Vaginal Bulging/Heaviness/Prolapse

Prolapse means that there has been damage to the tissues within the pelvis. This results in descent of the pelvic organs towards the vagina &/or vaginal entrance. It is very common in child bearing women (50 – 80 %) but many will not have any symptoms. In women over 70, 50% will have some form of prolapse.

In pregnancy, the added weight of the baby & softening of your ligaments may may make you aware of a mild prolapse that produced no symptoms before.

Common Symptoms of Prolapse

  • A sense of heaviness in the perineal area – particularly at the end of the day
  • A since of something bulging in the vagina
  • A slow or interrupted flow of urine
  • A sense of incomplete emptying of the bladder or bowel
  • Needing to support your perineum to empty your bowel
  • Wind or water trapping ( Fanny farts)
  • Difficulty in positioning or retaining tampons

 Causes of prolapse

Vaginal delivery can overstretch & damage the supportive structures in the pelvis -especially with babies over 4.0kg, if forceps are required or there is a prolonged pushing stage. Women who have multiple pregnancies in quick succession, or who try to return to vigorous exercise too quickly after birth, are more prone to prolapse. This is due to excessive strain on the tissues without sufficient recovery time.

As women reach Menopause there is reduced levels of protective Oestrogen to keep the tissue stronger.

Heavy lifting & chronic constipation create strong forces repeatedly pushing & overstretching the supportive ligaments & connective tissue.

Obesity means that the pelvic floor muscles & their ligaments are carrying an ever increasing load. This can also happen due to large fibroids or tumours in the pelvis

Women who are hypermobile (often called double jointed) are at risk because their collagen is soft & easily over stretched.

Chronic coughing will cause repeated strain of the pelvic floor, ligaments & connective tissue.

Being unfit can also contribute. Healthy exercise will strengthen the pelvic floor & its supportive structures.


How to support & improve your prolapse

Avoid activities that will cause excessive pressure in the pelvis – heavy lifting, coughing, constipation , heavy & propulsive exercise.

Reduce your BMI

Rest in the middle of the day lying down – take the effect of gravity off your pelvis. You can even put a pillow under your buttocks

Low impact exercises can lessen the load in your pelvis & still keep you fit.

Strengthen your pelvic floor muscles.

Lift your pelvic floor before coughing, sneezing, lifting etc.

Try intercourse & exercise  in the morning when the muscles are rested & more able to support.

Squat down in a stride position rather that with legs wide apart. This means your leg muscles can take more of the load.

Expect that you may be slightly worse before your period is due , so be prepared to take everything a little more gently during this time.


Most people think that prolapse means surgery. This is not necesariiy the case. Particularly if the prolapse is mild, there are other alternatives

Pelvic floor muscles are an important part of the framework that protects your pelvic organs. You can use these muscles to help support your prolapse & make you less aware of your symptoms.

Pessaries can help support the organs & enable your pelvic floor to contract efficiently.

If you require surgery you will have a much better result if you are at a healthy weight range, you have strengthened your pelvic floor & have eliminated the risk factors you have identified.

Genesis can help to identify your risks & give you advice on how you can tackle these. It is important to know how to contract your pelvic floor correctly. Many people bear down instead of squeezing up & forward- this will only make your prolapse worse! Make an appointment now on this webpage.