How to Reduce the Risk of your Prolapse Getting Worse

Are you worried about your prolapse getting worse? Woman thinking

Is prolapse worsening inevitable?

Is it possible to avoid prolapse worsening?

Read on now for expert tips that help reduce the risk of your prolapse getting worse.

Is Prolapse Worsening Inevitable?

No, the natural course of prolapse varies from one woman to the next.

Some women find that their prolapse rapidly worsens in a short space of time.

Others notice little change in their prolapse over many years.

Prolapse worsening isn’t inevitable – it varies from one woman to the next. While pelvic floor problems tend to worsen with increasing age, scientific studies tell us that the course of prolapse is unpredictable.

What’s more, you can reduce your overall risk of prolapse worsening or recurring after prolapse surgery, here’s how …

How to Reduce the Risk of your Prolapse Getting Worse

Reduce your risk of prolapse worsening

Please SCROLL DOWN for your prolapse management tip sheet

These tips will help you reduce the risk of your prolapse getting worse.

Reduce your risk by:

1. Exercising your Pelvic Floor

Pelvic floor exercises (Kegels) work with other strong supportive pelvic tissues to keep your pelvic organs in place and prevent them from falling into your vaginal walls (i.e. prolapse).

The evidence tells us that pelvic floor exercises can improve prolapse symptoms and lift the pelvic floor (and prolapse) to sit higher within the pelvis in some women (with mild to moderate prolapse).

Regular pelvic floor exercises are vital for maintaining pelvic floor strength and support long-term.

2. Using ‘The Knack’ Exercise Technique

‘The Knack’ is a pelvic floor exercise technique that can counteract downward strain on the pelvic floor with coughing, sneezing or lifting.

‘The Knack’ technique involves lifting and squeezing your pelvic floor muscles using a strong brisk contraction immediately before and during downward pressure on your pelvic floor e.g. immediately before and with a sneeze.

3. Using a Support Pessary

A support pessary can help to support prolapsed tissues and reduce prolapse symptoms.

While not for everyone, support pessaries can help some women manage their prolapse and avoid prolapse surgery.

Support pessaries come in a range of designs suited to different forms of prolapse.

Speak with your gynaecologist or pelvic floor physiotherapist regarding your suitability for being fitted with a support pessary.

4. Exercising your Whole Body

Keeping your whole body strong and active is a positive step you can take to reducing the load on your pelvic floor with your everyday exercises and activities.

If your body is strong you’ll be able to do more physical activity without overloading your pelvic floor (and your prolapse) than you would otherwise.

5. Choosing Pelvic Floor Safe Exercises Modified resistance exercises

Choose pelvic floor safe exercises and techniques for keeping your body strong and fit.

Pelvic floor friendly exercise involves matching your exercises to your existing pelvic floor support.

For most women pelvic floor safe exercise involves:

  • Choosing low impact fitness exercises
  • Avoiding intense abdominal core strengthening exercises
  • Avoiding inappropriate whole body resistance exercises and techniques

6. Managing your Bowels

Manage your bowels as a priority to avoid overloading your pelvic floor and straining your prolapse.

Good bowel management for prolapse protection involves:

  • Using the correct bowel emptying position and technique
  • Managing food intolerance/ IBS by working with a health professional
  • Minimising your risk of constipation and avoid straining
  • Minimising you risk of diarrhoea and associated straining

7. Manging Coughing

When you cough the pressure generated by your strong upper abdominal muscles is transferred downwards onto your pelvic floor.

The less you cough with a prolapse, the better. A severe bout of coughing with an acute chest infection can potentially worsen prolapse very quickly.

Manage your cough by:

  • Working with a health professional to manage a chronic cough e.g. asthma
  • Managing acute chest infections by seeing your doctor (you may wish to discuss using a cough suppressant if appropriate)
  • Using ‘The Knack’ technique every time you need to cough
  • Not smoking

8. Managing Allergies

Allergies can cause sneezing, coughing and repeatedly blowing your nose. The pelvic floor can become strained with hay fever and its associated symptoms.

Managing allergies for prolapse protection involves:

  • Avoiding known allergens that cause you to experience hay fever
  • Working with your health practitioner to manage existing allergies
  • Using ‘The Knack’ to counteract the pressure of sneezing and blowing your nose

9. Lifting Safely

The load that you lift and the way that you lift can increase the load on your pelvic floor. Safe lifting is vital for managing your prolapse well.

Safe lifting to protect your prolapse involves:

  • Avoiding heavy lifting that causes you to strain
  • Using the correct lifting technique
  • Lifting from waist height or above where possible
  • Minimising lifting from ground height
  • Avoiding repetitive lifting

10. Managing your Body Weight Abdominal body fat

Your abdominal body fat surrounds your abdominal organs and sits directly above your pelvic floor. Your pelvic floor supports the load of your abdomen so the greater the load of your abdominal fat, the greater the load on your pelvic floor.

Some women find that losing abdominal body fat reduces their prolapse symptoms markedly.

Reduce your risk of your abdominal fat overloading your pelvic floor by:

  • Losing weight if you’re overweight
  • Avoiding unnecessary weight gain
  • Understanding that if you are overweight, your pelvic floor is already under load during all of your everyday upright activities and exercises. You will benefit from a careful balance between pelvic floor safe activity, exercises and rest to reduce the load on your pelvic floor.

11. Listening to Prolapse Symptoms

Do you notice your prolapse symptoms with exercise or particular activities?

Don’t ignore these symptoms – your body is providing you with important information about activities and exercises that your pelvic floor is currently unable to withstand.

