by Dr. Ayesha Bhonsle PT, DPT, OCS, PRPC, RYT

Let’s talk about something most people don’t want to talk about — prolapse. It’s honestly something most women fear, their organs falling out beyond repair. But there’s more to it - way more.

Whether you’ve had a vaginal delivery or a C-section, you're not alone if you're dealing with feelings of heaviness, bulging, or pressure in your pelvis. These symptoms are more common than many realize — and they’re nothing to be ashamed of.

Every woman that comes through my door gets educated on what exactly is a prolapse, how to prevent it from happening or worsening, and what they can do to minimize symptoms of it. And if pelvic floor physical therapy isn’t the answer for them, there are other interventions thanks to modern medicine.

Prolapse Is Common — You're Not Broken

Pelvic organ prolapse affects about 1 in 2 people who have given birth vaginally. One large study found that up to 50%of women who have delivered vaginally will have some degree of prolapse on physical exam, even if they don’t feel symptoms. But it’s not exclusive to vaginal deliveries — cesarean births, although they bypass the vaginal canal, can still result in pelvic floor weakening from pregnancy’s impact on tissue, fascia, and hormones.

Still, prolapse is something many suffer through silently. It’s rarely talked about in postpartum checkups. It's underdiagnosed, misunderstood, and often feared. But it doesn't have to be.

Let’s destigmatize prolapse — and talk about your options.

What Is Pelvic Organ Prolapse?

Pelvic organ prolapse (POP) occurs when the muscles and connective tissues that support your pelvic organs (bladder, uterus, and rectum) become stretched or weakened, and the organs begin to descend into or even outside the vaginal canal.

There are several types of prolapse, including the most common that women (even women who haven’t had babies yet) deal with:

Cystocele (Bladder prolapse) – when the bladder drops into the front wall of the vagina
Rectocele (Rectal prolapse) – when the rectum bulges into the back wall of the vagina
Uterine prolapse – when the uterus descends into the vaginal canal

Understanding Prolapse Severity: The Grading System

Prolapse is measured in grades, which describe how far the organ has descended:

Grade 1: mild descent, often asymptomatic
Grade 2: descent to the vaginal opening — where many symptoms may begin
Grade 3: bulging beyond the vaginal opening
Grade 4: complete prolapse (organ is entirely outside the vaginal canal)

Symptoms might include:

A feeling of heaviness or dragging in the pelvis
Pressure that worsens throughout the day or with activity
A sensation of something "falling out"
Urinary leaks, frequency, or retention
Bowel difficulties like incomplete emptying or straining

So What Can You Do About It?

There are a lot of options — and they’re not one-size-fits-all. Here’s how we approach it in pelvic floor physical therapy:

Pelvic Floor Physical Therapy aka PFPT— Your First Line of Defense

PFPT is evidence-based, conservative care to treat prolapse, often recommended before exploring other interventions.

Pelvic Floor Physical Therapy will help you:

Assess how **you** move, breathe, lift, and hold tension
Help you learn to **coordinate your pelvic floor and deep core** (not just do Kegels!)
Train you to manage **intra-abdominal pressure** during daily activities and exercise
Build a program tailored to **your life**, whether that’s chasing toddlers or getting back to running

Studies show that consistent pelvic floor physical therapy can improve prolapse symptoms and quality of life, especially in grades 1–2 and even some mild grade 3 cases.

The goal of PFPT is to balance out your muscles, create space for your organs and also lift and support from the bottom up. It is scientifically PROVEN to help prolapse symptoms and grade severity.

Pessaries – A Non-Surgical Support Tool

Think of a pessary as a soft internal brace. It's a small medical-grade silicone device fitted by a provider (OBGYN or urogynecologist) that supports your pelvic organs from inside the vaginal canal.

Great for:

People who want to avoid surgery
Those who want relief during exercise, long days on their feet, or while returning to impact sports
Those who are pregnant again or planning pregnancy in the future

Pessaries can be life-changing and are very safe when monitored and cleaned appropriately.

Surgical Options – When Conservative Care Isn’t Enough

Surgery is a valid option, especially when prolapse significantly impacts your daily function and physical therapy or pessaries don’t provide enough relief.

Types of surgeries include:

Uterine suspension or hysterectomy with support repairs
Anterior or posterior vaginal wall repair
Colpopexy – using mesh or sutures to support the vaginal vault or organs

Important to note:

Surgery is not always permanent — some have recurrence, especially if underlying core or pelvic floor coordination isn’t addressed
Prehab and rehab with PFPT before and after surgery can greatly improve outcomes

Let’s Normalize the Conversation

Prolapse is not a failure of your body. It’s not a result of something you did wrong. It’s a natural response to major life events like pregnancy, birth, and aging.

You deserve answers. You deserve options. And you deserve to feel strong, supported, and safe in your body — whether you’re 6 weeks, 6 months, or 6 years postpartum.

If you think you might have prolapse — or if you’re unsure but something feels off — reach out to a pelvic floor physical therapist. We are here to listen, educate, and empower you with tools to heal and thrive.

Let’s keep the conversation going. Share this post with a friend, a new parent, or someone who needs to know they’re not alone.

Ready to Start Healing?

If you're looking for pelvic floor physical therapy, I can help — whether you prefer in-person visits or the flexibility of online sessions. As a pelvic health specialist, I meet you where you are — with compassion, clinical expertise, and a whole-body approach to healing - start here.

And if you're ready to take the first step toward feeling supported and strong again, I’ve created a 12-week guided program designed specifically to balance and strengthen your pelvic floor, so you can minimize prolapse symptomsand build confidence — at your own pace, in the comfort of your own home. Check it all out on my app - ReBlume - rebelling against traditional care.

You don’t have to “just live with it.” Healing is possible.
Let’s do it together. 💛

Let’s De-Stigmatize Prolapse