Your pelvic floor muscles undergo many changes throughout life, such as after childbirth and during menopause. In some cases, these muscles and surrounding connective tissues can weaken so much that the organs in your pelvis—including the uterus or bladder—start to sag. This is known as pelvic organ prolapse, or POP.
About 50% of women will develop POP at some point in their lives, and it’s more likely as you get older.
“It’s super, super common, but in a lot of the cases, it doesn’t actually affect the patient at all,” Whitney Horner, MD, a urogynecologist at the University of Washington Medicine in Seattle, tells SELF.
Even though POP can cause symptoms, like feeling a fullness in the vagina, pelvic pain or pressure, or bowel or urinary changes, POP isn’t always bothersome, Dr. Horner says. Just 3% to 6% of women say they have vaginal bulge symptoms, survey data shows. Many live with the condition, with mild or no symptoms.
Still, doctors say you should be aware of the possibility of POP, understand its risk factors and symptoms, and know what to do when it starts affecting your life.
What is pelvic organ prolapse?
The pelvic floor is made up of muscles, ligaments, connective tissues, and nerves that support your pelvic organs, including the bladder, uterus, vagina, small intestine, and rectum. This system keeps the organs in their proper places, according to Yale Medicine.
When the pelvic floor is weakened or damaged, pelvic organs can drop from their normal positions, causing POP, Shaun Adair, MD, a urogynecologist at Atlantic Health in Morristown, New Jersey, tells SELF.
“The vaginal tissues collapse downward, almost like the roof of a house caving in, and it can pull on the front wall, the back wall, or the top wall of the vagina,” Julia Geynisman-Tan, MD, a urogynecologist and reconstructive pelvic surgeon at Northwestern Medicine in Chicago, tells SELF.
Sometimes, the organs descend into the vagina, and, in advanced cases, protrude out of the vaginal opening, Dr. Horner says. This process typically happens gradually, Dr. Geynisman-Tan adds.
Who’s most at risk?
Age is the most common risk factor. As you get older, estrogen levels decline, which weakens tissues in the pelvis, Dr. Horner says. So POP can be common during perimenopause and menopause.
Another risk factor is pregnancy and vaginal delivery (comprising about 65% of childbirths), which can damage the pelvic floor, Dr. Adair says. “Multiple studies demonstrate that vaginal delivery, high number of pregnancies, and larger birthweight babies significantly increase the risk of prolapse.”
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