How to Manage a Prolapsed Bladder and Avoid Recurrent Bladder Prolapse

Prolapsed bladder management involves identifying factors contributing to your prolapse and bladder support exercises to improve prolapse support. Bladder illustration

This Pelvic Floor Physiotherapist information helps you understand how to best manage your bladder prolapse, exercise safely and prevent recurrent bladder prolapse after bladder prolapse surgery.

Read on for Physiotherapist tips and techniques for prolapsed bladder management:

1. What is a prolapsed bladder?
2. What are the symptoms of a prolapsed bladder?
3. Does a bladder prolapse cause bladder leakage ?
4. What causes a bladder prolapse?
5. Tips for protecting by your bladder prolapse and after prolapse surgery
6. How to exercise safely with a bladder prolapse, exercises to avoid and those to choose

Prolapse Exercises e-Book

International best selling prolapse exercise guide for women with prolapse and after prolapse surgery.

Prolapse Exercises Book

Prolapse Exercises teaches you how to:

  • Exercise safely after prolapse surgery
  • Reduce your risk or repeat prolapse
  • Avoid unsafe exercises
  • Choose pelvic floor safe exercises
  • Reduce your risk of prolapse worsening
  • Improve prolapse support
  • Increase your strength and fitness
  • Strengthen your core
  • Lose weight

1. What is a Prolapsed Bladder?

Bladder prolapse is commonly referred to as “dropped bladder” or “fallen bladder”, and is one  type of  pelvic organ prolapse. Bladder prolapse is relatively common in women and the risk increases with increasing age.

A prolapsed bladder occurs when when the bladder moves into the front wall of the vagina. Sometimes the front wall of the vagina is pushed down and out of the vagina and appears as a bulge at the entrance of the vagina. This occurs when there is a weakness in the pelvic floor support structures allowing the bladder to fall through the area of weakness.  Bladder support structures include pelvic floor muscles and thick supporting tissues.

You can see the importance of maintaining a strong pelvic floor muscles with kegels after prolapse surgery from this diagram, especially if you have been diagnosed with a bladder what is a prolapsed bladderprolapse or after bladder prolapse repair surgery. Pressure from within the abdomen can push the pelvic floor (and bladder prolapse) downwards. Strong supportive pelvic floor muscles help to resist the downward pressure on your pelvic floor from everyday activities and exercise.

2. What are the Symptoms of Bladder Prolapse?

Bladder prolapse may present with a number of different prolapse symptoms. When the prolapse is very mild it may not produce any symptoms. Prolapsed bladder symptoms tend to become more apparent as the prolapse worsens. Some women report one or more of the following symptoms:

  • Bulging, heavy sensation in the vagina, often worse at the end of the day
  • Lump coming down inside and/or out of the vagina
  • Difficulty inserting tampons
  • Difficulty emptying the bladder with slow stream and sometimes incomplete bladder emptying.

3. Does Prolapsed Bladder Cause Bladder Leakage?

No, bladder leakage does not occur because of a bladder prolapse. Some women may suffer from a leaking bladder in addition to their prolapse.

Sometimes a bladder prolapse causes a small kink or bend in the urine tube (urethra) which actually decreases leakage during activities stressful activities for the pelvic floor such as coughing or sneezing and this is called occult stress incontinence (because it is usually hidden). This is the reason why women who are found to have stress incontinence and bladder prolapse by their specialist may have a bladder sling or procedure to reduce leakage at the same time as their bladder prolapse surgery. If the prolapse is surgically repaired and the woman also has underlying stress incontinence which she may not have know about then she may start to leak when the prolapse is repaired and the urine tube is straightened out.

4. What Causes Prolapsed Bladder?

There are many different factors that can cause or contribute to a bladder prolapse.

Common causes of a prolapsed bladder include:

  • Pregnancy and childbirth (sometimes injury to the pelvic floor doesn’t appear until years later)  Bladder prolapse causes
  • Hormonal changes with menopause
  • Ageing
  • Constipation and straining repeatedly to empty the bowel.

Other factors which may contribute to bladder prolapse are:

  • Being overweight
  • Chronic coughing associated with smoking or asthma
  • Heavy exercise including intense core training and heavy resistance training
  • Previous pelvic surgery including surgery for urinary incontinence, sacrospinous fixation and perhaps hysterectomy.

