Pelvic Organ Prolapse: Causes, Symptoms & How Pelvic Floor Physical Therapy Can Help
Pelvic organ prolapse is a common pelvic floor condition that affects women throughout different stages of life. You may notice pelvic pressure, heaviness, urinary leakage, difficulty with bowel movements, or a sensation that something is “falling out.” For some women, however, pelvic organ prolapse causes few or no symptoms.
While prolapse becomes more common with age, pregnancy, vaginal childbirth, hormonal changes, aging, and changes in connective tissue can all contribute to pelvic organ support.
Understanding why pelvic organ prolapse happens can help you understand what you can do to support your pelvic floor—and why pelvic floor physical therapy may be helpful.
What Is Pelvic Organ Prolapse?
Your pelvic organs—including your bladder, uterus, and rectum—are supported by a combination of muscles, ligaments, and connective tissue.
When these support structures become stretched, weakened, or less effective, one or more pelvic organs can move downward. This is known as pelvic organ prolapse (POP).
There are several types of prolapse depending on which organ is affected, including bladder prolapse (cystocele), uterine prolapse, and rectal prolapse into the vaginal wall (rectocele).
Symptoms may include:
Pelvic pressure or heaviness
A feeling of vaginal bulging or something “falling out”
Urinary leakage or difficulty emptying the bladder
Difficulty with bowel movements or constipation
Discomfort with prolonged standing or physical activity
Pain or discomfort with intercourse
Not every woman with prolapse experiences symptoms, and the severity of symptoms does not always correspond directly with how noticeable the anatomical prolapse is.
When Does Pelvic Organ Prolapse Usually Occur?
Pelvic organ prolapse can occur at any age, but it becomes more common as women get older. Symptoms also become more common around and after menopause.
This does not mean that prolapse suddenly begins at menopause.
Instead, pelvic organ support is influenced by many factors that can accumulate throughout a woman's lifetime. Pregnancy and childbirth, aging, hormonal changes, genetics, bowel habits, body weight, physical activity, and repeated increases in abdominal pressure can all contribute.
A woman may have a vaginal delivery in her 20s or 30s and not experience noticeable prolapse symptoms until decades later.
Why Is Vaginal Delivery a Major Risk Factor?
Pregnancy and vaginal delivery are important contributors to pelvic organ prolapse.
During pregnancy, the pelvic floor supports the increasing weight of the uterus. During vaginal birth, the pelvic floor muscles, vaginal tissues, nerves, and surrounding connective tissues undergo significant stretching and mechanical stress.
Research has demonstrated an association between vaginal birth and an increased risk of pelvic organ prolapse.
However, having a vaginal delivery does not mean you will develop symptomatic prolapse.
Many women have vaginal births without ever developing bothersome prolapse symptoms. Your genetics, number of pregnancies and deliveries, tissue quality, age, bowel habits, physical activity, and many other factors contribute to your individual risk.
What Does Estrogen Have to Do With Pelvic Organ Support?
This becomes particularly important as women approach and move through menopause.
Your pelvic organs are not supported by your muscles alone. Your pelvic floor also relies on ligaments and connective tissue for passive, or “static,” support
Think of your pelvic organ support system as having two major components:
Static support: Ligaments and connective tissue help hold the pelvic organs in their anatomical position.
Dynamic support: The pelvic floor muscles actively contract and respond to movement and changes in abdominal pressure.
As estrogen levels decline during the menopausal transition, changes occur throughout the genitourinary and connective tissues. Estrogen plays an important role in maintaining the health and function of these tissues.
This does not mean that estrogen loss is the sole cause of prolapse. Instead, it is one factor that can influence the tissues responsible for pelvic organ support.
As the passive support system changes, the active support provided by the pelvic floor muscles becomes increasingly important.
Your pelvic floor muscles are constantly responding to what you are doing. When you stand, walk, lift, cough, sneeze, or exercise, pressure within your abdomen changes. Your pelvic floor needs to coordinate with your breathing and other muscles to help manage that pressure and support your pelvic organs.
Will My Pelvic Organs Fall Out?
This is one of the most common fears we hear from women who are concerned about pelvic organ prolapse. The short answer: No.
Prolapse describes a change in the position or support of one or more pelvic organs. It can range from mild changes that cause no symptoms to more significant prolapse that produces a noticeable vaginal bulge or other symptoms.
Your pelvic organs remain supported by a combination of muscles, ligaments, connective tissue, and the surrounding structures of the pelvis.
So if you have been told that you have prolapse, or you're experiencing pelvic pressure or heaviness, it does not mean that your organs are suddenly going to “fall out.”
Instead, it is important to understand what is actually happening and how it is affecting you.
Does Pelvic Floor Physical Therapy Help Prolapse?
Pelvic floor physical therapy is one of the conservative treatment options used to manage pelvic organ prolapse. Pelvic floor muscle training is recommended as a first-line conservative treatment for many women with symptomatic prolapse.
But pelvic floor therapy isn't simply about doing more Kegels.
A pelvic floor physical therapist can evaluate:
Pelvic floor strength and endurance
Your ability to fully relax the pelvic floor
Coordination between your breathing, core, and pelvic floor
How you manage abdominal pressure during movement
Hip and core strength
Bladder and bowel habits
How your symptoms change with different activities
Your treatment should be based on your symptoms, your goals, and how your pelvic floor is actually functioning.
Pelvic Floor Physical Therapy in Alpharetta, Milton & Cumming
At Jacobson Physical Therapy, we provide mobile pelvic floor physical therapy throughout Alpharetta, Milton, Cumming, and surrounding North Atlanta communities.
Instead of traveling to a clinic, we bring individualized physical therapy directly to your home, workplace, or another convenient location.
Whether you're experiencing pelvic pressure, urinary leakage, heaviness, or symptoms of pelvic organ prolapse, you don't have to assume that you simply have to live with it.
Comments