An Introduction to Pelvic Organ Prolapse: A Pelvic Physiotherapist's Perspective

Affecting up to 50% of women who have given birth vaginally, POP is a common yet under-recognised issue that significantly impacts physical, emotional, and social wellbeing (Swift et al., 2005).

From a pelvic physiotherapist’s perspective, POP is not just a mechanical problem—it’s a complex condition with wide-reaching consequences. Women may experience a sensation of vaginal pressure, heaviness, or bulging, particularly at the end of the day or during physical activity. Urinary incontinence, bowel dysfunction, and sexual difficulties are also frequently reported, contributing to a diminished quality of life (Weidner & Bump, 2020).

Understanding the Causes and Risk Factors

The primary risk factors for POP include vaginal childbirth, aging, menopause (due to declining oestrogen), obesity, chronic constipation, and prolonged heavy lifting (Vergeldt et al., 2015). These factors compromise the integrity of the pelvic support system, leading to the descent of pelvic organs. Despite its prevalence, many women are reluctant to seek help due to embarrassment or a belief that symptoms are a normal part of aging.

The Role of Pelvic Physiotherapy

Pelvic physiotherapists play a pivotal role in the conservative management of POP. We focus on educating patients, improving pelvic floor muscle strength, and guiding lifestyle modifications that reduce intra-abdominal pressure. Studies show that pelvic floor muscle training (PFMT) is an effective first-line treatment for POP, capable of reducing symptoms and preventing progression when performed consistently under professional guidance (Bo et al., 2015).

Physiotherapy interventions typically include tailored PFMT programs, bladder and bowel retraining, and behavioural modifications such as posture and lifting techniques. We also emphasize the importance of addressing co-existing conditions like chronic cough or constipation that may exacerbate symptoms. For women post-menopause, working alongside medical professionals to address oestrogen deficiency can enhance treatment outcomes (Robinson & Cardozo, 2018).

Psychosocial Implications

Beyond physical symptoms, POP carries significant emotional and psychological burdens. Women often report feelings of shame, reduced body image, and anxiety about sexual activity. As pelvic physiotherapists, we provide a supportive, non-judgmental environment that empowers women to talk openly about their experiences and take control of their recovery.

Conclusion

Pelvic Organ Prolapse is a significant women’s health issue that deserves greater awareness and proactive management. Pelvic physiotherapists are uniquely positioned to deliver holistic, evidence-based care that not only alleviates symptoms but also enhances quality of life. Early intervention, education, and empowerment are key to helping women live confidently and comfortably with POP.

References

• Bo, K., Hilde, G., & Stær-Jensen, J. (2015). Pelvic floor muscle training for the treatment of pelvic organ prolapse: A systematic review. International Urogynecology Journal, 26(11), 1551–1560. https://doi.org/10.1007/s00192-015-2766-1
• Robinson, D., & Cardozo, L. (2018). The role of estrogens in female pelvic organ prolapse. Climacteric, 21(9), 257–260. https://doi.org/10.1080/13697137.2018.1469706
• Swift, S., Tate, S. B., & Nicholas, J. (2005). Correlation of symptoms with degree of pelvic organ support in a general population of women. Obstetrics & Gynecology, 95(3), 389–394.
• Vergeldt, T. F., et al. (2015). Risk factors for pelvic organ prolapse and its recurrence: A systematic review. International Urogynecology Journal, 26(11), 1559–1573.
• Weidner, A. C., & Bump, R. C. (2020). Pelvic organ prolapse treatment: What’s new. Women’s Health, 16, 1745506520935861. https://doi.org/10.1177/1745506520935861