5. Tips for Bladder Prolapse and After Bladder Prolapse Repair Surgery


  • Constipation and repeated straining to use your bowels (see our free training video now on how to overcome bowel movement problems to learn how to empty and avoid straining)
  • Heavy lifting, pushing/pulling, bending
  • Smoking (to reduce coughing)
  • High impact exercise (e.g. jogging, sit-ups, horse-riding, high impact aerobics)
  • Heavy resistance exercises and intense core abdominal exercises
  • Excessive weight gain


  • Regular pelvic floor exercises or kegels after prolapse surgery – start after bladder prolapse surgery when you have your specialist’s approval to commence. If you are not sure seek further information on how to exercise your pelvic floor muscles (see our free training video on how to find and feel your pelvic floor muscles to the right of your screen, read Inside Out or check with your women’s health physiotherapist).
  • Consider a pessary ring – pessary rings are designed to support the prolapse and minimise symptoms by sitting high inside the vagina. Women often find that using a pessary ring helps them to better exercise their pelvic floor muscles by lifting their prolapse and reducing dragging. Speak with your specialist about the feasibility of a pessary for your condition.
  • Wear quality support underwear (briefs) or a pelvic when you are active
  • Practice good bowel habits – choose bowel friendly foods and never strain to use your bowels. Some women find they can support their dropped bladder by holding a pad of toilet paper over the vagina when using their bowels.
  • Alternate activities – avoid prolonged standing especially when recovering from pelvic floor repair surgery.
  • Split tasks –  do household chores over a few days rather than all in one day.
  • Lose weight if you are overweight.
  • Rest in the afternoon and elevate your legs if possible.
  • Manage chronic cough, chronic hay fever and sneezing by visiting your doctor
  • Practice good posture – to promote good pelvic floor function
  • Choose low impact exercise

6. Safe Exercise With Prolapsed Bladder?

Many everyday exercises can increase pressure on your pelvic floor and worsen your bladder prolapse symptoms or even contribute to repeat prolapse after already having had prolapse surgery. You need to make sure that you are fully informed about the exercises that are suitable for you if you are living with a prolapse.

1. Fitness exercises that reduce pressure on the pelvic floor

Fitness exercise should be low impact to reduce pressure on the pelvic floor. This means choosing exercises keeping one foot at least on the ground with exercise. This is quite different to high impact exercise such as running or jumping where both feet are off the ground.  Low impact exercises include:

  • Cycling
  • Walking
  • Dancing
  • Bush walking
  • Swimming

2. Strength training and abdominal exercises

Many everyday strength training and abdominal exercises have the potential to increase the downward pressure on the pelvic floor.  These are some exercises to avoid with a bladder prolapse:

  • Intense abdominal strength exercises and abdominal exercise machines which have the effect of increasing pressure on the pelvic floor
  • Specific strength exercises such as leg press and wide leg squats that increase pressure on the pelvic floor and prolapse
  • Heavy lifting and straining when lifting weights
  • Breath holding when lifting weights-breathe out with the effort of lifting, pushing or pulling
  • Plus sit on a ball or a bench for all your strength exercises wherever possible to support your pelvic floor

For further information articles and free videos on safe exercise with a prolapsed bladder and after prolapse surgery include  prolapse protection for strength training and 12 abdominal exercises to avoid with prolapse or after prolapse surgery.

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We Welcome Your Comments


  1. Hi Michelle

    Just wondering if you could provide some advice. I have Diatassi recti of 2.5 fingers 4cm and epigastric hernia of walnut size and a small umbilical hernia. I use to do kettle bells classes, alongside hitt style classes, yoga and zumba, I would always modify the exercises and leave out core stuff with pelvic friendly ones. I went to see womens pt 2 in fact I said everything was fine, the other told me i have a small Grade 1 anterior wall prolapse, she advised to stop all exercising and just walk 30mins a day and do some pelvic floor strengthening exercises. I feel very down at only 43. My Doctor has been very unsupportive hence why I went to a pt. Any advice I would be very appreciated? Would your book be useful?

    • Author: Michelle Kenway Pelvic Floor Physiotherapist says

      Hi Karen
      I’m not quite sure why you’ve been told not to exercise unless your pelvic floor is very weak or not functioning well, perhaps ask your women’s pt for her rationale for this advice? Most women with small grade 1 anterior vaginal wall prolapse can in fact exercise with a huge range of exercises and this may actually help to reduce the load off the prolapse by keeping the body strong and active. Yes the Prolapse Exercises book describes at length appropriate strength training, cardio fitness exercises as well as bone health strength training and weight management exercises. You will also find multiple prolapse exercise articles and videos on this site that are free to access that will help you understand more too

  2. Hi Michelle, i am 53, and have not had a period in about 3 1/2 years. I am in good health and not over weight. I do not have problems with constipation. I was just told i have a bladder prolapse. I have been a retail manager with the same company for 9 years. My job is very physical, I’m required to work 48 hours a week. I am always on my feet, walking briskly back and forth to the stock room, bending, kneeling, reaching ect. Every week we get a shipment of between 60 and 130 cases weighing between 20 and 60 lbs. So i was wondering if lifting off the floor and carring these cases around the store could have cause this prolapse. Just wondering if i should step back and let some of the younguns handle the heavy stuff. I appreciate your in put.
    Thanks Michelle G.

