Declining levels of estrogen during and after menopause can increase your risk of pelvic organ prolapse (POP), which occurs when one or more pelvic organs — the uterus, bladder, and/or rectum — slip down from their normal position and end up pressing into or out of the vagina.
While this is not life-threatening, it can cause discomfort, embarrassment, and/or incontinence, although some people experience few to no symptoms. The important thing to know is that it is a treatable condition, and there are many things you can do to improve your quality of life.
Other top risk factors
Beyond the hormonal shifts of menopause, which can contribute to weakening pelvic muscles and connective tissues, there are other risk factors that can play a role, including
- Vaginal childbirth. Multiple vaginal births can raise your risk of pelvic organ prolapse later in life, as well as having a baby weighing more than 8 ½ pounds.
- Long-term pressure on your abdomen. This can be caused by chronic coughing (such as from smoking), obesity, heavy lifting, or straining frequently during bowel movements (aka constipation).
- Being over the age of 60. About 37 percent of women with pelvic floor disorders are between the ages of 60 to 79, and about half are age 80 or older.
It’s also possible to have pelvic organ prolapse without any of these risk factors. Around 1 in 3 people will experience POP by their 60s, so knowing the symptoms and the range of what’s normal can benefit everyone.
Recognizing the symptoms
If you’ve seen or felt something coming out of your vagina, or you’ve experienced feelings of pressure, discomfort, aching, or fullness in the pelvis — particularly during sex or physical activity — it’s a good idea to schedule a consultation and exam with your OB/GYN or primary care provider. You can also meet directly or ask for referrals to specialized urogynecologists and pelvic floor therapists.
Other potential signs of pelvic organ prolapse include pelvic pressure that gets worse when standing or coughing, or over the course of the day. You may also start to have problems inserting tampons or controlling your bladder, leading to the involuntary leaking of urine (aka urinary incontinence). It’s also possible to have similar problems with stool, which is called fecal incontinence.
Don’t wait to get treated
There are a range of options for managing and treating pelvic organ prolapse, and the exact interventions recommended will likely depend on the severity of your symptoms as well as your age, type of prolapse, and level of sexual activity. So many people are embarrassed or delay getting support because it’s hard to talk about their experience. POP is a treatable medical condition, and providers are here to listen and find a plan that works for you!
Potential treatments might include:
- Trying pelvic floor muscle therapy, which can strengthen your muscles and improve a wide range of symptoms.
- Adding more fiber to your diet is a key lifestyle change if you’re dealing with chronic constipation. Quitting smoking is another valuable change.
- Inserting a pessary, a removable vaginal device that can help support the pelvic organs
Undergoing surgery, which can help support the uterus or vagina. This is medically indicated surgery by a qualified urogynecologist, and not cosmetic or marketed as vaginal rejuvenation. Cosmetic surgery will not improve symptoms and has risks of its own.
Reviewed by the Ovia Health Clinical Team
“Pelvic Organ Prolapse”. Office on Women’s Health. Office on Women’s Health.https://www.womenshealth.gov/a-z-topics/pelvic-organ-prolapse.
Dr. Cheryl Iglesia. “5 Things I Wish All Women Knew About Pelvic Organ Prolapse”. American College of Obstetrics and Gynecology. American College of Obstetrics and Gynecology. December 2021. https://www.acog.org/womens-health/experts-and-stories/the-latest/5-things-i-wish-all-women-knew-about-pelvic-organ-prolapse#:~:text=When%20a%20pelvic%20organ%20drops,and%20others%20can%20be%20isolating