Pelvic pressure, vaginal heaviness, or the feeling that something is “falling” can be frightening—especially when nobody prepared you for the possibility of pelvic organ prolapse.
A prolapse diagnosis does not automatically mean surgery, giving up exercise, or living with symptoms indefinitely.
At Floor Fabulous Physical Therapy, we provide individualized pelvic floor physical therapy for women with pelvic organ prolapse in Las Vegas. We look beyond the diagnosis to understand how your pelvic floor, breathing, movement, bowel habits, and pressure-management strategies may be contributing to your symptoms.
Then we build a treatment plan around your body, your symptoms, and the activities you want to get back to doing.
What Is Pelvic Organ Prolapse?
Pelvic organ prolapse (POP) occurs when the muscles and connective tissues supporting the pelvic organs no longer provide adequate support, allowing one or more pelvic structures to descend toward or into the vagina.
Prolapse may involve the:
- Bladder or front vaginal wall
- Rectum or back vaginal wall
- Uterus or cervix
- Top of the vagina following hysterectomy
Some women have prolapse without experiencing significant symptoms. For others, pelvic pressure, heaviness, bladder or bowel changes, or discomfort during activity can interfere with everyday life.
What Does Pelvic Organ Prolapse Feel Like?
Pelvic organ prolapse doesn’t feel exactly the same for everyone.
You may notice:
- Pelvic or vaginal pressure
- Vaginal heaviness
- Feeling like something is “falling” or dropping
- Seeing or feeling a bulge near the vaginal opening
- Symptoms that become worse after standing for long periods
- Increased pressure or heaviness later in the day
- Symptoms during lifting or exercise
- Difficulty completely emptying your bladder
- Changes in bowel movements or difficulty emptying
- Discomfort during intercourse
If these symptoms sound familiar, an evaluation can help determine what’s happening and what treatment options may be appropriate.
What Causes Pelvic Organ Prolapse?
Pelvic organ support depends on more than pelvic floor muscle strength alone.
Factors that may contribute to prolapse include:
- Pregnancy and childbirth
- Changes to pelvic floor muscles and connective tissues
- Aging
- Menopause and hormonal changes
- Chronic constipation and repeated straining
- Repetitive increases in abdominal pressure
- Previous pelvic surgery
- Genetics and connective tissue factors
Not every woman with these risk factors will develop bothersome prolapse.
More importantly, knowing that you have prolapse doesn’t tell us everything about why you’re experiencing symptoms or what treatment will work best for you.
That’s where an individualized assessment becomes important.
What Types of Pelvic Organ Prolapse Are There?
“Pelvic organ prolapse” isn’t one single condition.
Bladder Prolapse or Cystocele
Anterior vaginal wall prolapse occurs when the front vaginal wall descends, often involving the bladder.
Some women experience vaginal pressure or bulging along with bladder symptoms such as difficulty completely emptying.
Rectocele
Posterior vaginal wall prolapse occurs when the back vaginal wall descends, often involving the rectum.
Some women experience difficulty with bowel movements, incomplete emptying, constipation, or the need to change position during a bowel movement.
Uterine Prolapse
Uterine prolapse occurs when the uterus and cervix descend toward the vaginal opening as their supporting structures change.
Vaginal Vault Prolapse
After a hysterectomy, the top portion of the vagina can lose support and descend.
More than one area can also be involved at the same time.
Understanding which structures are involved and what symptoms you’re experiencing helps guide appropriate treatment.
Can Pelvic Floor Physical Therapy Help Prolapse?
Yes. Pelvic floor physical therapy is an established nonsurgical treatment option for pelvic organ prolapse.
But prolapse treatment isn’t simply doing more Kegels.
Your pelvic floor needs to appropriately contract, relax, coordinate with your breathing, and respond to changes in pressure when you stand, lift, exercise, cough, use the bathroom, and move throughout your day.
