Pelvic Organ Prolapse: What It Is & What You Can Do About It

Written By Ashley Gadelha

If you’ve ever felt heaviness in your pelvis, noticed pressure in your vagina, or even had the sensation that “something is falling out,” you may have wondered: could this be prolapse?

Pelvic organ prolapse is more common than most women realize—and while it can feel overwhelming at first, there are evidence-based strategies that make a real difference. Let’s break down what prolapse is, why it happens, and what you can do to feel stronger and more supported.

What Is Pelvic Organ Prolapse?

Pelvic organ prolapse (often shortened to “POP”) happens when the muscles and connective tissue of the pelvic floor are not able to provide enough support for the organs above them—like the bladder, uterus, or rectum.

Instead of staying lifted, one or more of these organs shift downward, pressing into the vaginal wall. In some cases, tissue can even begin to bulge or descend into the vaginal opening.

Why Does Prolapse Happen?

Prolapse isn’t caused by just one thing—it’s usually a combination of factors:

  • Pregnancy & Vaginal Delivery: Carrying and delivering a baby stretches the pelvic floor muscles and connective tissues, sometimes beyond their ability to fully recover.

  • Aging: As we age, our muscles naturally lose some tone and strength. The supportive tissues of the pelvis can also become less elastic over time.

  • Lower Estrogen Levels: Estrogen supports muscle tone and connective tissue. As estrogen declines (especially around perimenopause and menopause), tissues can weaken.

  • Other Factors: Chronic coughing, constipation, repeated heavy lifting, or high-impact activities may increase downward pressure on the pelvic floor.

👉 One important note: menopause itself isn’t an independent risk factor. The changes often associated with menopause—like aging, lower estrogen, and shifts in tissue structure—play a larger role.

Common Symptoms of Prolapse

Every woman’s experience is unique, but some of the most common symptoms include:

  • A feeling of heaviness or pressure in the vagina or pelvis

  • The sensation that something is “falling out”

  • Aching in the vagina, lower abdomen, groin, or low back

  • Bladder control problems when coughing, sneezing, or lifting

  • Difficulty emptying the bladder or bowels completely

  • Needing to use your fingers (“splinting”) to help with bowel movements

  • More frequent urinary tract infections

What You Can Do: Strategies to Support Your Pelvic Floor

The good news? Prolapse symptoms can often be improved—and sometimes significantly reduced—with conservative, non-surgical strategies. Here are a few evidence-based steps you can start today:

1. Learn to Manage Pressure

How you breathe, lift, and move matters. If pressure is constantly pushing downward on your pelvic floor, it can worsen prolapse symptoms.

  • Avoid holding your breath while lifting or straining.

  • Use an exhale with effort strategy: breathe out as you lift, push, or move something heavy.

  • Try to keep your ribcage stacked over your pelvis (instead of slouching or arching) to balance pressure.

2. Breathe Better with 360 Breathing

Diaphragmatic or “360 breathing” helps your diaphragm, core, and pelvic floor work together.

  • Place your hands around your ribcage.

  • Inhale and feel your ribs expand outward, back, and slightly downward—not just up into your shoulders.

  • Exhale gently and let your ribs and belly return, feeling your pelvic floor lightly recoil upward.

This strategy reduces downward pressure and helps retrain pelvic floor coordination.

3. Strengthen with Gentle Core & Pelvic Floor Activation

Targeted strengthening can improve support for the bladder, uterus, and rectum.

  • Practice gentle pelvic floor contractions (Kegels), focusing on a lift-and-release motion.

  • Pair contractions with your breath—exhale as you lift, inhale as you let go.

  • Layer in core exercises that emphasize control and alignment, not high intensity.

(Tip: If you’ve tried Kegels before without success, a pelvic floor physical therapist can help you fine-tune your technique.)

4. Address Constipation & Straining

Chronic straining with bowel movements adds a lot of pressure downward.

  • Stay hydrated and eat fiber-rich foods.

  • Use a stool under your feet to improve toileting posture.

  • Don’t “push hard”—instead, exhale gently and allow your body time to release.

5. Consider Pelvic Floor Physical Therapy

Research strongly supports pelvic PT as an effective, conservative treatment. A pelvic PT can assess your specific needs and give you individualized strategies that work for your body.

Bottom Line

Prolapse doesn’t mean your body is broken. It’s a signal that your pelvic floor needs more support—and with the right strategies, you can reduce symptoms, move with more confidence, and protect your long-term pelvic health.

You don’t have to live with heaviness, leaking, or discomfort. Small, consistent changes can help you feel stronger and more supported in daily life.

👉 Want more strategies? Download my Free Perimenopause & Menopause Guide—your simple starting point for pelvic floor and core support.

Ashley Gadelha
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