Pelvic Organ Prolapse: How to Stop the POP

Since the internet can be a scary rabbit hole of self-diagnosis, here’s what you *actually* need to know about pelvic organ prolapse, so you can spare yourself the information overload of Google’s search results. Pelvic organ prolapse occurs when a pelvic organ, such as your bladder, uterus, or rectum, drops — or prolapses — from its well-suspended place in your pelvis and bulges down into your vagina.

Prolapse sounds intense, and it definitely can be, but it’s also a condition that’s more common than you’d think. One study estimates that 1 in 8 women in the U.S. will undergo surgery for POP by the time they’re 80 years old (sidebar: surgery isn’t the only option, just keep reading). 

 Many women aren’t diagnosed until their prolapse reaches a certain level of severity, and most of us are never taught simple preventive habits to protect our health. This lack of information about our bodies has very real consequences, and that needs to change!

To learn more about treating and living with POP, I chatted with two people who deal with it on the daily: Francie, a breast milk-expressing expert who’s experienced prolapse, and Lindsey Vestal, our resident pelvic health specialist.

Pelvic organ prolapse symptoms and causes

Lindsey explains that pregnancy and childbirth can open the floodgates to pelvic organ prolapse, but its cause is a little more nuanced than that. Any grade of prolapse really stems from a lifetime of habits or conditions that gradually reduce your pelvic floor support. Frequent constipation, heavy lifting, surgeries like hysterectomies, and even respiratory issues that cause chronic coughing can all contribute to prolapse over time. It’s also a condition that’s slightly more prevalent in older women, in part because of lowered estrogen levels during perimenopause and menopause, which can weaken the pelvic floor muscles (that’s also why some women start to experience bladder leaks as they age — and why our Hi-Waist undies come in handy).

Conditions affecting the spinal cord, like muscular dystrophy, multiple sclerosis, and spinal injuries that lead to paralysis of the pelvic floor muscles can all contribute to POP too. In many cases, prolapse is triggered by more than just one factor. Some common symptoms of pelvic organ prolapse include:

• Painful sex

• Constipation

• Urinary incontinence

• A heavy, bulging sensation in your lower bod

• Lower back pain

• Vaginal bleeding or spotting

For Francie, the first clue that something was off-balance came when her IUD fell out. Twice. This experience, combined with frequent constipation, vaginal dryness, and a heavy, pressured feeling while having bowel movements made her concerned enough to visit her doctor. When it comes to POP (and most women’s health issues) there’s no such thing as “too soon” to talk to a health professional. The earlier you educate yourself about pelvic health, the better you’ll be able to practice prevention or put your bod on the road to recovery. 

Types of pelvic organ prolapse

There are actually four different kinds of prolapse, and every POP case is categorized based on its severity:

Cystocele happens when the bladder sags down into the front wall of the vagina.

Rectocele occurs when part of the rectum relaxes and pushes up against the back wall of the vagina, making constipation a pretty constant state.

Uterine prolapse is when the uterus descends lower into the vagina than it’s supposed to.

No matter which kind of prolapse a person experiences, their condition will be ranked on a scale from 0-4, with stage 4 being the most severe form. The recommended treatment will also vary depending on what stage you have. If the prolapse is on the milder side, Kegels and bladder training may be all that you need. If the prolapse is on the severe side or is interfering with your daily life, then surgery is likely the route your doctor will recommend.

What you can do

POP is a condition that worsens over time, and Lindsey says that it’s possible to control the progression of prolapse by making lifestyle changes. Techniques to relieve the pressure of constipation, pelvic floor exercises tailored for you, and adjustments like cutting out cigarettes or other chronic cough-inducing habits can help manage POP’s progression. 

No matter how you approach prolapse, it’s important to surround yourself with a support system — whether it consists of family, friends, a health professional you trust, or all three. When Francie was diagnosed, she wanted to shout it from the mountaintops to normalize it. “When we believe we have power over our own bodies and our health, we have the power to make the choice to feel better.”

While many women opt for surgery in more severe cases, the results often vary from case to case. If surgery is the best option for you, Lindsey strongly encourages women to work with a pelvic floor therapist beforehand *and* after. She explains that “it only serves you and your body better to be prepared by strengthening those muscles.” Working with a qualified pelvic floor therapist can restore more than just your bod’s health — it can also boost your confidence. Francie is working with a pelvic floor therapist, and she’s confident that POP “isn’t something that’ll prevent me from living a badass life.” 

How much were you taught about your pelvic floor? Are you navigating prolapse? Share your story in the comments.