Pelvic organ prolapse in younger women
Finding out you have pelvic organ prolapse in your 20s, 30s, or 40s can be a shock. Most people think of prolapse as something that happens to older women. It can happen at any age, and it is not your fault.
Prolapse is common after pregnancy and childbirth. In one study of first-time mothers, about 1 in 3 had some loss of pelvic support 6 to 12 months after delivery. Most of it was mild, and mild prolapse often causes no symptoms at all. Even after a cesarean, a small number of women had prolapse.
Treatment works for younger women too. 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. Vaginal birth is the biggest risk factor, and having your first baby before age 25 may add to it.
- Connective tissue differences. Some women are born with tissue that gives less support, such as joint hypermobility or Ehlers-Danlos spectrum.
- A job that involves heavy lifting.
- Chronic constipation and straining.
- Family history. Women whose mother or sister had prolapse are more likely to have it.
None of these mean you did something wrong. Your body is built a certain way, and childbirth adds strain.
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
- Pain or a change in sensation with sex
These symptoms can feel scary or embarrassing. Bring them up anyway. There is a lot we can do.
How we treat it
There is no single right path. We talk through your options and choose what fits your goals. You do not have to try one treatment and fail it before you can choose another.
For many younger women, these work well:
- Pelvic floor physical therapy. A pelvic floor therapist builds a program for your muscles and how you move. In a large trial, women with prolapse who did individualized pelvic floor training had fewer symptoms at a year. We have 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 stop using it at any time. Using one now does not limit your options later, including pregnancy.
- Surgery. If you may want more children, many women wait on surgery, since a later pregnancy and birth can affect the repair. If you want surgery before you are done having children, a repair that keeps the uterus (hysteropexy) is an option. Pregnancy after it is possible, but the data are limited, and prolapse returned in about 1 in 7 women who later gave birth vaginally.
If you are done having children, all options are often open, including repairs designed to last longer. One thing to know: prolapse is more likely to come back after surgery in women under 60. A repair done at 35 has to hold for decades. That is part of why timing matters.
Your next steps
If you have symptoms, schedule a visit with a urogynecologist. Write down what bothers you most, what activities you want to get back to, and whether you plan more pregnancies. Those answers shape the plan as much as the exam does.
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
- Committee on Practice Bulletins-Gynecology, American Urogynecologic Society. Pelvic organ prolapse. Obstet Gynecol. 2019.
- Chang OH, Carter Ramirez A, Edwards A, et al. The role of uterine preservation at the time of pelvic organ prolapse surgery. Urogynecology. 2025. doi:10.1097/SPV.0000000000001667
- Wieslander CK, Weinstein MM, Handa VL, et al. Pregnancy in women with prior treatments for pelvic floor disorders. Female Pelvic Med Reconstr Surg. 2020. doi:10.1097/SPV.0000000000000822