What is a vaginal prolapse or pelvic organ prolapse?

Inside a women’s pelvis are organs including the bladder, uterus and rectum (back passage). Tissues called “fascia” and “ligaments” hold these three organs in place inside your pelvis with the pelvic floor muscles also working to provide upward support acting as a ‘hammock’ holding the weight of these organs from below.

Problems can occur due to stretching, tearing or weakening of the fascia tissue, or pelvic floor muscles. This can often be caused by vaginal child birth, chronic constipation or menopause. What may happen is the pelvic organs may bulge down into the vagina. This is known as a vaginal prolapse, or pelvic organ prolapse.

Early signs of vaginal prolapse can be difficulties with good bladder control or pain when attempting to insert a tampon, or have sex.

How do you know if you have vaginal prolapse?

Early on, it may be hard to know if you have a vaginal prolapse and your GP at a routine PAP smear, or a women’s health physiotherapist during an internal examination may first detect early signs.

You may notice some of the following changes to your pelvic floor area indicating early signs of a vaginal prolapse:

• Do you feel a heavy feeling in your vagina, often worse at the end of the day?
• Do you notice or feel a lump in your vagina?
• Do you experience pain or less feeling with sex?
• Do you experience difficulty in emptying your bladder, or notice a weak urine stream?
• Do you suffer from recurring urinary tract infections?
• Do you find it hard to empty your bowel?

How do you treat a vaginal prolapse?

Depending on the degree of the prolapse, management can be as simple as pelvic floor muscle retraining and a change to good bowel and bladder habits.

Early stages of vaginal prolapse can be corrected through insertion of a pessary. Pessaries serve as a prop or support for your vagina to bring your organs back to a higher position. Amy can determine the need for this through an initial assessment of your pelvic floor function and structure.

What should I expect?

You do not need a referral to see our women’s health physiotherapists, but you may be referred by your GP or gynaecologist. After speaking with you over the phone about your pelvic floor problem, we will book you an hour long assessment.

The assessment will involve taking a very detailed history about your pelvic floor habits, from bladder and bowel control, to sex, to lower back and pelvic pain. The internal vaginal examination will follow and a management plan decided together with you. The structure and degree of any ‘bulges’ in your vagina can be measured through this internal examination. If a pessary is required, Amy will refer you onto a specialist equipped in measuring and fitting this device for you.

Treatments after this time will be different for each woman, but may involve a weekly or fortnightly treatment session to teach you exercises (some to strengthen and others to relax) and educate you on good pelvic floor habits and use of the pessary, if prescribed.