Depending on your evaluation, pelvic floor PT may address:
- Pelvic floor strength and coordination
- Breathing mechanics
- Abdominal and pelvic pressure management
- Bowel mechanics and reducing unnecessary straining
- Lifting technique
- Exercise modifications
- Return to running, strength training or other activities
- Bladder symptoms
- Muscle tension when present
- Strategies for activities that reproduce pressure or heaviness
Current clinical guidance supports supervised pelvic floor muscle training as a first treatment option for women with symptomatic stage I or II pelvic organ prolapse.
Physical therapy won’t necessarily eliminate the anatomical prolapse, but it may improve symptoms and pelvic floor function and help you better manage the activities that matter to you.
You Don’t Have To Figure This Out Alone
Your evaluation is designed to help you understand what’s happening, what may be contributing to your symptoms, and what your treatment options look like.
What Happens During a Pelvic Floor Evaluation for Prolapse?
Your first appointment isn’t about handing you a generic sheet of pelvic floor exercises.
We start by understanding you.
We’ll discuss your symptoms, medical history, pregnancy and childbirth history when relevant, bladder and bowel habits, exercise routine, previous surgeries, and the activities that make your symptoms better or worse.
Your evaluation may include assessment of:
- Pelvic floor muscle function
- Strength and coordination
- Ability to relax the pelvic floor
- Breathing patterns
- Abdominal pressure management
- Hip and trunk function
- Bowel mechanics
- Lifting technique
- Exercise or movements that reproduce your symptoms
An internal pelvic floor examination may also be recommended when appropriate and with your consent.
Most importantly, we’ll explain what we’re finding and why it matters to your symptoms.
Our Pelvic Organ Prolapse Treatment Reviews
“Antoinette is a consummate professional. She is obviously well-studied and trained in her field, but her demeanor and patient care set her apart as a clinician. She takes time to explain the exam, her assessment and recommended treatment plan and patiently and thoroughly responds to any questions I have. I recommend her to anyone that needs pelvic floor support.”
– Tara N.
Do I Have to Stop Lifting or Exercising Because I Have Prolapse?
Not automatically.
Women with prolapse are sometimes given broad restrictions:
“Don’t lift anything heavy.”
“Stop running.”
“Don’t squat.”
“Never lift more than ___ pounds.”
But your long-term plan shouldn’t be based entirely on a generic restriction.
If lifting, running, strength training, or another activity increases your symptoms, we can evaluate what actually happens when you perform that movement.
We may look at:
- Your breathing
- How you manage pressure
- Your technique
- Your pelvic floor response
- The amount of load
- When your symptoms appear
- Whether temporary modifications are appropriate
The goal is to help you understand your body and participate in the activities that matter to you as confidently as possible.
Does Pelvic Organ Prolapse Mean I Need Surgery?
No. A prolapse diagnosis does not automatically mean you need surgery.
Treatment depends on factors including:
- Your symptoms
- Type of prolapse
- Degree of prolapse
- How much it affects your quality of life
- Your medical history
- Your activity goals
- Your personal preferences
Nonsurgical management may include pelvic floor physical therapy, lifestyle and bowel strategies, or a vaginal pessary.
Some women ultimately choose surgery. Others manage their symptoms without surgery.
And sometimes pelvic floor physical therapy is useful as part of a larger treatment plan before or after surgery.
If you’re trying to decide between your options, read our guide:
What Is a Pessary?
A vaginal pessary is a removable device placed inside the vagina to help support prolapsed tissues.
For some women, a pessary can reduce prolapse symptoms during daily activities or exercise and provide a nonsurgical management option.
Pessaries come in different shapes and sizes and need to be appropriately fitted by a qualified medical provider.
Physical therapy and pessary use aren’t necessarily competing treatments. Depending on your needs, they may be used together as part of a broader prolapse-management plan.
What If I Think I Have Prolapse but Haven’t Been Diagnosed?
Feeling vaginal pressure or discovering a bulge can be alarming.
