If you notice a bulge in your vagina, this is most likely a prolapse. Prolapse is not an organ problem but a problem with the support of the organ. Some of the organs in the pelvis are suspended from above by ligaments, attached sideways by fascia (connective tissue) and supported from below by the muscles of the pelvic floor.
Fascia is like lycra in your swimming costume – it holds the fabric together. Too much wear and tear and the lycra gives way and the swimmers go saggy in parts. Fascia in the vaginal wall holds the vaginal walls together and keeps the pelvic organs up where they belong, if the fascia stretches or tears the vaginal wall stretches and the pelvic organ bulges through.
Repetitive cough e.g. smoker’s, asthma, bronchitis, post viral, whooping cough
Repetitive heavy lifting – occupational, domestic, gym exercise
Stretched supportive ligaments from above
Weak pelvic floor muscles
Being overweight or obese
What organs can bulge or prolapse?
Uterus (womb); or top of the vagina if you have had a hysterectomy in the past
Urethra (water pipe)
What might I feel if a have a prolapse?
Difficulty fully emptying the bowel or bladder
Dragging/heavy sensation; rarely, nausea
Discomfort with intercourse
Bulge in the vagina
Low back ache
What can I do about a prolapse?
The main focus of conservative treatment is to decrease the load from above arriving into your pelvis and increase the support from below via increased pelvic floor muscle (PFM) strength
See an experienced pelvic floor physiotherapist for conservative management strategies. You may need a ring pessary or surgery. Talk with your doctor. If you do trial a pessary or go on to have surgery, PFM exercises will complement the ring pessary or surgery.