Fellowship-Trained Urogynecologist
Urogynecology & Reconstructive Pelvic Surgery
Green Bay, Wisconsin
✓ Medically reviewed May 15, 2026
Does pelvic organ prolapse get worse over time?
Prolapse can change over time, but most of the time it stays about the same. In a large study, 78% of women with untreated prolapse had no change after 16 months. Only about 11% had the prolapse move down by 2 centimeters or more over 3 years. Some prolapse even gets better on its own, with about 1 in 5 women seeing improvement without treatment.
That said, some women do notice gradual worsening. I talk with my patients about what makes progression more or less likely so we can build a plan together.
What affects whether prolapse gets worse
- Ongoing strain on the pelvic floor from chronic cough, constipation, heavy lifting, or extra body weight
- Menopause, because lower estrogen weakens pelvic tissues over time
- Aging, which leads to natural changes in connective tissue
- Pelvic floor muscle health, since women who keep these muscles strong tend to have slower progression
What you can do
Research shows that working with a pelvic floor physical therapist can make a real difference. In the largest trial of its kind (the POPPY trial), women who did individualized pelvic floor training had much better symptom scores than women who only got a lifestyle advice pamphlet. 57% in the training group said their prolapse felt better at one year, compared to 45% in the control group.
Pelvic floor therapy is more than just Kegels. It includes strength training, learning to relax tight muscles, coordination work, endurance exercises, and training the surrounding muscles in your hips, core, and thighs. We have in-office pelvic floor physical therapists who can work with you one-on-one.
Beyond PT, here are other things that help:
- Keeping a healthy weight to reduce pressure on your pelvic floor
- Treating chronic cough or constipation so you strain less
- Learning proper lifting and bracing techniques
- Checking in regularly so we can track any changes over time
When to talk about treatment
Not every prolapse needs treatment right away. If your prolapse is not bothering you, watching it over time is a reasonable choice. When symptoms do bother you, like feeling pressure or a bulge, or having trouble with your bladder or bowels, we can talk through your options together. Those options range from a pessary (a removable support device) to pelvic floor therapy to surgery, depending on what matters most to you.
References
- ACOG/AUGS Practice Bulletin No. 214: Pelvic Organ Prolapse. Obstetrics & Gynecology. 2019.
- Carberry CL, Tulikangas PK, Ridgeway BM, et al. AUGS Best Practice Statement: Evaluation and Counseling of Patients With Pelvic Organ Prolapse. Urogynecology. 2025. doi:10.1097/SPV.0000000000001641
- Barber MD. Pelvic organ prolapse. BMJ. 2016. doi:10.1136/bmj.i3853
- Hagen S, Stark D, Glazener C, et al. Individualised pelvic floor muscle training in women with pelvic organ prolapse (POPPY): a multicentre randomised controlled trial. The Lancet. 2014. doi:10.1016/S0140-6736(13)61977-7
- Wallace SL, Miller LD, Mishra K. Pelvic floor physical therapy in the treatment of pelvic floor dysfunction in women. Current Opinion in Obstetrics and Gynecology. 2019. doi:10.1097/GCO.0000000000000584
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