    • Michelle Kenway Physiotherapist says

      Hi Michelle
      Yes likely that long hours on your feet and ongoing heavy lifting will exacerbate/cause prolapse especially in a woman predisposed to this condition e.g. long-term constipation and straining that can weaken the pelvic floor and predispose to prolapse. If you have the luxury of avoiding this loading to your pelvic floor then you’ll be doing yourself a favor avoiding it (but please don’t give the job to a new mum). Also a good idea to see a Pelvic Floor Physio if you can, get your constipation under control to stop straining and maybe discuss the use or a pessary to help you out too as I imagine you’re a very hard worker, hard to slow down and you’ll likely keep this type of work up. A pessary may allow you to do more physical work than you would do otherwise with less impact on your prolapse, all the best to you

  3. Michelle,

    My daughter just got a trampoline for her birthday. I have prolapse. If I use my pessary will it help support the pelvic floor so I can jump once in a while with her?

    • Michelle Kenway Physiotherapist says

      Good question Angie,

      I definitely wouldn’t recommend doing a whole lot of jumping, but there’s one simple way to test and that is having a trial and see how it goes. If you notice any symptoms or the pessary moving then best to avoid. If you remain asymptomatic this may be something you can do on occasions with your daughter.


  4. Hi Michelle,
    I am 28 years old have recently discovered that I have a mild prolapsed bladder, I think caused by the birth of my son 2.5 years ago. Although I don’t have any pain, I am finding it extremely uncomfortable. All my doctor has told me to do is pelvic floor exercises…. I was wondering what you thought my chances of full recovery were, if this is the only “treatment” I get.
    I know there are people worse off, but this feels terrible enough and I am really hoping to get back to normal…. I certainly don’t want it to get any worse.
    Thank you

    • Michelle Kenway Physiotherapist says

      Hi Dee

      Yes short answer – try to get an appointment with a gymaecologist or Pelvic Floor Physio trained to fit support pessary. Gynaecologists do this routinely and now some Australian Physios have been trained to fit pessaries too. I can provide you with some contacts for Australian Pelvic Floor Physios trained in this area. You can read more on support pessary here

      My other thought is to check that it is the prolapse that is actually causing the discomfort and not something else like increased pelvic floor muscle tension again see an Pelvic Floor Physio to assess and treat appropriately see here

      All the best Dee

  5. Christie says

    I have a bladder prolapse after difficult natural birth. Slight bulge @ vagina. Do have some bladder weakness also. My son now 2.5yrs whom i still breastfeeding & I have PCOS which Ive heard affects it due to hormones. I would like to have another baby. However very concerned as to what might happen through pregnancy & if natural birth even possible. I was running but stopped after being told can make it worse. So now walk & do pelvic floor excercises few times a day. I wondered if your DVD would be appropriate for me to use & also your thoughts on another pregnancy?
    Warm regards

    • Michelle Kenway says

      Hi Christie
      Thank you for your email. Usually most of the pelvic floor damage with natural delivery is done during the first delivery, this is not to say that another delivery will help things. Some ladies have a pessary to help them through pregnancy. It is really vital to do your pelvic floor exercises daily with another pregnancy and to rehabilitate beyond that. i would also suggest that weight management and good bowel management will also be vital. I hope this helps you Christie, best of luck!

  6. Hi Michelle,

    I was diagnosed with bladder prolapse kind of a month ago after delivering my 4 kg baby boy (who is now 2 months), honestly I freaked out a a bit. Therefore I’m most pleased to find your site – I’ve been searching for information for weeks, this is by way the best page I could find. I also find it very encouraging that you describe how exercising can be continued (I’m forty and used to do a lot of astangha yoga and abdos before my pregnancy).

    Now to my questions:

    1. My gynecologist told me that it is too early to draw conclusion two months after birth about my condition as in the months after delivery tissues still recuperate a bit, that in her view could help with my prolapse. What is your view on this? (I think i have a moderate prolapse, the bladder has bulged a bit into the vagina = if i bend forward i can see a bit of sg in my vagina – I started to do Kegels + hypopressive training and since than it can happen that I don’t see anything :), but nevertheless can feel that sg is in there….).

    2. My kiné tells me to forget about abdos and also ashtanga but she said swimming could be a good option. My question is: can it happen that during swimming I pressure the pelvic floor (I’m not a big swimmer, to be honest).

