Your Guide to Managing Pelvic Organ Prolapse

If you’ve recently been diagnosed with pelvic organ prolapse (POP), you might be feeling overwhelmed, scared, or even embarrassed. Take a deep breath – you’re not alone, and there’s plenty of reason for hope. Let’s talk about what pelvic organ prolapse really is, how incredibly common it is, and most importantly, the effective treatment options available to you, regardless of your age.

You’re In Good Company

First things first: pelvic organ prolapse affects up to 50% of women who have given birth. Yes, you read that right – half! Yet despite being so common, it’s rarely discussed openly. This silence can make you feel isolated, but the truth is, millions of women are navigating this same journey.

POP occurs when the muscles and tissues supporting your pelvic organs (bladder, uterus, or rectum) weaken, allowing these organs to drop or press into the vagina. Think of it like a hammock that’s lost some of its elasticity – it still functions, but it might need some extra support.

Breaking the Age Myth

One of the biggest misconceptions about prolapse treatment is that certain options, particularly pessaries, are “just for older women.” This couldn’t be further from the truth! Women in their 20s, 30s, and 40s successfully use pessaries to manage their symptoms while maintaining active lifestyles, careers, and yes, even planning future pregnancies. At our clinic, we’ve seen marathon runners, new mothers, and busy professionals of all ages find relief with pessaries. Your age doesn’t determine your treatment options – your individual needs and preferences do.

The Power of the Pessary

A pessary is a removable device that fits into your vagina to support your pelvic organs. Think of it as a sports bra for your pelvic floor – providing support exactly where you need it. Modern pessaries come in various shapes and sizes, from rings to cubes to specialized designs, ensuring there’s an option that works for your body and lifestyle.

Here’s what might surprise you: recent research shows that long-term pessary use doesn’t just manage symptoms – it can actually improve the anatomical position of your organs. Studies have found that the genital hiatus (distance from the urethra to the back of the vaginal canal) decreases as duration of pessary use increases. This has been correlated with less prolapse progression over time. Women with more severe prolapse (stages 3-4) showed significant anatomical improvement with consistent pessary use.

This means a pessary isn’t just a “bandaid” solution – it’s actively helping your body while you wear it.

Your Pelvic Floor: The Unsung Hero

While pessaries provide external support, your pelvic floor muscles are your body’s built-in support system. Pelvic floor muscle training (PFMT) – not just “Kegels” but comprehensive, guided exercises – has been proven to:

• Reduce prolapse symptoms in women with stage 1 and 2 prolapse
• Improve the grade of prolapse in many cases
• Decrease associated symptoms like urinary incontinence
• Help maintain the benefits achieved with pessary use

The key is working with a pelvic floor physiotherapist who can ensure you’re doing the exercises correctly. Many women think they’re doing Kegels properly when they’re actually bearing down or using the wrong muscles. Professional guidance makes all the difference.

A Personalized Approach

One of the most empowering aspects of prolapse management is that you have choices. Your treatment plan should fit your life, not the other way around. Here’s what a comprehensive approach might include:

• Pessary Options: From rings that you can leave in during intercourse to cubes that you remove nightly, there’s a pessary for every lifestyle. Some women wear them continuously, while others use them “on demand” for specific activities like exercise or long workdays
• Pelvic Floor Therapy: Targeted pelvic floor muscle training can improve both symptoms and anatomy. This isn’t about doing hundreds of Kegels – it’s about quality over quantity with proper technique
• Lifestyle Modifications: Simple changes like managing constipation, maintaining a healthy weight, and modifying exercise routines can significantly impact your symptoms
• Hormonal Support: For postmenopausal women, local estrogen therapy can improve tissue health and enhance the effectiveness of other treatments

Real Stories, Real Hope

“I was devastated when I was diagnosed with prolapse at 32,” shares Sarah, a mother of two. “I thought my active life was over. But with a ring pessary and pelvic floor therapy, I’m back to running and playing with my kids. I honestly forget it’s there most days.”

Maria, 45, adds:

“I was skeptical about pessaries, thinking they were for ‘old ladies.’ But my physiotherapist helped me find one that works perfectly. I’ve actually seen improvement in my prolapse grade over the past year.”

These stories aren’t unique – they’re typical of what we see in clinical practice every day.

Your Next Steps

If you’re dealing with pelvic organ prolapse, remember:

• You’re not alone – this is incredibly common
• You have options that work for women of all ages
• Conservative treatments like pessaries and pelvic floor therapy are recommended as first-line options
• Treatment can improve both symptoms and anatomy
• You deserve support and comprehensive care

Don’t let embarrassment or misconceptions keep you from seeking help. The sooner you explore your options, the sooner you can get back to living life on your terms. Whether you’re 25 or 75, whether you’re planning more children or done with that chapter, there’s a treatment approach that’s right for you.

Your pelvic floor has supported you through so much – now it’s time to return the favour. With the right support, both literally and figuratively, you can manage your prolapse and continue living your best life.

Kristen Parise BSc, MSc, BHSc PT., is a pelvic health physiotherapist, educator and founder of Blueberry Therapy, The Hole Shebang Podcast and The Pleasure Principle Conference.