Can menopause cause pelvic organ prolapse?

It is usually one part of the picture rather than a single cause. Pregnancy and vaginal birth, chronic coughing, constipation with straining, heavy lifting and previous pelvic surgery can also reduce pelvic support.

Pelvic organ prolapse occurs when muscles and connective tissues no longer hold the bladder, uterus, bowel or top of the vagina in their usual position. The organ may press into the vaginal wall or create a bulge at the vaginal opening.

Possible symptoms include vaginal heaviness, dragging or pressure, a bulge you can see or feel, urine leakage, difficulty emptying the bladder, or trouble opening the bowels. Some prolapses cause no symptoms and are found during an examination.

A pelvic-floor physiotherapist can check whether you are contracting and relaxing the correct muscles, then create an exercise plan. Managing constipation, treating a persistent cough and adjusting lifting technique can reduce repeated downward pressure.

If symptoms interfere with daily life, options may include a vaginal pessary to support the organs or surgery. Vaginal oestrogen may help dryness or irritation after menopause, but it does not physically lift a prolapse. Treatment depends on the organ involved, symptom burden, general health and preferences about future vaginal intercourse or surgery.

Book a gynaecology or primary-care appointment for a new vaginal bulge, persistent pelvic pressure, urine leakage, difficulty emptying your bladder or bowel, bleeding from exposed tissue, or symptoms that limit walking, exercise or sex. An examination can identify which organ has moved and rule out other causes.

Seek urgent care if you suddenly cannot pass urine, develop severe pelvic pain, have heavy bleeding, or the protruding tissue becomes very painful or changes colour. These symptoms should not wait for a routine visit.

Ask which pelvic organ is prolapsing, whether your bladder empties fully, and whether pelvic-floor physiotherapy or a pessary suits your symptoms. If considering surgery, discuss recovery, how the procedure may affect bladder, bowel and sexual function, and whether prolapse could recur.