What is actually happening
If you have just heard the words "pelvic organ prolapse" for the first time, whether from a doctor or from your own late night searching, take a breath. This page explains what is going on in your body in plain language, without alarm and without jargon.
The short answer
Your pelvic organs sit in a hammock of muscle and connective tissue called the pelvic floor. That hammock holds your bladder, uterus, rectum, and small intestine in place. When it weakens or tears, one or more of those organs can drop from its usual position and press against the wall of the vagina.
In milder cases you may never feel a thing. In more noticeable cases, tissue can bulge into the vaginal opening, or past it.
The five types
Doctors name prolapse after whichever organ has shifted. Plenty of women have more than one type at once. That is normal, and it does not mean your situation is worse.
- Cystocele, or bladder prolapse. The bladder presses into the front wall of the vagina. This is the most common type.
- Rectocele. The rectum presses into the back wall of the vagina.
- Uterine prolapse. The uterus descends into the vaginal canal.
- Enterocele. The small intestine presses down into the vaginal space.
- Vaginal vault prolapse. The top of the vagina drops down, usually after a hysterectomy.
Why did this happen to me?
First, the part that matters most: this is not your fault, and you did not cause it by doing something wrong. Prolapse usually builds from several things at once, over years.
- Pregnancy and vaginal childbirth. The single biggest factor, especially after multiple or difficult deliveries.
- Menopause. Lower estrogen changes the strength and elasticity of pelvic tissue.
- Chronic straining. Long term constipation, a persistent cough, or repeated heavy lifting.
- Genetics. Some women simply have more elastic connective tissue, which is why prolapse also turns up in women who have never given birth.
- Everything else. Prior pelvic surgery, higher body weight, and plain time and gravity.
How common is it, really?
Far more common than almost anyone realises. When doctors examine women, up to half show some degree of prolapse, though many of them feel nothing at all. Somewhere between three and six percent of women have prolapse that noticeably affects daily life.
Screening is not routine, and most women are too embarrassed to raise it, so prolapse stays one of the most under discussed conditions in women's health. That silence is exactly why this community exists.