    3. And my last question is: I read in your article on yoga poses that you suggest to avoid uddiyana bandha as it can put pressure on the pelvic floor. With my kinesytherapist we are doing hypopressive exercises (as developed by Marcel Caufriez) which might work upon the same principle (?, you lift your diaphragm creating apnea that in fact pulls up the pelvic floor), and in principle could strengthen a bit the weakened ligaments. In any case, since I’m doing these exercises I feel some improvement but now reading your advise I became a bit hesitant.

    I’d most appreciate if you could share with me your views on the above three issues – and thanks again for your excellent blog.

    • Michelle Kenway says

      Hi Monika

      Thanks for your questions – yes I do firmly believe that exercise can usually be continued with a moderate prolapse.

      You know I often wonder why women in your position with moderate prolapse and coping with being new mums with added workload including lifting aren’t offered a support pessary for management. The prolapsed tissues are supported helping to alleviate strain, symptoms are decreased, women vcan be more active and the pelvic floor exercises may be more effective. Take a peak at this article if you are interested in support pessary treatment.

      1. Yes it will take quite some time for your pelvic floor tissues to recover from pregnancy and childbirth – it took them 9 months plus birthing a big baby boy to get them where they are now. It takes up to 6 months to strengthen weak pelvic floor muscles added to the favct you may be breastfeeding, you are fatigued, possibly acrring more weight than usual, many factors come into play. You won’t know the true state of your prolapse until you have fully recovered your pelvic floor muscle support and control.

      2. If you’re not a big swimmer why do it? Do what you enjoy and modify to keep it pelvic floor safe. You need to follow medical advice. It is worth noting that many Yoga poses are in fact very safe with pelvic floor prolapse issues.

      3. During the uddiyana bandha or belly look the belly is drawn in strongly which increases pressure within your trunk. The pressure needs to be directed somewhere up or down, up is to the diaphragm and down is the pelvic floor. Your pelvic floor is your weakest link so it will be likely forced downwards if you belly lock with the in breath unless your pelvic floor is very strong. Imagine squeezing a toothpaste tube in the middle – the same principle applies as the pressure is incresed in the middle – does this rather crude analogy make sense? When you breathe out and your diaphragm lifts your pelvic floor is simply being passively drawn up, it is not strengthening your prolapse supports. The pelvic floor moves up and down to match our regular breathing in all of us. Ultimately this is far less effective than actual pelvic floor strengthening I would think.

      Lots for you to think about here, I hope this gives you some positive direction.

      • Many thanks for your fast reply Michelle! In fact I asked my gynecologist about her views on a pessary – she told me that was sg very old-fashioned and used nowadays mostly for elderly ladies who are not fit for surgery, but not for a sexually active woman. Will try once more with her :). I’ll also do pelvic floor strengthening exercises (I have a little “gadget” called epi-no that help with the Kegels).

        Thanks again.

        • Michelle Kenway says

          Yes that’s the shame of it. Women should be at least made aware of the prolapse management options available to them and encouraged to make informed decisions about what will work best for them at their age and stage of life. Pessary can be especially helpful for women in their childbearing years and for those having trouble strengthening their pelvic floor muscles.

          Pessaries are definitely not only used in ‘old ladies’. I am not sure where you live however in Australia we manage quite a number of post partum women with support pessary to help them manage prolapse issues. We use support pessaries in a range of ages and there is no need to discriminate on the basis of age. Women can experience prolapse problems at any age/stage of childbearing years and beyond.

          Pessaries date back to the Ancient Egyptians where I have read even pomegranate fruit were used as a form of pessary. They do indeed have an extensive history of use so you can definitely say they are old fashioned that’s for sure. There is a trial underway in investigation whether pessaries actually assist with pelvic floor exercises for prolapse. There are also some great little in out flexible pessary devices available in the US that allow women to use these devices and manage themselves for sport and activity where their prolapse is troublesome.
          Ultimately you are guided by your gynaecologist on this Monika however it may well be an option to assist you and worth discussing further.

          Always interested to hear how things go for you with this!
          All the best

  7. Thank you for your wonderful sight. I am 38 and was just diagnosed with a moderate-severe bladder prolapse, discovered during a 2-week bout of forceful coughing. I love/NEED to be active, and this is devastating for me. I notice that when I do anything active, even low impact exercise like an elliptical machine, my bladder seems to buldge even more into my vaginal opening. It returns to the usual buldge at the vaginal opening if I manually push it up, or the next morning after resting all night. Am I making things worse by exercising? How far can my bladder drop? I want to avoid surgery for as long as possible (if not forever), but I MUST be able to play with my little girls, exercise, and remain active for my emotional health.

    Thank you for your advice!

