Vaginal Prolapse: Understanding and Managing This Common Condition
What is Vaginal Prolapse?
Vaginal prolapse is a general term for one or more of the vaginal walls dropping from their normal position: the front wall (near the bladder), the back wall (near the rectum), or the top (apex) of the vagina. When the top of the vagina loses its normal shape and sags into the vaginal canal or outside the vagina, it’s called vaginal vault prolapse. This page focuses on prolapse of the upper vagina, which most often develops after a hysterectomy, once the tissues that supported the top of the vagina no longer hold it in place.
Causes and Risk Factors
Several things raise your risk of vaginal prolapse:
- Childbirth, especially multiple vaginal deliveries
- Menopause and age-related changes
- Chronic constipation or straining
- Obesity
- Heavy lifting over many years
- Family history of pelvic floor disorders
- Connective tissue disorders
Did you know?
While vaginal prolapse is more common in older women, it can affect women of all ages.
Symptoms
Symptoms vary, but often include:
- A feeling of fullness or pressure in the vagina
- A bulge at or protruding from the vaginal opening
- Lower back pain
- Difficulty with urination or bowel movements
- Discomfort during sexual intercourse
- In advanced cases, tissue may protrude outside the vagina
Some women have mild prolapse and don’t notice any symptoms.
Diagnosis
If you think you have vaginal prolapse, see a urogynecologist or pelvic floor specialist. Diagnosis usually involves:
- A detailed medical history
- A pelvic examination
- Imaging tests if necessary
Your doctor may also perform tests to assess your bladder and bowel function.
Treatment Options
Treatment depends on how severe the prolapse is, your symptoms, and your overall health. Options include:
Conservative Treatments
- Pelvic floor muscle exercises (Kegels)
- Pelvic floor physical therapy
- Pessary devices
- Lifestyle modifications (e.g., weight loss, avoiding heavy lifting)
Surgical Options
For more severe cases or when conservative treatments aren’t effective, surgical options may include:
- Vaginal repair surgery
- Sacrocolpopexy (abdominal or laparoscopic)
- Vaginal closure procedures, also known as colpocleisis (for women who no longer desire to be sexually active)
Important:
The best plan for you depends on the severity of your prolapse, your age, and your preferences. Go over every option with your healthcare provider.
Living with Vaginal Prolapse
Many women manage vaginal prolapse well and keep a good quality of life. These habits help:
- Perform pelvic floor exercises regularly
- Maintain a healthy weight
- Practice good bowel habits to avoid constipation
- Use proper lifting techniques
- Follow up with your healthcare provider as recommended
Prevention Strategies
You can’t prevent every case of vaginal prolapse, but you can reduce your risk by:
- Maintaining a healthy weight
- Practicing pelvic floor exercises throughout your life
- Treating and preventing constipation
- Avoiding heavy lifting or using proper lifting techniques
- Quitting smoking
When to Seek Help
Call your healthcare provider if you:
- Notice a bulge in or protruding from your vagina
- Experience persistent pelvic pressure or discomfort
- Have difficulty with urination or bowel movements
Early intervention can often lead to better outcomes and may help you avoid more invasive treatments down the line.
Emotional Well-being
Many women feel anxious or embarrassed about vaginal prolapse. Keep in mind:
- You’re not alone. This condition affects many women.
- Effective treatments are available
- Talking openly with your healthcare provider helps you find the right treatment
Supportive Tip:
Consider joining a support group or speaking with a counselor if you’re struggling emotionally with your diagnosis.
Vaginal prolapse is treatable. With the right care, most women get relief from their symptoms and stay active. Your healthcare team can help you build a treatment plan around your symptoms and goals.
References
- Committee on Practice Bulletins—Gynecology, American Urogynecologic Society. Pelvic organ prolapse (ACOG Practice Bulletin No. 214). Obstetrics & Gynecology. 2019.
- Haylen BT, Maher CF, Barber MD, et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic organ prolapse (POP). Neurourology and Urodynamics. 2016. doi:10.1002/nau.22922
- Haylen BT, Vu D. Surgical anatomy of the vaginal vault. Neurourology and Urodynamics. 2022. doi:10.1002/nau.24963
- Hooper GL, Moynihan L, Leegant A, et al. Vaginal pessary use and management for pelvic organ prolapse. Urogynecology. 2023. doi:10.1097/SPV.0000000000001293
- 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
- Carberry CL, Tulikangas PK, Ridgeway BM, et al. American Urogynecologic Society best practice statement: evaluation and counseling of patients with pelvic organ prolapse. Urogynecology. 2025. doi:10.1097/SPV.0000000000001641