First: don’t panic.
Pelvic organ prolapse usually isn’t an emergency, but new pelvic symptoms deserve an appropriate evaluation.
A gynecologist or urogynecologist can medically evaluate your symptoms, determine whether prolapse is present, and discuss medical options when appropriate.
A pelvic floor physical therapist evaluates different pieces of the problem—including pelvic floor function, movement, pressure management, bowel and bladder habits, and how your symptoms respond to everyday activities.
These providers can work together.
If you’re wondering what to do first, we’ve written a complete guide:
Pelvic Floor Physical Therapy That Helps You Understand Your Body
We don’t want you leaving treatment simply knowing which exercises to perform.
We want you to understand why you’re doing them.
At Floor Fabulous, your treatment is built around your individual assessment and goals.
We’ll help you understand:
- What we’re finding during your evaluation
- How those findings may relate to your symptoms
- Why we’re choosing particular treatment strategies
- How to modify activities when necessary
- How to apply what you’re learning outside of the clinic
Our goal is to give you a better understanding of your body and a plan for moving forward.
Pelvic Organ Prolapse After Pregnancy or Childbirth
Pregnancy and childbirth can affect the muscles and connective tissues that support the pelvic organs.
Some women notice pelvic pressure or heaviness relatively soon after delivery. Others don’t recognize prolapse symptoms until months or years later.
If you’re postpartum and experiencing vaginal pressure, heaviness, a bulge, bladder or bowel changes, or symptoms when returning to exercise, a pelvic floor evaluation can help determine what may be contributing.
Treatment can then be built around both your symptoms and your goals—whether that’s comfortably caring for your child, returning to exercise, lifting weights, running, or simply getting through your day without constantly thinking about pelvic pressure.
Frequently Asked Questions About Pelvic Organ Prolapse
Can pelvic floor physical therapy fix pelvic organ prolapse?
Pelvic floor physical therapy may improve prolapse symptoms and pelvic floor function, but it should not be presented as a guaranteed anatomical “cure.” Treatment focuses on your symptoms, function, pelvic floor coordination, pressure management, and activities.
Does stage II prolapse require surgery?
Not necessarily. Clinical guidelines recommend considering supervised pelvic floor muscle training as a first option for symptomatic stage I or II prolapse. Treatment decisions should also consider your symptoms, goals and preferences.
Can I exercise with pelvic organ prolapse?
Many women with prolapse remain physically active. Whether an activity needs to be modified depends on your symptoms and individual response. A pelvic floor physical therapist can assess how your body manages movement, breathing, load and pressure.
Can prolapse cause bladder problems?
Pelvic floor disorders can involve overlapping symptoms. Some women with prolapse experience difficulty emptying their bladder, urinary leakage, urgency or frequency. Bladder symptoms can have other causes as well, so an individualized evaluation is important.
Can prolapse cause constipation?
Some women with prolapse, particularly posterior vaginal wall prolapse or rectocele, experience bowel-emptying difficulties. Constipation and repeated straining may also contribute to pelvic floor symptoms.
Should I see a pelvic floor PT or urogynecologist?
They provide different and often complementary care. A urogynecologist can medically assess prolapse and discuss options such as pessaries or surgery. A pelvic floor physical therapist evaluates pelvic floor function, movement, bowel and bladder factors, exercise and pressure management.
You Have Options for Pelvic Organ Prolapse
A prolapse diagnosis can feel overwhelming, but it doesn’t mean you have to stop exercising, immediately consider surgery, or simply accept uncomfortable symptoms.
The right treatment starts with understanding your prolapse and how it affects your life.
At Floor Fabulous Physical Therapy, we provide individualized pelvic floor physical therapy for women with pelvic organ prolapse in Las Vegas.
We’ll help you understand what’s happening, identify factors that may be contributing to your symptoms, and build a treatment plan around the activities and goals that matter to you.
Ready to find out what your next step should be?
Book Your Evaluation Today
