Pelvic organ prolapse in younger women
Finding out you have pelvic organ prolapse in your 20s, 30s, or 40s can be a shock. Many people think of prolapse as something that only happens to older women. It can happen at any age, and it is not your fault.
Prolapse is real, and it is common after pregnancy and childbirth. In one study, about 1 in 3 women had some loss of pelvic support within a year of their first birth. Most did not even know it. So if this is you, you are not alone.
The good news is that treatment works well for younger women. We build a plan around your life, your activity level, and whether you may want children in the future.
Why this happens
Prolapse in younger women usually comes from one or more of these:
- Pregnancy and childbirth. This is the most common cause in younger women.
- Connective tissue differences. Some women are born with tissue that gives less support, such as joint hypermobility or Ehlers-Danlos spectrum.
- Heavy lifting or high-impact sports over time.
- Family history. Prolapse can run in families.
None of these mean you did something wrong. Your body is built a certain way, and life events like childbirth add strain. That is the cause, not anything you failed to do.
Signs to get checked
See a doctor if you notice:
- Pressure or a bulge in your vagina
- Something you can see or feel coming out of your vagina
- Trouble using tampons
- Heaviness that gets worse as the day goes on, or with activity
- Changes in how you pee or have bowel movements
These symptoms can feel scary or embarrassing. They are worth bringing up. You are in control of what happens next, and there is a lot we can do.
How we treat it
There is no single right path. We talk through your options together and choose what fits your goals. This is shared decision-making, not a fixed set of steps you have to climb in order.
For many younger women, these tools work well:
- Pelvic floor physical therapy. This is much more than Kegels. A pelvic floor therapist works on muscle strength, the ability to relax and lengthen those muscles, coordination, and endurance. They also look at the muscles around the pelvis, including your hips, glutes, thighs, and core, plus your breathing and posture. Our practice has pelvic floor therapists in the office, with a wider network across northeast Wisconsin and Michigan’s Upper Peninsula.
- A pessary. This is a small, removable support you wear in the vagina. It can ease the bulge and pressure, and you can use one even if you want to get pregnant later.
- Surgery. This is an option too. If you may want more children, many women choose to wait on surgery, since a future pregnancy can affect the repair. That is a choice we make together, based on what matters most to you.
If you are done having children, all options are open, including more lasting surgical repairs. Your activity level and your goals guide the plan.
A note on pregnancy and prolapse: having prolapse does not stop you from getting pregnant. Symptoms may feel worse during pregnancy, but a pessary and pelvic floor therapy can help you stay comfortable, and things often settle after delivery.
Your next steps
Prolapse at a younger age is more common than most people think. Please do not let embarrassment keep you from getting help. A urogynecologist gets what you are dealing with and will build a plan with you, not for you.
Learn more about pelvic organ prolapse
References
- Handa VL, Nygaard I, Kenton K, et al. Pelvic organ support among primiparous women in the first year after childbirth. Int Urogynecol J. 2009. doi:10.1007/s00192-009-0937-3
- Hilton P, Dolan LM. Pathophysiology of urinary incontinence and pelvic organ prolapse. BJOG. 2004. doi:10.1111/j.1471-0528.2004.00505.x
- 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. Lancet. 2014. doi:10.1016/S0140-6736(13)61977-7
- Hooper GL, Moynihan L, Leegant A, et al. Vaginal pessary use and management for pelvic organ prolapse (AUGS-SUNA joint clinical consensus statement). Urogynecology. 2023. doi:10.1097/SPV.0000000000001293
- Wallace SL, Miller LD, Mishra K. Pelvic floor physical therapy in the treatment of pelvic floor dysfunction in women. Curr Opin Obstet Gynecol. 2019. doi:10.1097/GCO.0000000000000584
- 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