your healthcare provider may ask about pressure, bulging, bladder or bowel symptoms, childbirth history, and activities that make symptoms worse.

During the pelvic exam, you may be asked to cough or bear down so the provider can see how the pelvic organs move under pressure. Additional bladder testing or imaging may be used when symptoms are complex, but many cases can be diagnosed without extensive testing.

Identifying both the type and severity of prolapse is important because treatment for mild symptoms can be very different from treatment for advanced prolapse.

TreatmentWhen It May HelpWhat to Know
Pelvic floor muscle trainingMild prolapse or pelvic floor weaknessCan improve strength and support, but does not physically reposition a prolapsed organ
ElitoneWomen with stress or mixed incontinence and pelvic floor weaknessFDA-cleared external treatment that strengthen pelvic floor muscles
PessaryMild to more advanced prolapseA removable device placed in the vagina to support pelvic organs
Lifestyle changesAny stage, especially when constipation, coughing, or heavy lifting worsen symptomsReducing repeated pelvic pressure may help prevent symptoms from worsening
Pelvic floor physical therapyWhen weakness, coordination problems, or complex symptoms are presentProvides individualized assessment and exercise guidance
SurgeryMore advanced or bothersome prolapse when conservative treatment is not enoughCan restore pelvic support but involves recovery and procedure-specific risks

Treatment Options for Pelvic Organ Prolapse

Treatment depends on how severe the prolapse is, which organs are involved, and how much the symptoms affect daily life. Mild prolapse may be managed without surgery, while more advanced or bothersome prolapse may require a pessary or surgical repair.

For women with mild prolapse or pelvic floor weakness, pelvic floor muscle training can improve strength and support. It is important to understand that strengthening does not physically lift a prolapsed organ back into place, but it may help reduce symptoms and improve pelvic support in appropriate cases.

When Pelvic Floor Strengthening May Help

Pelvic floor strengthening is most useful when weakness is part of the problem and the prolapse is mild enough for conservative management. Kegel exercises are commonly recommended, but they need to be performed correctly and consistently.

For women who also have stress or mixed urinary incontinence, Elitone provides external pelvic floor muscle stimulation and produces 100 contraction and rest cycles during each 20-minute treatment. Elitone is FDA-cleared for stress and mixed incontinence; it is not cleared to correct pelvic organ prolapse itself.

If pelvic pain, painful sex, or difficulty relaxing the pelvic floor is present, strengthening may not be appropriate. See What Is Hypertonicity? for more on an overly tight pelvic floor.

Pessaries and Other Nonsurgical Options

A pessary is a removable device placed in the vagina to support prolapsed pelvic organs. It can be an effective nonsurgical option for women who want to avoid surgery, are not ready for surgery, or need symptom relief while considering other treatments.

Pessaries come in different shapes and sizes and usually need to be fitted by a healthcare provider. Some women manage and clean them on their own, while others return to a clinician for periodic removal and care.

Other conservative strategies may include treating constipation, managing chronic cough, avoiding repeated heavy straining, maintaining a healthy weight, and modifying activities that noticeably worsen symptoms.

When Surgery May Be Needed

Surgery may be considered when prolapse is advanced, significantly affects quality of life, or does not improve enough with conservative treatment.

The type of surgery depends on which organs are involved, whether the uterus is present, sexual activity, overall health, and personal preferences. Some procedures repair the vaginal walls or restore support to the uterus or vaginal vault.

If surgery is being considered, a urogynecologist or other pelvic floor specialist can explain the available procedures, expected recovery, and potential risks and benefits.

Pelvic Organ Prolapse and Bladder Leaks

Pelvic organ prolapse and urinary incontinence often occur together, but one does not always cause the other. A prolapsed bladder may contribute to difficulty emptying, urgency, or other urinary symptoms, while pelvic floor weakness can also contribute to stress leakage.

If you leak when coughing, sneezing, laughing, lifting, or exercising, stress urinary incontinence may be part of the picture. If your main problem is sudden urgency or leaking before reaching the bathroom, overactive bladder may be more likely.

For a broader explanation of these patterns, see The Definition of Incontinence, plus the Best Treatment for Each Type.

Women with prolapse and bladder symptoms may need more than one type of treatment. Strengthening, bladder treatment, pessary use, and surgery can each address different parts of the problem.

Elitone is your easy to use at home solution for incontinence.

Frequently Asked Questions

No. Pelvic organ prolapse becomes more common with age, but it is not something you simply have to accept. Depending on the type and severity, treatment may include pelvic floor strengthening, a pessary, lifestyle changes, pelvic floor physical therapy, or surgery.

Yes. Pelvic organ prolapse can sometimes cause pressure, discomfort, pain during sex, or changes in sensation. Treatment may help improve these symptoms, although sexual changes can also have hormonal, pelvic floor, or other causes.

Your healthcare provider will usually review your symptoms and medical history and perform a pelvic exam. You may be asked to cough or bear down so the provider can see how the pelvic organs move under pressure. The type and stage of prolapse will help guide treatment recommendations.

Yes. Depending on which organs are involved, prolapse can contribute to difficulty emptying the bladder, urinary urgency or frequency, urine leakage, constipation, or difficulty with bowel movements. It is important to tell your provider about all bladder and bowel symptoms, not just the vaginal pressure or bulge.

Yes, some women with a pelvic organ prolapse may not have any symptoms. The condition is sometimes discovered incidentally during a routine gynecological exam, such as a cervical screening test.

Elitone strengthens the pelvic floor muscles, which help support the bladder, uterus, and rectum. Pelvic floor muscle training, including Kegel exercises, may be recommended for women with mild prolapse. If your healthcare provider has recommended pelvic floor strengthening and you also experience stress or mixed urinary incontinence, Elitone can provide external pelvic floor muscle stimulation with 100 contraction and rest cycles during each 20-minute treatment. Elitone does not physically reposition or correct a prolapsed organ.

Elitone is an external, non-invasive treatment, designed for incontinence, but does strengthen the pelvic muscles. It does not require a vaginal probe or anything inserted internally. Because prolapse varies in type and severity, check with your healthcare provider or pelvic floor physical therapist before beginning treatment to confirm that pelvic floor strengthening is appropriate for you.

References

American College of Obstetricians and Gynecologists. Pelvic Support Problems. Accessed August 2026.

American College of Obstetricians and Gynecologists. Surgery for Pelvic Organ Prolapse. Accessed August 2026.

National Institute of Diabetes and Digestive and Kidney Diseases. Cystocele. Accessed August 2026.

National Institute for Health and Care Excellence. Pelvic Floor Muscle Training for the Management of Symptoms. Accessed August 2026.

Weintraub AY, Glinter H, Marcus-Braun N. Narrative Review of the Epidemiology, Diagnosis and Pathophysiology of Pelvic Organ Prolapse. International Brazilian Journal of Urology. 2020;46(1):5–14.

Jones KA, Harmanli O. Pessary Use in Pelvic Organ Prolapse and Urinary Incontinence. Reviews in Obstetrics & Gynecology. 2010;3(1):3–9.

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