    • Michelle Kenway says

      Hi Kirsten
      Yes agreed exercising with a prolapse can at first seem daunting however it is very possible for most women. Have you discussed the possibility of being fitted with a pessary by your gynaecologist? There are a range of designs of pessary for different types and severity of prolapse so this would be a start. Pelvic floor exercises are a must for all women and this is really imperative for young women like you. The bladder can actually force the front vaginal wall to bulge out of the vagina – it can become difficult to empty the bladder completely as the bladder prolapse worsens.

      Elliptical is probably not the best low impact exercise with a prolapse – stationary cycling (seated or recumbent) might be better in terms of support and allowing you to exercise at a moderate intensity you can read more using this link on bike riding and prolapse.

      Otherwise the newly released Prolapse Exercises book outlines how to exercise safely and reduce prolapse symptoms with exercise specifically written to help women with prolapse to exercise – it’s an easy read, simple and straightforward.

      Hope this helps get you started Kirsten

  8. Hi Michelle, you mention sitting/resting in the afternoon with feet up. Does sitting in a recliner put too much pressure down onto the pelvic floor and increase the position of a woman with hysterectomy’s bladder to drop? I am trying to find a resting seated position to say read or watch TV that would be supportive and not take away from my good positioning during exercise. I really enjoy reading but now am paranoid that my “rest time” is detrimental! I have not had prolapse surgery, I was just told at my last check that indeed the bladder had dropped…this due to paddle boarding 30 min one leisurely Sunday evening which I will not be repeating :( Thank you for any advise

    • Michelle Kenway says

      Hi Melly
      Sitting on a recliner with your feet up will reduce pressure on the pelvic floor and is a great position for resting in the afternoon. This position is ideal for women seeking to alleviate/relieve pressure off the pelvic floor. Post op we recommend lying down with a pillow under the knees and I think you can see how similar the recliner is. Recliner chair will reduce rather than increase pressure on the pelvic floor when compared with sitting upright or standing so enjoy!

  9. I am in the beginning stages of prolapse bladder. Have had a hysderectomy and doc says there is nothing holding bladder in place.
    I want to get a rebounder for cardio and sculpting; however, am concerned that jumping up and down might cause bladder to drop?

    My doc told me I could do fitness vibration if I did kegals during. I can do that; however, not sure I can hold kagel during rebounder exercise.

    I have no symptons from prolapse and don’t want any.

    I was hoping since there is no jarring and low impact from rebounder this would be a safe and effective form of exercise.

    I really need something – I am 58, previously in good shape until stressful job took a toll and came close to Addisons Disease.

    Feedback on my situation, please?


    • Michelle Kenway says

      Hi Kathie
      I would agree with your concerns about the possible effect of a rebounder on bladder prolapse, especially if moderate-severe. I also think it is vey difficult for many women to activate and maintain their pelvic floor contraction (Kegels) during exerise, as well as not the most appropriate way to use pelvic floor muscles. Have you considered walking or cycling as low impact pelvic floor safe options for exercise? The way the rebounder is used also impact upon pelvic floor safety, with both feet off at once then the impact increases as opposed to keeping one foot in contact with the rebounder throughout.

  10. Does anybody have any thoughts on this?–I had surgery a year ago to repair a prolapsed bladder, a hysterectomy was performed at the same time leaving my ovaries. I am well past the menopause having had my last period 3 years prior to surgery. A year later the bladder has prolapsed again, i am getting worse hot flushes than i ever did and have put on a lot of weight. So where do i go from here. At my age(58) is it worth having more surgery and what might that entail.I am seeing the doc soon but was wondering if anybody else has found themselves in this position.

  11. Dear Michelle. What is your view regarding posture as a treatment for cystocele. Christine Kent says standing in a particular way can alleviate a cystocele. Kind regards anna

    • Michelle Kenway says

      Hi Anna
      We know that slumped forward posture increases the pressure within the abdomen, which is transferred to the pelvic floor. If you think about the slumped forward posture in ladies with osteoporosis and dowager’s hump this is an exaggerated form of the posture I am trying to describe. This posture is known to increase bladder incontinence problems in women, and the same is true for prolapse. In this slumped forward posture the load on the pelvic floor is increased and the core muscles are less able to provide support. The pelvic floor muscles work most effectively with the ‘normal’ inward lower back curve.

      Hope this is clear, let me know if not.

  12. Hi my name is Evelyn,
    I have a mild bladder prolapse I’m just 24 yrs old. I feel like a dead person alive after I found out about this, all I do is cry. My son is just 2 months and already weights 13lbs I just want to enjoy him and I’m scared that by next month I won’t be able to lift him up.

  13. Hi Michelle!
    I have a bladder prolpase after giving birth to my beautiful son 6 months ago – before being diagnosed with this I enroled to do a massage course – it’s started off with the theory side of it all and I was wondering does giving a massage say a deep tissue massage put much pressure on my pelvic floor? Any feedback would be appreciated – Ellie

    • Michelle Kenway says

      Hi Ellie
      I have had some ladies contact me in the past after prolapse surgery with this same concern, and I think it is a worthwhile question.

