What causes vaginal bulge?

The pelvic floor muscles and connective tissues help hold the bladder, bowel, and uterus in position. If this support stretches or weakens, an organ can press into the vaginal wall or move lower. A cystocele involves the bladder side of the vaginal wall; a rectocele involves the bowel side; and uterine prolapse involves the uterus moving downward. Pregnancy and vaginal childbirth can affect support, while ageing, repeated straining, constipation, chronic coughing, higher body weight, or previous pelvic surgery may add pressure. The sensation may be worse after standing or later in the day and can occur with heaviness, urinary symptoms, or difficulty passing stool.

Arrange an examination if you can see or feel a new bulge, pressure, or dragging sensation. A clinician can identify which area is involved and discuss pelvic floor physiotherapy, bowel habits, activity adjustments, or a vaginal pessary. Avoid repeated straining and manage constipation with advice suited to pregnancy, medicines, and other health conditions. Do not push through pain or assume every bulge needs surgery; treatment depends on symptoms, examination findings, and your preferences.

Seek prompt care if the bulge becomes suddenly painful, cannot be gently pushed back when advised, bleeds, or is associated with inability to pass urine or stool. Fever, severe pelvic pain, vomiting, or a rapidly changing mass also needs urgent assessment. Make a routine appointment for persistent symptoms, even when discomfort is mild, because support problems can be assessed before they interfere more with bladder, bowel, movement, or intimacy.

Which organ or vaginal wall is causing the bulge? How advanced is the prolapse, and could pelvic floor physiotherapy help? Would a pessary suit me, and what symptoms should prompt an earlier review?