Ever felt a strange heaviness in your lower belly, or like something’s just… off down there?
Maybe you’ve noticed a bulge near your vaginal opening and thought, “Is this normal?” Here’s the thing: it’s not, and you’re not alone.
Pelvic organ prolapse (POP) affects nearly 1 in 2 women, yet most suffer in silence, brushing it off as just another part of aging or post-baby recovery. It’s uncomfortable. It’s confusing. And it can quietly chip away at your confidence, intimacy, and even how you move through your day.
In this guide, we’ll break down what pelvic organ prolapse really is, what causes it, the signs to watch for, and how Pelvic Organ Prolapse physiotherapy can help you heal naturally, often without the need for surgery.
If you’re ready to understand what your body’s trying to tell you, this is where it starts.
What is Pelvic Organ Prolapse and Why Does It Happen?
Here is the Pelvic Organ Prolapse Diagram:
Your pelvic organs include your bladder, uterus, rectum, and small intestine. These organs are supported by a network of muscles and connective tissues, collectively known as your pelvic floor.
When those muscles or tissues stretch, tear, or weaken (which can occur over time or after childbirth), they can no longer hold everything in place. The result? One or more pelvic organs begin to descend or press into the vaginal canal, a condition known as pelvic organ prolapse (POP).
What Causes Pelvic Organ Prolapse?
Pelvic organ prolapse can develop for a variety of reasons. Common contributing factors include:
- Pregnancy and vaginal delivery (especially multiple or traumatic births)
- Aging and menopause (estrogen decline weakens connective tissue)
- Chronic pressure from coughing, constipation, or heavy lifting
- Genetics (some women have weaker collagen or connective tissue)
- Pelvic surgery like hysterectomy, which alters structural support
Additional Risk Factors
Risk factors for pelvic organ prolapse include:
Connective Tissue Disorders: Conditions like Ehlers-Danlos syndrome can predispose individuals to POP due to weakened connective tissues.
Obesity: Excess weight increases pressure on pelvic organs.
Chronic Respiratory Conditions: Persistent coughing can strain pelvic support structures.
Types of (POP) Pelvic Organ Prolapse: What’s Moving Where?
Pelvic organ prolapse comes in different forms depending on which organ is affected:
- Cystocele (Bladder Prolapse)
- Urethrocele (urethra into vagina)
The bladder bulges into the front vaginal wall. - Rectocele (Rectum Prolapse)
The rectum pushes into the back vaginal wall, which may lead to incomplete bowel movements or a feeling of pressure. - Enterocele
The small intestine slips down and presses against the top of the vagina, more common after hysterectomy. - Uterine Prolapse
The uterus descends into the vaginal canal and can eventually protrude from the vaginal opening. - Vaginal Vault Prolapse
After uterus removal, the top of the vaginal canal collapses, often due to lack of internal support.
Staging of Pelvic Organ Prolapse
The severity of POP is classified using the Pelvic Organ Prolapse Quantification (POP-Q) system:
Stage 0: No prolapse.
Stage I: The most distal portion of the prolapse is more than 1 cm above the hymen.
Stage II: The most distal portion is within 1 cm of the hymen.
Stage III: The most distal portion is more than 1 cm below the hymen but less than 2 cm less than the total vaginal length.
Stage IV: Complete eversion of the total length of the lower genital tract.
Understanding the stage of prolapse helps in determining the appropriate treatment approach.
Pelvic Organ Prolapse Symptoms and Signs
Symptoms can vary depending on the type and severity of the prolapse. Some women have mild symptoms; others experience life-altering discomfort.
Early-Stage (Stage 1–2) Symptoms:
- Feeling of vaginal heaviness or pressure
- A subtle bulge you may notice when wiping or showering
- Mild urinary leakage or frequent urge to pee
- A dragging sensation in your pelvis after long hours standing
Moderate to Severe (Stage 3–4) Symptoms:
- A visible bulge or lump at the vaginal opening
- Trouble urinating or fully emptying your bladder
- Difficulty with bowel movements, sometimes requiring manual support
- Pain or discomfort during sex
- Lower back ache or abdominal pressure
If left untreated, the prolapse can worsen and affect your quality of life significantly.