      First of all, I don’t know of any evidence to suggest that doing deep tissue massage can overload the pelvic floor – I think this will come down to the types of techniques used, and the types of clients you have (large muscular framed individuals can require more intense effort than light, and less muscular individuals speaking from experience).

      I think there are ways to modify the effort required and you can perhaps discuss these with your teacher for example leaning the body weight through the elbow to create pressure and trigger points rather than working with your hands and thumbs. This may well have a bearing on the type of massage field you pursue – for example rather than sports massage with a football team you may choose to work with women who have chronic pain (just ideas). You might also choose to avoid long days of successive clients which can also be very fatiguing. So I believe there are ways you can pursue your massage career and modify the potential pressure on your body ad avoid overloading your pelvic floor. This is a good opportunity to be opn to different forms of massage too.

      Best of luck and hope this helps you a little

  14. Hi Michelle, thank you so much for this informative site and for taking up your time to answer our questions. I have a moderate cystocele mild rectocele and moderate uterine prolapse. I am 59.
    I went to a physio 2 weeks ago she she started me on a program. Week one was a 100 pelvic lift a day holding them for 10 seconds. I am exhausted and in moderate pain around the pubis bone. I dont want to go back and cancelled my appointment. What is a normal number to start off with? and how long should I hold them for? and how many session a day please. Jan

    • Michelle Kenway says

      Hi Jan
      Thank you for your question. Normally when starting out women are prescribed pelvic floor exercises on the basis of what they can comfortably do with the correct technique.

      I think an example helps best here:
      If a woman can comfortably hold her pelvic floor contraction for 2 seconds and repeat this twice, then that is where she starts and repeats this 3 times a day. These days pelvic floor strengthening is prescibed along the same scientific principles as presciption for general muscle strengthening for strength i.e. 8-12 repetitions (repeated exercises), 3 times a day maximum aiming to maintain the pelvic floor muscles contracted for up to 10 seconds. Back in the days when Arnold Kegel first recommended Kegel exercises, they were prescribed at up to 200 reps a day, these days we understand how muscles strengthen most effectively and this number of repetitions is inconsistent with what science tells us about how muscles strengthen best.

      I think technique is worth mentioning here too in view of your discomfort. Having once contracted, the pelvic floor muscles need to be completely relaxed and rested before the next attempt otherwise the risk of overactive pelvic floor muscles (with pelvic pain) is very real just like holding your neck muscles contracted and not giving them a rest. The other thing to remember if that for the first week or two exercises are very gentle to familiarise yourself, then when confident in technique gradually increase the strength of contractions ensuring full relaxation.

      I hope this helps Jan & best of luck

  15. Pearl Robinson says

    I have a dropping bladder and let me say it is uncomfortable. My doc prescribed some estrogen for me to insert into my vagina but I am afraid because I smoke, and I have COPD. What should I do?

    • Michelle Kenway says

      Hi Pearl
      Thanks for your question – vaginal oestrogen acts locally on the vaginal tissues to thicken them after menopause, it acts differently to the way the way oral hormone replacement therapy acts which acts on the whole body. Unfortunately the chest problems and coughing you suffer will no doubt impact upon your pelvic floor. Your doctor would have assessed your suitability before prescibing this to you, if you are still concerned aboutthis then speak with your doctor again.

  16. Louise sullivan says

    My daughter is now 4 after a horrific forcep delivery, where I ended up with a prolapse of the bladder. I am now a year on from having a cystocele repair where everything has seemed much much better. The problem I now have is that I have always been a keen runner, I’ve been back running for 6 months since op but still struggle sometimes (mainly if I don’t manage to have a wee straight before run) ie on club runs and events, with leaking wee which I find really embarrassing and its also holding me back from being myself. I do my pelvic floor exercises and have had loads of physio after op, but am wondering if I can use the aquaflex exerciser or the kegel 8 cones??
    Does anyone have any help or guidance on how I can deal with this please???

    • Michelle Kenway says

      Hi Louise
      Have you thought about trialling Contiform or Incostress? Both are designed to support the urethra, and hence are designed for stress urinary incontinence. Some women find these are great to use to overcome unwanted bladder leakage with exercise. Here is a Contiform review I wrote some time ago which may give you some further insight.
      Best of luck

  17. Hi I had a vaginal hyst while that was going on I had prolapsed bladder and prolapsed vagina both were stitched up lots of stitches! Not healed when I had my 6 week check up..I was an avid weight lifter that was my excerise of choice what now?

