Understanding Prolapse Symptoms & Causes
Prolapse Mini Series
Part One: Understanding Prolapse Symptoms & Causes
Part Two: Is it Possible to Heal Prolapse Without Surgery?
Prolapse is one of the most common core health topics I get asked about. This condition involves the descent of pelvic organs—such as the bladder, uterus, or bowel—into or out of the vaginal vault, leading to symptoms of pelvic heaviness, leaking, difficulty with voiding, constipation and more. Despite common misconceptions, prolapse can often be healed naturally without resorting to surgery.
In part one of this mini series, we’ll look at what prolapse is, the symptoms of prolapse and the main causes of prolapse. In part two, we’ll explore how to treat and heal prolapse naturally without surgery.
What is Prolapse?
Prolapse occurs when the pelvic organs fall downward and descend into the vaginal vault. The pelvic organs include the uterus, bladder and bowel. These organs (and all of your organs) are supported by ligaments that connect the organ to the spine, pelvis, fascia, and muscles that surround them. The uterus is the central organ in your pelvis, with the bladder in front of it and the bowel behind it. The vagina (also known as the vaginal vault) is located under the uterus. When the ligaments that support the pelvic organs are compromised, the organs can move out of their best position and descend downward into the vaginal vault. One, two or all of the pelvic organs can prolapse.
There are 3 different types of prolapse, referring to which organ has fallen:
- Cystocele: Prolapse of the bladder
- Rectocele: Prolapse of the bowel
- Uterine Prolapse: Prolapse of the uterus
Prolapse is also characterized by the degree to which the organ has fallen. A system called the Pelvic Organ Prolapse Quantification System is used to measure and classify prolapse by stages.
- Stage 1: the organ has descended into the upper portion of the vagina.
- Stage 2: the organ has descended into the lower portion of the vagina.
- Stage 3: the organ has descended to the opening of the vagina
- Stage 4: the organ has slipped outside of the vagina.
I have seen incredible success resolving stage 1-3 prolapse with consistent implementation of The Core Recovery Method® protocol.
Prolapse Causes
The primary cause of prolapse is the inability of the core muscles to manage the pressure in the abdomen appropriately. The primary role of the core muscles is to keep the organs in their best position by absorbing the inevitable increases in pressure we all are exposed to on a daily basis. These inevitable increases in pressure include coughing, laughing, sneezing, lifting, talking, transitional movements, and certain postures and breathing patterns. If the core muscles are not functioning properly, these pressure increases are taken by the organs and supporting ligaments instead of the core muscles. Chronic, repetitive increases in intra-abdominal pressure, compounded by core muscle dysfunction can lead to prolapse overtime. The core muscles—comprising the diaphragm, pelvic floor, and abdominal muscles—should work together to manage this pressure. For most individuals with a well-functioning core, these pressures are well-managed, and the organs remain supported.
However, when core muscle dysfunction occurs, these pressures are not adequately managed, leading to undue stress on the pelvic organs and the ligaments that support them. Over time, this constant pressure can weaken and stretch the ligaments and fascia, which, unlike muscles, cannot contract to regain their shape, resulting in organ displacement and, eventually, prolapse.
Prolapse can also be caused by childbirth. When the pushing phase of labor is lasts a long time, this can place significant stress on the pelvic organs and prolapse can result. If the core muscles are not properly rehabbed after birth so that the organs resume their optimal position, the prolapse caused by childbirth can continue into and beyond the post partum phase. This is why implementing an effective post partum rehab protocol, like The Core Recovery Method®, is so critical after delivery.
Prolapse Symptoms
Prolapse symptoms can vary widely. Some individuals may not experience any symptoms at all, while others might experience significant discomfort.
Common prolapse symptoms include:
- A feeling of heaviness or fullness in the vagina
- Pelvic pressure
- Urinary urgency or frequent urination
- Difficulty emptying the bladder or bowel
- A sensation of "organs falling out" during activities like coughing, sneezing, or lifting
- Pelvic and abdominal pain or cramping
- Lower back pain
- Pain with sex
It's important to note that these symptoms do not always indicate a prolapse, but are often associated with prolapse. To get a true diagnosis of prolapse, a urogynecologist will perform the Pelvic Organ Prolapse measurements in order to confirm the diagnosis.
While it is a significant health concern, especially among post partum and post menopausal women, it is often misunderstood and misdiagnosed. Many women who learn they have prolapse come to me scared, confused, and hopeless after being told they have prolapse. However, the first order of business is to check your source. Many women are told they have “prolapse” without actually receiving an exam that is qualified to diagnose it. Physical therapists cannot diagnose prolapse. We can tell you if your organs are moving more than is normal, but we are not trained to diagnose it. Midwifes and gynecologists can also tell you if you have the symptoms of prolapse and if prolapse is likely, however only a urogynecologist can perform the gold standard measurements necessary to truly diagnose a prolapse. So if you have been told you have prolapse, don't worry, there is a lot you can do to heal it!
Surgery is Not the Only Option to Fix a Prolapse
For those recently diagnosed with prolapse or even those who have undergone surgery, it’s important to remember that you are not alone, and prolapse is not a life sentence. While traditional medical approaches may suggest surgery as the primary solution, there are effective, non-surgical alternatives that can provide relief and healing.
As a doctor of physical therapy, I also come from a western medicine background where I was taught that prolapse cannot be fixed without surgery. And while surgery can reposition the organs, it often does not address the underlying issue of core muscle dysfunction. If the core muscles are not retrained and strengthened post-surgery, the same pressures that caused the prolapse can lead to a recurrence, potentially necessitating further surgical interventions.
The Core Recovery Method® offers a comprehensive, natural approach to healing prolapse. By addressing the root cause—core muscle dysfunction—rather than just the symptoms, this method provides a sustainable solution to support organ position and overall pelvic health. With dedication and the right techniques, individuals can find relief and reclaim a sense of normalcy and strength in their lives. We’ll explore this non-surgical approach to healing prolapse in greater detail in part two of this series.
“I never thought my incontinence and prolapse was going to improve. When you search the web, all you see is bad news for women who have these problems. My main doctor said I have to live with it and that surgery was my only option. Then my gynecologist recommended pelvic floor therapy by using biofeedback and kegels. It didn’t work. Even the person who was doing the treatment is also living with prolapse and recognized it’s not a permanent solution. And of course my gynecologist said surgery was the permanent solution as well. I wasn’t convinced.
I searched and searched and searched and decided to do The Core Recovery Method® program and I have no regrets. I really think this program should reach more people. I have talked to a lot of women who think incontinence and prolapse is normal. Just wanted to say The Core Recovery Method® works. In the first few weeks of starting it I was able to see changes just by doing the abdominal massage. It was incredible.”
M.V.