If you’re suffering from any of these pelvic organ prolapse symptoms, AlphaOne Physiotherapy provides the best physiotherapy for pelvic organ prolapse in Calgary—offering compassionate care and proven treatment strategies to help you regain comfort and control
When to See a Prolapse Physiotherapist vs. a Surgeon
You should see a pelvic floor physiotherapist if:
- Your prolapse is mild to moderate (Stage 1–2)
- You feel early signs like pressure, occasional leakage, or heaviness
- You’re postpartum or peri-menopausal
- You want to avoid surgery or delay it safely
You should consider surgical consultation if:
- You experience Stage 3 or 4 symptoms
- The bulge is persistent and affects bowel, bladder or sexual function
- You’ve tried conservative care like physiotherapy and it hasn’t helped
The surgical fixation of a prolapsed vagina to a surrounding structure is known as sacrocolpopexy (typically done with mesh through minimally invasive surgery). Physiotherapy should always be your first step unless the condition is truly severe. Surgery has its place, but recovery takes time and recurrence can still happen.
How Pelvic Organ Prolapse Physiotherapy Can Helps
Let’s be clear: physiotherapy can’t “undo” prolapse completely—especially if it’s severe, but it can help manage, reduce or even reverse early-stage prolapse.
Here’s what a tailored physiotherapy plan typically includes:
1. Pelvic Floor Muscle Training (PFMT)
These include Kegels, but not just any Kegels.
A pelvic physio teaches you how to contract the correct muscles, not your abs or glutes. Research shows that PFMT significantly improves symptoms, especially in Stage 1–2 prolapse.
2. Breathing Techniques
Diaphragmatic breathing helps regulate intra-abdominal pressure, especially during lifting, coughing, or using the toilet.
3. Manual Therapy
A physiotherapist can gently release tight or overactive pelvic floor muscles, which can interfere with proper activation.
4. Biofeedback
This involves using sensors to visualize muscle contractions, which helps you to train smarter, not harder.
5. Pessary Support
A vaginal pessary is a small, removable device that gives your pelvic organs some much-needed support while you work on rebuilding strength through physiotherapy.
Best Exercises for Pelvic Organ Prolapse (POP)
Strengthening your pelvic floor is key to improving symptoms and preventing progression. Here are gentle, effective prolapse physiotherapy exercises that support healing:
- Kegel Exercise
- Alternating Pelvic Tilt
- Supine March
- Elevated Glute Bridge
- Happy Baby Pose
- Side Leg Swings
- Cat/Cow and Child’s Pose
If you’re searching for how to treat pelvic organ prolapse at home, you can watch this helpful YouTube video by Dr. Kristie Ennis Youtube Video Pelvic Prolapse Relief
What is Pelvic Organ Prolapse In Men?
Male pelvic organ prolapse is very unusual but can happen nonetheless—most often as rectal prolapse. This occurs when the rectum moves out of its normal position and even sticks out from the anus. It’s most often due to chronic straining from constipation, chronic coughing, lifting heavy objects, or prior pelvic or prostate surgery. Symptoms may be a pressure sensation in the pelvis, bulge from the rectum, or bowel movement difficulty. Less discussed but very real, it can be treated with pelvic floor therapy or, in advanced cases, surgery.
How Long is Recovery After Pelvic Organ Prolapse Surgery?
Prolapse surgery recovery will vary depending on the type of procedure and your healing rate. Generally, you’ll need to rest for the first couple of weeks and avoid heavy lifting or straining. Most people return to normal daily routines in about 6 to 8 weeks. Full recovery can take up to 12 weeks, especially if tissue repair or mesh placement was involved. Following your surgeon’s post-op instructions and attending follow-ups is key to healing well and avoiding recurrence.
Can Physiotherapy Fix Prolapse?
Yes, in the early stages, physiotherapy can improve symptoms, support organ function, and reduce the need for surgery.
What Happens If Prolapse Goes Untreated?
It often progresses, affecting urination, bowel movements, intimacy and daily comfort. Don’t wait until it disrupts your life.
What Structure Is Protruding In A Cystocele?
In a cystocele, the bladder protrudes into the front wall of the vagina due to weakened pelvic floor support.
Pelvic organ prolapse is a physical condition, but it often carries emotional weight too—frustration, confusion, even shame. Many women live with discomfort, unsure if their feelings are normal or worth mentioning. But when it comes to your body and health, every concern is valid and every question deserves to be asked.
If you’ve noticed pressure, heaviness, or a bulge, your body is trying to tell you something, and it’s time to listen. Prolapse physiotherapy gives you a safe, personalized way to rebuild strength, reduce symptoms, and feel supported every step of the way. You don’t have to wait for it to get worse. Book your pelvic health assessment with AlphaOne Physiotherapy Calgary and take back control—calmly, confidently, and on your own terms.