  18. marsha niel says

    Hi I found out I have prolapse bladder about a year ago it’s been hard to deal with. especialy when it’s time for sex, my boy friend understands but, sometimes I feel afraid to have sex . is it ok for me to do it or will it make my prolapse worse. I need some advise on how to take care of it, the doctor says I should do kengel exerice because i’m at stage one and that’s the only thing for me right now. tell me is there any thing else that I can do to help my self at the moment.

    • Michelle Kenway says

      Hi Marsha
      Yes I understand your conerns and fears, to be honest with a mild prolapse your partner will be extremely unlikely if not unable to notice anything at all. It takes alot of practice doing physical examinations to be able to even detect a prolapse. Having sex with a mild prolapse will not make it worse ever. This article on prolapse and sex should help you out too. I think it is unfortunate that women such as yourself are left to feel concerned and fearful of intimacy with a prolapse as this need not be the case. It is more to do with the fact that while many women suffer from pelvic prolapse, the concern regarding sex is not spoken of openly. I do hope this helps you out.
      Best wishes

  19. We have got a trampoline for our grandchildren this xmas. I had a prolapse surgery last Feb.  Can I use the trampolene? I am 51, do zumba, boxing, light wieghts using swissball and walking. I love being able to exersise but do not want to jeopordise my repair.

    • Trampoline and pelvic floor prolapse

      Hi Suzie

      Thank you for your question regarding the safety of trampolining after prolapse surgery.

      Suzie a couple of things immediately come to mind upon reading your question. With perimenopause/menopause and previous prolapse surgery the risk of pelvic floor dysfunction is increased. This places you close to if not in this category. We also know that with high impact exercise, the risk of pelvic floor dysfunction is increased. High impact exercise involves both feet off the ground simultaneously. It would follow that jumping on a trampoline is increased impact exercise and that the higher the jump on a trampoline the higher the impact upon the pelvic floor. Whether or not your pelvic floor is capable of withstanding this type of downward pressure is an unknown factor to me but the risk does exist. This is also worth bearing in mind with repect to high impact Zumba dance moves, best to try to keep one foot on the ground to lower the impact if this is the goal.

      Hope this information helps you continue to enjoy your exercise Suzie.

  20. I have been doing pelvic floor exercises for about 3 months since I discovered my prolapsed bladder which was precipitated by my stopping Premarin because of breast cancer. (Whew, long sentence)

    My biggest problem is tons of gas which I never had when I was able to exercise my abs. GasX is not doing a thing. Any input on an exercise approach?? Loved your book Inside Out.
    Also, a TV program featured 3 prolapse experts who demonstrated a “Super Kegel” by
    standing with feet crossed and then tightening the whole area much as a little girl would stand when she has to go to the bathroom. Any input about that idea?

    • Re Bladder prolapse, gas and Kegel exercises

      Hi Cara

      Yes bladder prolapse often occurs because of oestrogen levels lowering, which influences the thickness and support of the pelvic tissues. In effect the pelvic floor becomes floppy and weak with decreased oestrogen. Some women notice this during their monthly cycle and their prolapse becomes heavier immediately prior to their period.

      As far as gas goes, this is a new comment. The act of compressing the abdomen perhaps increased your previous ability to expel flatus however this should not influence the amount of wind you produce. My feeling is it is perhaps more to do with hormonal changes if not food changes. Have you tried reducing your flatus producing foods? i.e. legumes, dried fruit including prunes, cruciferous vegetables (greens such as cabbage, broccoli, brussel sprouts), foods high in insoluble fibre such as wheat bran, onions, radishes, corn, carbonated drinks and spinach. Perhaps you are or have been on some new medication that is influencing your gas production? It is worth mentioning bowel changes to your doctor, especially if dietary changes have no effect on solving this issue.

      Regarding super kegels, really these are just kegel exercises performed with legs crossed position. Doing kegel exercises in standing with toes turned in is known to influence the length of the pelvic floor muscles and some women find it easier to do their kegels with their toes turned in. It strikes me that this is a little like crossing the legs however I am not sure how this position influences the ability of the pelvic floor muscles to contract. At the end of the day it is most important that for increased pelvic floor strength you progress to doing regular strong kegels in standing, so that your pelvic floor muscles work well for you in this upright position where you need them most. Unfortunately there is no magic Kegel as much as we wish there was one.

      Hope this helps Cara

  21. What is your advice on using a mini trampoline for excercise? I realise that rebounding on it could cause pelvic floor strain but would walking on it be ok? I have ordered you book Inside Out but am keen to allieviate my prolapse and get some cardio workout too.

