We all know how to describe a headache, a sore throat, or nausea. But a strange heaviness down there? A dragging sensation in your vagina? Feeling like something is sitting lower than it used to? It can be much harder to describe, never mind bringing it up in conversation.
These can all be symptoms of pelvic organ prolapse, and yes, we know the name sounds pretty intimidating, but it needs to be spoken about.
Your pelvic floor is a group of muscles that acts a bit like a supportive hammock, helping hold your bladder, uterus and bowel in place. When those muscles and surrounding tissues become weakened or stretched, one or more of the pelvic organs can move downwards and bulge into the vagina. Depending on the organ involved, this may be a uterine, bladder or bowel prolapse.
However, it’s important to know that not everyone with prolapse will have obvious symptoms. A mild prolapse may be discovered during a routine examination without you ever knowing it was there.
It can be a little hard to describe. For some women, it feels like pressure or heaviness in the pelvis or vagina. You might notice a dragging sensation, or feel or see a lump or bulge around the vaginal opening.
You may also notice other changes that don’t immediately seem like they would be related to the pelvic floor — like leaking urine, needing to rush to the bathroom, difficulty completely emptying your bladder or bowel, or discomfort during sex.
Symptoms can become more noticeable after you’ve spent a long time standing or exercising and may ease when you lie down.
Two of the most common risk factors for pelvic prolapse are pregnancy and childbirth. Both place extra load on the pelvic floor, while vaginal birth can stretch or injure the muscles and supporting tissues. But it’s not just after childbirth.
Ageing and hormonal changes after menopause can affect the pelvic floor too. Chronic constipation and repeatedly straining on the toilet, a persistent cough and repeated heavy lifting can also increase pressure on the pelvic floor over time.
Many women assume that a prolapse diagnosis automatically means you will need surgery. That’s just not the case. Treatment depends on the type and severity of the prolapse, your symptoms and how much they’re affecting your everyday life.
For mild prolapse, pelvic floor physiotherapy can be enough to help improve muscle strength and function. A women’s health physiotherapist can also make sure you’re actually doing pelvic floor exercises correctly.
Other management options can include lifestyle changes, treating constipation and using a vaginal pessary, a device placed inside the vagina to support the pelvic organs. In some cases, vaginal oestrogen may be recommended, while surgery can be considered when symptoms are more significant or other treatments haven’t helped.
At Grace Private, women’s health physiotherapy can form part of a broader approach to pelvic health, alongside specialist gynaecological care.
If further specialist assessment is needed, a referral to a urogynaecologist may be recommended. While this specialty isn’t available at Grace Private, your physiotherapist can discuss appropriate referral options with you where clinically indicated.
If you’re experiencing vaginal heaviness or pressure, noticing a bulge, having difficulty emptying your bladder or bowel, leaking urine or experiencing pain during sex, it’s worth talking to your doctor.
Don’t feel embarrassed about bringing it up. Pelvic health symptoms can feel deeply personal, which means women sometimes quietly adjust their lives around them, avoiding certain exercises, always knowing where the nearest bathroom is or simply accepting discomfort as something that happened after having children.
But you deserve to know what’s actually going on.
If something feels different down there, request an appointment with Grace Private and get the support and treatment that’s right for you.
