You're at happy hour with your four girlfriends. You talk and laugh into the night, bonding over shared experiences with jobs, partners and parenthood. You feel comfortable talking to each other, but if health topics come up, you're highly unlikely to talk about pelvic organ prolapse (POP). Why? Statistically, among your group of five, at least two of you may experience POP.

It’s not unusual to hear people talk about a hernia — when organs push through weakened abdominal muscles. But how often do you hear people talk about pelvic organ prolapse?

“This condition is rarely spoken about,” says urogynecologist Stephanie Ann Sansone, M.D. “But I can guarantee you that a few people in your circle of friends are dealing with a pelvic floor disorder and you shouldn’t be embarrassed to seek treatment.”

About 40% of women across the world experience pelvic organ prolapse at some point in their lives. Commonly referred to as a “hernia of the vagina,” it involves the descent or bulging of pelvic organs, such as the bladder, uterus, or rectum, into the vaginal space.

Because prolapse of the uterus and other organs is so common, it’s important to break down the stigma associated with it. Consider these five things every person should know about POP:

#1: Pelvic Organ Prolapse is Often Subtle at First

Pelvic organ prolapse (POP) is often called the silent intruder because its symptoms are initially subtle and easily dismissed. Sometimes, there are no symptoms at all. While it’s more common in older women, it can affect women of any age, especially those who have given birth, have had pelvic surgery, or strain often from chronic constipation.

“It’s very common for gynecologists to diagnose pelvic organ prolapse during a routine exam without the patient experiencing any symptoms,” says Dr. Sansone. “And most patients seek care once they notice something protruding past the vaginal opening.”

Recognizing the subtle signs, such as a feeling of pelvic heaviness or a noticeable bulge, is helpful for early intervention. While it is difficult to predict the progression of prolapse over time, identifying certain risk factors and knowing your options for treatment is crucial for individualized management. 

#2: Childbirth Isn’t the Only Risk Factor

While vaginal childbirth is a well-known risk factor for pelvic organ prolapse, it’s not the sole culprit. Aging, hormonal changes, chronic coughing, smoking, obesity, chronic constipation, and even a genetic predisposition can contribute to the weakening of pelvic floor muscles. 

Understanding these risk factors is essential for preventive measures and targeted interventions. It’s a misconception that only women who have given birth are at risk, and many other factors can affect pelvic health.

#3: You Can Prevent POP

Another common misconception is that prolapse of the uterus or other pelvic organs is an inevitable consequence of aging or childbirth and can’t be prevented. However, lifestyle modifications such as regular pelvic floor exercises, maintaining a healthy weight, not smoking, and avoiding constipation can significantly reduce the risk of POP. 

“It’s time to shift the narrative from inevitability to empowerment,” says Dr. Sansone. “All women can take proactive steps to safeguard their pelvic health.”

#4: You Have Many Treatment Options for POP

You may have heard about surgery for pelvic organ prolapse, but it’s not the only option. 

• Lifestyle changes: First, there are things you can do in your daily life, like exercises for your pelvic floor muscles, watching your weight, and eating foods that help with digestion. 
• Pelvic floor physical therapy: If those don't work, you could try pelvic floor physical therapy, where you work with a specialist to strengthen your muscles. 
• Pessary: Some people might use a device called a pessary, which is like a supportive ring placed inside the vagina to hold things in place. 
• Surgery: If you still have bothersome symptoms, doctors might suggest surgery to reconstruct the pelvic floor. This may or may not involve a hysterectomy.

The choice of treatment depends on how severe the prolapse is and each patient’s goals.

#5: You Don’t Have to Suffer in Silence

Beyond the physical effects, pelvic organ prolapse can take a toll on a person's emotional well-being. The embarrassment and stigma associated with the condition often lead women to suffer in silence, impacting their mental health. 

That’s why it’s important to acknowledge the emotional aspects of POP and foster open conversations with your family, friends, and health care provider. Open communication and educational resources can help break the silence surrounding the emotional toll of pelvic organ prolapse.

“You shouldn’t feel embarrassed if you have prolapse of the uterus or other pelvic organs, such as the bladder or rectum,” says Dr. Sansone. “Act on it if you have bothersome symptoms. Don’t be afraid to talk to your urogynecologist about how you want to pursue treatment.” 

Next Steps & Resources

• Meet our source: Stephanie Ann Sansone, M.D.
• To make an appointment with Dr. Sansone or another physician near you, call 800-822-8905 or visit our website.

The material provided through HealthU is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care.