Pelvic organ prolapse occurs when the muscles, connective tissues, and ligaments of a woman’s pelvic floor weaken and stretch, losing their ability to support the pelvic organs properly. The pelvic floor is a group of muscles and tissues that acts like a hammock, supporting organs such as the bladder, uterus, rectum, and, in some cases, the small intestine. When these muscles or tissues are compromised, the organs can drop out of their normal position and press into or protrude through the vaginal canal. This descent, or “prolapse,” can cause discomfort, functional issues, and even visible bulging.

The primary cause of pelvic organ prolapse is the weakening of the pelvic floor, which can result from several factors. One of the most common causes is childbirth, particularly vaginal deliveries. The process of childbirth can overstretch or tear the pelvic muscles and tissues, especially with larger babies, multiple births, or complicated deliveries. Aging and menopause also contribute to prolapse, as the body’s estrogen production decreases, leading to a loss of tissue strength and elasticity. Other risk factors include chronic pressure on the pelvic region, which can result from obesity, chronic coughing (due to smoking or asthma), or repeated heavy lifting. Additionally, hysterectomy (removal of the uterus) can sometimes lead to prolapse, as the remaining organs may lose structural support. Genetic factors also play a role, with some women more predisposed to pelvic muscle weakness.

There are several types of prolapse, depending on which organ is affected. Cystocele refers to bladder prolapse, while rectocele involves the rectum bulging into the vaginal space. Uterine prolapse occurs when the uterus descends, and enterocele happens when the small intestine shifts down into the pelvic region. Women may experience symptoms such as a sensation of heaviness in the pelvis, discomfort during intercourse, difficulty with urination or bowel movements, and sometimes a visible bulge from the vagina.

Treatment options range from non-surgical approaches, like pelvic floor exercises and the use of pessaries, to surgical interventions aimed at restoring support to the pelvic organs. The appropriate treatment depends on the severity of the prolapse and a woman’s overall health and preferences.