What Does Vaginal Prolapse Feel Like?
Vaginal prolapse, also called pelvic organ prolapse, occurs when one of the pelvic organs descends due to changes in the support structures of the pelvis. Common symptoms include heaviness, pressure, a bulge sensation, bladder changes, and discomfort during daily activities.
Symptoms can vary throughout the day and are often influenced by standing, lifting, exercise, bowel movements, or prolonged activity. Understanding when symptoms worsen and what risk factors contribute to prolapse can help individuals seek appropriate care.
This article explains what vaginal prolapse can feel like, common signs and symptoms, risk factors, and how pelvic floor physical therapy can support symptom management and recovery.
Understanding Vaginal Prolapse
Pelvic Organ Prolapse is the descent of one of the organs in the pelvis. This can be caused by increased laxity in the ligaments that support the organs due to pregnancy, childbirth, constipation, trauma, coughing or decreased pelvic floor strength. The organs affected in vaginal prolapse can be the bladder or uterus resulting in a bladder prolapse or uterine prolapse. Prolapse symptoms can include heaviness, pressure, the feeling of a bulge, the feeling of something coming out, low back pain and sometimes difficulty urinating.
Prolapses can be graded as mild, moderate, and severe. A mild prolapse is a small descent, moderate is lower down and severe would be exiting the vagina. A prolapse can be diagnosed by an internal exam performed by a pelvic floor physical therapist or urogynecologist.
Are you feeling symptoms such as heaviness, pressure, a bulge or the sensation of something coming out? Experiencing symptoms of prolapse can be very distressing. Navigating finding accurate and evidence-based information about prolapse can also be difficult. Prolapse is a unique injury that often has more of a psychological impact than a sprained ankle. While prolapse is very common, especially in women who have had children, it is often not discussed as a potential post birth injury or complication. This can lead to feelings of being surprised and overwhelmed. If you are experiencing any of these symptoms or feelings, it can be really helpful to book a session with a pelvic floor therapist who can take the time to examine you and explain different approaches to managing prolapse.
Common Symptoms of Vaginal Prolapse
· Feeling of heaviness or pressure in the vagina.
· Difficulty emptying the bladder completely.
· Urine leakage (stress incontinence).
· Visible or palpable bulge in the vaginal area.
· Discomfort when standing for long periods or during bowel movements.
· Symptoms may worsen late in pregnancy or after exertion.
What Pelvic Pressure Can Feel Like
Pelvic pressure can feel like a sensation of fullness and heaviness in or near the vaginal opening. You may also feel the sensation of there being something in between your legs or something coming out of the vaginal canal. Some people experience low back pain or a feeling of pressure or discomfort in the lower abdomen. Sometimes the sensation of pressure only comes on after prolonged activities or certain activities.
Changes You May Notice During Daily Activities
You may notice more pelvic pressure and heaviness after certain activities such as prolonged standing, walking or after certain exercises such as jumping or lifting. Some people will feel discomfort sitting and others may feel pressure or heaviness after using the restroom or having a bowel movement. Often the discomfort feels better after resting or laying down.
Bladder and Bowel Symptoms
Vaginal prolapse can cause bowel and bladder symptoms. Bladder symptoms can include urgency, frequency, a feeling of incomplete emptying, leaking or difficulty initiating a stream. Bowel symptoms can include feelings of pressure after having a bowel movement and difficulty completing a bowel movement.
When Symptoms Tend to Get Worse
Prolapse symptoms tend to get worse with prolonged coughing, straining or lifting that is outside of your normal activities. Often patients who have had children will experience a culmination of these symptoms right around when they develop feelings of pelvic pressure or heaviness.
Risk Factors for Vaginal Prolapse
1. Pregnancy and childbirth (very common)
2. Connective Tissue Disorders such as Ehlers-Danlos Syndrome (this leads to increased ligamentous laxity)
3. Chronic constipation with excessive straining
4. Chronic coughing
5. Professions that require regular heavy lifting
6. Rapid weight gain or obesity
7. Decreased estrogen due to menopause (can lead to decreased integrity of ligaments)
When to See a Pelvic Floor Specialist
Pelvic floor specialists can help you manage prolapse and figure out how to return to activities that you love or build endurance for activities that are currently provoking symptoms. If you are feeling symptoms or pressure or heaviness or have received this diagnosis from a physician, reach out to a pelvic floor therapist. Pelvic floor specialists often help translate what the diagnosis means for you in terms of function and activities of daily living and answer any questions that you may have.
If you are experiencing intense pelvic pain, bleeding, the inability to empty the bladder or bowel, or see any organs visibly protruding outside your body you should see a physician such as your primary care doctor, OBGYN or urogynecologist. In case of very severe symptoms, seek emergency care.
Treatment Options for Vaginal Prolapse
Pelvic floor physical therapy and pessary support can be very helpful for prolapse management. A pelvic floor therapist will take on a holistic approach that extends beyond Kegels. A pelvic floor specialist will first assess your pelvic floor muscle tone, endurance and coordination. For example, many patients have increased pelvic floor muscle tone that will need to be addressed first. They can also discuss your bowel health and make sure to address any constipation or straining.
Patients with prolapse symptoms also greatly benefit from targeted strengthening to the hip and core muscles. Exercise programs should progress to include resistance training that challenges the trunk and that includes overhead, single leg and dynamic movements. While many patients see improvement in weeks, therapy needs to be consistent for long-term goals to be met.
Alongside therapy, many patients may benefit from the use of a pessary. A pessary is a removable device made of silicone that can act as a support for the pelvic organs. A urogynecologist can help fit a pessary. Sometimes, you need some time and trial and error to find the right fit for comfort. A pessary can help decrease the symptoms of heaviness and pressure associated with a bladder or uterine prolapse. Some patients use a pessary only for high impact activities, whereas others will wear their pessary all the time.
Where To Find Prolapse Treatment and Pelvic Floor Physical Therapy in Queens, NYC
If you are experiencing prolapse symptoms, help is available! Pelvic floor physical therapy is the gold standard treatment for this condition. If you are in the Forest Hills, Queens, NYC area and you are looking for help today, reach out to us! Give us a call or fill out our contact form today!
