Do I have a prolapse?
By Lauren Zanelli, Pelvic Health Physiotherapist
If you've ever felt a sense of heaviness or pressure "down there," or noticed something doesn’t feel quite right in your pelvic region, you may have wondered: Do I have a prolapse? You’re not alone - and you’re not imagining it.
Pelvic organ prolapse (POP) is more common than many people realise. It affects around 1 in 2 women who’ve had a vaginal birth, and yet, it's a topic that often goes undiscussed.
What Is a Prolapse?
Pelvic organ prolapse occurs when one or more of the pelvic organs - such as the bladder, uterus, or bowel - descends or bulges into the vaginal space. This happens when the supportive muscles, ligaments, and tissues of the pelvic floor become stretched or weakened.
There are different types of prolapse:
Bladder: often felt as pressure at the front vaginal wall.
Uterine prolapse: descent of the uterus, sometimes accompanied by a feeling of something “coming down.”
Bowel: can cause difficulty with bowel movements or a sensation of bulging at the back vaginal wall.
Signs You Might Have a Prolapse
Every woman’s body and experience is different, but here are some common symptoms that may indicate a prolapse:
A feeling of heaviness, dragging, or pressure in the vagina - especially by the end of the day
A noticeable bulge or lump at the vaginal entrance
Difficulty inserting tampons
A sensation of something "falling out" or needing to be "held in"
Difficulty fully emptying the bladder or bowel
Bleeding, discharge or infection
Lower back ache or discomfort during intimacy
It’s important to note: symptoms often fluctuate—some women notice them more after prolonged standing, lifting, or towards the end of the day, while others may feel fine most of the time.
Risk Factors
Prolapse can happen for a range of reasons, often due to a combination of factors, including:
Vaginal childbirth (especially with forceps or prolonged pushing)
Chronic coughing or constipation
Heavy lifting (including occupational or fitness-related)
Menopause (due to hormonal changes in tissue support)
Genetics (some women have more stretch-prone connective tissue)
Obesity
Persistent constipation
According to the Royal Women's Hospital, the biggest cause of prolapse is pregnancy and birth, though a number of other factors such as family history, lifestyle, and certain medical conditions can also contribute to its development.
The Good News: Help Is Available
Experiencing symptoms of prolapse can be worrying or even confronting—but you don’t have to just live with it. There are highly effective treatments that can reduce symptoms and help you regain confidence in your body.
At Hatched House, our pelvic health physiotherapists offer:
Comprehensive internal assessments (with your consent and comfort as our priority)
Personalised pelvic floor exercise plans (not just “do your Kegels”)
Education and support to help you understand what’s happening in your body
Lifestyle guidance on safe movement, lifting, and managing symptoms day-to-day
For some women, we may also explore options such as pessary fitting, collaboration with GPs or specialists, or referrals for imaging when needed.
Evidence-Based Support
Research underscores the effectiveness of pelvic floor muscle training in managing prolapse symptoms. The POPPY trial, a multicentre randomised controlled study co-authored by Professor Helena Frawley, demonstrated that individualised pelvic floor muscle training can significantly reduce prolapse symptoms and improve quality of life.
Additionally, a longitudinal cohort study by Hagen et al. found that pelvic floor disorders, including prolapse, can persist decades after childbirth, highlighting the importance of early intervention and ongoing support.
When to Seek Help
If you’re noticing symptoms—even mild ones—we recommend booking an appointment. Early support can make a big difference, and even if you don’t have a prolapse, we’ll help you understand what’s happening and how to feel your best.
You deserve to feel confident in your body, strong in your core, and supported by a team that truly understands.
Empowering women through every stage of motherhood and beyond.