It’s not the easiest thing to talk about or contend with, but pelvic organ prolapse is more common than most women realize. It happens for several reasons – childbirth, surgery, or just with time – and there are things you can do to help alleviate it.
First Things First: What is Pelvic Organ Prolapse?
Pelvic organ prolapse (POP) occurs when the muscles and connective tissues that support the pelvic organs become weakened or damaged, allowing organs such as the bladder, rectum, uterus, or small bowel to shift downward and press against the vaginal wall. For some, the symptoms are barely noticeable. For others, they can cause discomfort, pain, or a dragging sensation in the pelvis.
Common symptoms include:
A feeling of pressure or heaviness in the pelvic area
A visible or palpable bulge at the vaginal opening
While prolapse isn’t typically dangerous, it can be distressing and disrupt everyday life. That’s why lifestyle changes and exercises that target the right muscles can go a long way in managing symptoms in mild to moderate cases.
Pelvic Floor Strengthening
Movement is good, but the right kind matters when you’re dealing with prolapse. Exercises that add a lot of downward pressure on the pelvic floor can make symptoms worse. You’ll want to skip things like:
High-impact aerobics
Running or jumping
Deep squats
Heavy lifting or straining
Instead, go for lower-impact options like:
Swimming or water aerobics
Seated cycling or spinning
Gentle strength training
Modified yoga or Pilates (just don’t strain your core or increase pressure)
Walking or light, impact-free dancing1
If an exercise makes you feel heavier or more symptomatic afterward, that’s your body’s way of asking you to back off. It’s best to listen. Pelvic floor exercises (also called Kegels) are the gold standard for improving pelvic support. There are two types:
Slow squeezes – These build endurance.
Lie down with your knees about 6 inches apart.
Squeeze the muscles as if trying to hold urine midstream (but don’t practice while urinating). The gluteus muscles should not be engaged.
Hold the squeeze for up to 10 seconds, then rest for a few seconds.
Aim for 8–10 repetitions.
Quick squeezes – These help your pelvic floor respond to sudden movements, such as sneezing.
Use the same muscles, but just a quick lift-and-release.
Repeat 10–20 times.
Together, slow and quick squeezes make up one session. Do this at least 3 times per day (aiming for 3–5 sessions total), ideally spaced out by about a couple of hours. Pair them with routines like brushing your teeth or waiting for coffee to help build the habit.1
You’ve probably heard about “engaging your core,” and it’s a useful technique here. Activating your transversus abdominis (a deep abdominal muscle that wraps like a corset) can work in sync with your pelvic floor to improve support.
Try this:
As you exhale, gently draw your lower abdomen inward, as if zipping up tight jeans.
Don’t suck in or hold your breath.
You should feel your lower abs tighten slightly without bearing down.
Release gently and aim for several repetitions.
In some studies, this type of core activation, especially when combined with pelvic floor exercises, has led to measurable improvements in pelvic muscle strength and even organ position over time.²
Everyday Habits
Exercise isn’t the only thing that affects your pelvic health. Small tweaks to daily routines can help reduce pressure on the pelvic floor and protect your progress:
Bowel health matters. Straining during bowel movements is a significant risk factor for prolapse. Stay regular by drinking 64 ounces of water daily, eating plenty of fiber, and resting your feet on a stool during bowel movements to make things easier.
Coughing? Sneezing? If you have a chronic cough, talk to your doctor. Repeated bouts of coughing increase pressure on the pelvic floor over time.
Avoid heavy lifting. That includes large grocery hauls, pets, or even young grandkids. When you do need to lift something, bend your knees and exhale as you lift to help engage your core, as long as you aren’t straining to get back up.
Be mindful of your posture. Sitting hunched for long periods or standing with poor posture can exacerbate the issue. Check-in with your body now and then – and if you’re sitting, uncross those legs!
When Exercises Aren’t Enough
If you’re feeling symptoms, struggling with bladder leaks, or unsure whether your current at-home plan is helping, it’s okay to ask for help.
At Georgia Urology, our women’s pelvic health specialists understand the physical and emotional toll that prolapse can take. We offer comprehensive evaluations and customized care plans – whether that means continued conservative management, pelvic floor therapy, or minimally invasive surgical options.
You don’t have to wait until things get worse. Let’s work together to keep you moving, strong, and supported. Schedule a consultation with one of our experienced urologists today and explore what’s right for your body and your lifestyle.
References:
Churches, J. (2024). Exercising with a pelvic organ prolapse. In Pelvic Health Physiotherapy. Royal Berkshire NHS Foundation Trust. https://www.royalberkshire.nhs.uk/media/pnynkf5w/exercising-with-a-pelvic-organ-prolapse.pdf.
Bernardes, B. T., Resende, A. P., Stüpp, L., Oliveira, E., Castro, R. A., Bella, Z. I., Girão, M. J., & Sartori, M. G. (2012). Efficacy of pelvic floor muscle training and hypopressive exercises for treating pelvic organ prolapse in women: randomized controlled trial. Sao Paulo medical journal = Revista paulista de medicina, 130(1), 5–9. https://doi.org/10.1590/s1516-31802012000100002.
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