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Dr. Nasreen Ashfaq

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Pelvic Organ Prolapse: Symptoms, Causes, Diagnosis, Treatment, and Prevention

Introduction

Pelvic organ prolapse happens when the muscles and tissues in the pelvis become weak. As a result, organs like the bladder, uterus, or rectum can drop down into the vagina. This condition can affect daily life and comfort. Many women experience pelvic organ prolapse, especially after childbirth or with age. Although it can be uncomfortable, treatment for pelvic organ prolapse is available. Early care can help improve quality of life. According to the World Health Organization, pelvic floor disorders are common among women worldwide.

Symptoms

Pelvic organ prolapse symptoms can vary from mild to severe. Sometimes, women may not notice any signs at first. However, as the condition worsens, symptoms may appear. Common signs include:

  • A feeling of pressure or fullness in the pelvis
  • A bulge or lump in the vagina
  • Discomfort during sex
  • Leaking urine or trouble emptying the bladder
  • Constipation or trouble with bowel movements
  • Lower back pain
  • Spotting or bleeding from the vagina

    • Sometimes, symptoms get worse after standing or lifting heavy objects. But, lying down may help relieve the pressure.

    Causes and Risk Factors

    Pelvic organ prolapse happens when the pelvic floor muscles weaken. Several factors can increase the risk. For example, common causes and risk factors include:

  • Vaginal childbirth, especially multiple or difficult births
  • Getting older, as muscles lose strength over time
  • Menopause, due to lower estrogen levels
  • Obesity, which puts extra pressure on the pelvis
  • Chronic coughing or straining, such as from constipation
  • Heavy lifting over long periods
  • Family history of pelvic organ prolapse

    • Because these factors can add up, it is important to know your risks. Early action may help prevent problems.

    Diagnosis Methods

    Doctors use several methods to diagnose pelvic organ prolapse. First, they ask about your symptoms and medical history. Next, a physical exam is done. During the exam, the doctor checks for bulges or changes in the vagina. Sometimes, you may be asked to cough or bear down. This helps the doctor see how much the organs have moved. In some cases, imaging tests like ultrasound or MRI are used. These tests give a clearer picture of the pelvic area. According to the CDC, early diagnosis helps guide the best treatment for pelvic organ prolapse.

    Treatment Options

    Treatment for pelvic organ prolapse depends on how severe your symptoms are. Some women need only simple care, while others may need surgery. Common options include:

    Medical Treatments

  • Pelvic floor exercises: These help strengthen the muscles and support the organs.
  • Pessary device: A small device placed in the vagina to hold organs in place.
  • Hormone therapy: Estrogen creams may help after menopause.

    • Surgical Treatments

  • Repair surgery: The surgeon lifts and supports the organs using stitches or mesh.
  • Removal of the uterus (hysterectomy): Sometimes needed if the uterus is causing problems.

    • Because every woman is different, your doctor will help choose the best treatment for you.

    Lifestyle Guidance and Self-Care

    Simple changes can help manage pelvic organ prolapse symptoms. For example, you can:

  • Do pelvic floor exercises daily
  • Maintain a healthy weight
  • Avoid heavy lifting when possible
  • Eat fiber-rich foods to prevent constipation
  • Stop smoking to reduce coughing

    • With these steps, many women feel better and keep symptoms from getting worse.

    Prevention Tips

    While not all cases can be prevented, you can lower your risk. Try these tips on how to prevent pelvic organ prolapse:

  • Practice pelvic floor exercises, even before symptoms start
  • Keep a healthy weight to reduce pressure on your pelvis
  • Eat a balanced diet to avoid constipation
  • Lift objects with your legs, not your back
  • See your doctor for regular check-ups

    • Because prevention is easier than treatment, start these habits early.

    When to See a Doctor

    If you notice symptoms of pelvic organ prolapse, don’t wait. See a doctor if you:

  • Feel a bulge or pressure in your vagina
  • Have trouble urinating or with bowel movements
  • Experience pain or discomfort during sex
  • Notice bleeding or spotting

    • Early care can help prevent more serious problems. Your doctor can also guide you on the best treatment options for pelvic organ prolapse.

    Consult Dr. Nasreen Ashfaq, a gynecologist, for personalized advice and care tailored to your needs