Act on your prolapse symptoms by:

  • Modifying activities or exercises that worsen your prolapse symptoms
  • Spreading out your activities during the day
  • Resting to unload your pelvic floor and reduce prolapse symptoms


12. Knowing when your Prolapse Risk is Increased

There are times and events in every woman’s life when her pelvic floor works less effectively to support her pelvic organs.

The risk of pelvic floor problems is increased:

  • With menopause and beyond
  • Immediately after pregnancy & childbirth
  • During the breastfeeding months
  • After pelvic surgery
  • With lower back pain
  • With pelvic pain
  • With illness

If you’re living with a prolapse, be mindful of the times in your life when your risk of worsening is increased. During these times you’ll likely benefit from increased pelvic support and reduced pelvic floor load.

13. Getting Sufficient Rest

Your pelvic floor will be more vulnerable to strain when you’re fatigued or unwell. Be mindful of the need to protect your prolapse particularly when you’re fatigued.

If your prolapse is moderate – severe or symptomatic with activity:

  • Balance your activities and exercises with rest
  • Put your feet up if the opportunity arises during the day
  • Try to avoid prolonged standing or heavy/repetitive lifting

How to Reduce your Risk of Prolapse Worsening

Tip Sheet

Reduce your risk of prolapse worsening

Download as PDF

Key Principles for Prolapse Management

In summary, there are 2 key principles for prolapse management:

1. Improving prolapse support
2. Reducing prolapse loading

The tips outlined in this article will help you improve prolapse support and reduce your risk of prolapse overload.

If you can incorporate these principles into your everyday life, you’ll be doing everything you can to manage your prolapse and reduce the risk of your prolapse getting worse.



We Welcome Your Comments



  1. I used to use orbitrek Cycling For 2 years now i feel something comes out of my vegina i feel bulge also when i insert my finger i find myself with something blocks my finger sometimes sudden pain occurs in my vegina n hip right side also pains

  2. Hello!

    Thank you so much for all the information! It is so hard to find out much info about this taboo topic. I had no idea that I should be doing The Knack when I cough!

    I have a question. I had a C-section with our first child, and a vaginal birth with our second. I acquired a stage 1 bladder prolapse with our second child – my first vaginal birth. I was told to push even though I didn’t have a contraction, because the baby’s heart was dropping. This is when I got the stage 1 bladder prolapse, I believe. We would love to have a few more children. Do you know what would be the best way to proceed with the next births? Do you know whether it would be better to have a C-section, or vaginal birth in order to prevent it from getting worse? I don’t have many symptoms as of now, but would like to keep it that way. Thank you very much!!

    • Michelle Kenway Physiotherapist says

      Hi, thanks for your question – yes this is one of those qns I’m asked frequently and can’t answer definitively as there are so many factors involved and your risk factors and condition are unique to your situation. Factors such as your body weight, your pelvic floor support, your bowels, your tissue laxity all come into play.

      The best way to approach this would be to seek an assessment of your pelvic floor & other risk factors with an experienced pelvic floor physio. Being informed about the condition of your pelvic floor and your potential risks with future vaginal deliveries (& pregnancies) will ultimately help you make this difficult decision.

      It makes sense that further vaginal deliveries won’t help the existing prolapse however common thinking is that most of the damage occurs in the first delivery. If you have an understanding Obstetrician this would be worth discussing with him/her too.

      If you have any further qns please feel most welcome to post them.


  3. I am so pleased to have found your site. I hadn’t had problems before having my gall bladder removed but as I have had breathing problems since I was a child I believe the combination of this & my operation have caused my prolapse problem. I am hoping that following your tips & exercises will make it possible to rebuild my pelvic floor strength.
    Thank you for your helpful explanations

    • Michelle Kenway Physiotherapist says

      Hi Tina

      Thanks for your comment – yes breathing problems can contribute to pelvic floor dysfunction. It’s important that the loser abdominal wall and pelvic floor muscles are working as they should in this situation. Unfortunately breathing problems can hamper the strength and coordination of these muscles.

      All the best

  4. Thank you so much for being available to help! I really am truly grateful to have this, and your youtube channel as a resourse. I have a few questions that hopefully you can help me with. I havea prolapsed bladder and would like to find out if using a kickboard in the swimming pool is safe for me to do, and if so, what is the best way to hold the board so there is little to no pressure on my peivic floor? Thank you so very much for your time and assistance.

  5. Thank you Michelle for the proper method for bowel movements. I had an anterior wall surgery for bladder prolapse last Sept. and the dr. told me it’s very important not to strain. Your method is helping me very much. It works better than taking Miralax. I am so grateful to you.

  6. Thank you. I had pro laps operation approx. 2004. I am now 79 years old.

  7. Thank you, thank you! I’ve been trying to keep my prolapse at the original stage. I have been to pelvic floor therapy in Nashville however I didn’t discuss coughing properly with my therapist. Now I have my answer. Your site is a blessing to me. Thanks again, Pamela

    • Michelle Kenway says

      Hi Pamela

      Yes really important to protect with coughing!
      Use the Knack to help you

      All the best

  8. christine says

    Once again, Michelle, it seems you are telepathic! Just as concern about potential worsening of prolapse has crept in, you are there “on the button” with a well-timed and helpful email.
    If only you could influence G.Ps and Physios over here, where help and information is scant indeed, making things more scary for women.
    We are indebted to your professionalism and care. Thank you so much.

    • Michelle Kenway says

      Hi Christine

      Thanks for letting me know that this is what you needed to read.

      Take care

      Best wishes

  9. Good to see all exercises.
    my hysterectomy has been done on 23 Feb 2015 in which one Overy and utras has been removed. My age is 40 years.