What are the risk factors for pelvic organ prolapse?

The pelvic floor and surrounding connective tissues help hold the bladder, womb, and bowel in position. Pregnancy and vaginal childbirth can stretch or injure these supports, particularly after a difficult birth, a large baby, or more than one vaginal birth. Menopause can lower oestrogen, which may contribute to changes in vaginal and pelvic tissues. Prolapse can also occur after a caesarean birth or without childbirth.

Long-term constipation, repeated straining, chronic cough, smoking, heavy lifting, and higher body weight can increase pressure inside the abdomen. Previous pelvic surgery, a family tendency toward weaker connective tissue, and increasing age may add to risk. A risk factor does not mean prolapse is certain, and symptoms can range from mild pressure to a visible bulge.

A pelvic-floor physiotherapist can teach exercises matched to your symptoms and help you avoid breath-holding while lifting. Treat constipation, discuss a persistent cough with a clinician, and use lifting technique that keeps the load close to your body. If you notice pressure, urinary leakage, difficulty emptying the bowel, or a vaginal bulge, arrange an examination rather than trying to diagnose the type of prolapse yourself.

Book a clinical assessment for a new vaginal bulge, pelvic heaviness that affects activity, trouble passing urine, or difficulty emptying your bowel. Seek urgent care if you cannot pass urine, have severe pain, heavy bleeding, fever, or a bulge that becomes very swollen, dark, or trapped outside the vagina.

Ask which pelvic organs are affected, whether pelvic-floor physiotherapy or a pessary could help, and which activities should be modified while symptoms are being assessed.