    • Re: Mini trampoline and prolapse
      Hi Frankie

      This is a good question. I really think it will depend how you use the minitramp as to the effect it may have on a vaginal prolapse. If you are running on the minitrampoline with your knees lifted high and have both feet off the surf ace at once you will increase the impact on your pelvic floor. If you use it keeping one foot in contact with the surface at all times you will make this a lower impact exercise which is more pelvic floor friendly. The safety for your prolapse will also depend upon how strong your pelvic floor is to withstand the pressure of the exercise, as with all exercises. To be honest I really like cycling for a great low impact fitness exercise that is going to reduce pressure on a bladder prolapse and have great fitness outcomes.

      Thanks for your question Frankie

  22. HiI am 48 years Old and I have been menopausal for about a year or so.
    I started suffering from a feeling like something was going to fall out or a small ball sitting in the opening of my
    my vagina. I found out after seeing my gynaecologist that it is because my body is not producing enough estrogen anymore to keep my bladder up. He prescribed estrogen as tablet (Vagifem pessary) form to be insert in the vagina twice a week. But, the problem is I am still suffering from this pressure of my bladder sitting inside the opening of my vagina on the days I am not using the vagifem. He said that pelvic floor exercises don’t really help and I agreed because I feel that the pelvic exercises that I do, don’t seem to do anything. The gynaecologist did say the womb was still up in it’s place.
    I was wondering if you can help suggest something for me as I really don’t like this feeling of a small ball sitting on the inside of my vagina opening.

    Thank you.



    • Hi Lyn
      Thanks for your comment. I think it is important for you to understand how oestrogen has an effect upon the pelvic floor. As you know with menopause your oestrogen levels decline. Oestrogen has a role in making your pelvic floor tissues and muscles strong and thick. When it declines, the pelvic floor (including the muscles) tends to become thin, floppy and weak and this one reason why women experience prolapse with menopause and beyond. What we do know is that effective pelvic floor exercises help to lift the pelvic floor muscle hammock higher in the pelvis in addition to thickening up the pelvic floor muscles creating more support. This is why in Australia there is an increasing trend for women to receive training in pelvic floor exercises or kegel exercises even before they undergo surgery (to help hold everything up afterwards). Unfortunately many women don’t understand how to do their pelvic floor or kegel exercises properly and just give up on them. My suggestion is that if possible; see a pelvic floor physiotherapist to help with your exercises. Your gynaecologist may mean that the size of your prolapse is too large for pelvic floor exercises to make a difference to your symptoms. When the prolapse is mild-moderate, pelvic floor exercises can often reduce and alleviate symptoms such as yours, however if the prolapse is large, surgery may be required and that is your specialist’s decision. Another option that is often trialled is to use a pessary ring. These can be very useful in supporting a prolapse and alleviating symptoms. Some women find that support underwear is also beneficial in improving their pelvic support. I hope this gives you some information to assist with your future management. Best of luck Michelle

  23. Hello I live in California I followed your advise and asked my Dr if i should return to work with restrictions and he said yes they consiste of not lifting more than 10 to 15 lbs my employeer was unable to acomadate me so I was put on a LOA, I am afraid to lose my job since I have no more FMLA hours, this protecte my job position, the company that I work for can guarante that i will have my work position back. So I was wondering if I should tell my Dr. if its ok to returne to work with no restictions (60lbs) for the first five hours of my shift then the other three have 15lbs restrictions. I lost my house already I dont want to lose my job I have five children to support and I realy dont know much of laws here in CA. Can any one guid me if this is something I should do?

  24. Hi I have a prolapse is it ok to do aqua fit

  25. i am 34 and have a bladder prolapse my dr has told me that i need surgery i had a baby 7 weeks ago and ready to go back to work but i am not sure if that would be a good idea i work for a warehouse where there is alot of heavy lifting (60 lbs) alot of bending, squating, and pushing should i request some kind of restrictions

  26. christine says

    Hi, iam betting mixed up! i have a prolapsed bladder,my physho has told me to stop doing plaites which I do 4 times a week as she says its pulling down when I do the pelvic floor but when i READ ON THE INTERNET it says differnt?I have stopped the classes but ID like your take on this,i also do step,weights,pump,spinning she didnt say anything regarding these,can you advice please. regards chris hamdorff

    • Pelvic Exercises says

      Hi Christine
      Yes I have to agree that many Pilates exercises have the potential to place a large amount of pressure on your prolapse. We have just posted a free video that explains this issue and demonstrates appropriate Pilates exercises for the pelvic floor including women with pelvic organ prolapse and unsafe Pilates exercises.
      As far as your other qns go, I think that spinning classes are excellent for fitness and kind to the pelvic floor as long as the gears are not too heavy and you stay seated in the saddle throughout. As far as gym exercise goes I have to say this is a potential minefield for women like yourself with pelvic floor issues. I suggest you read our many articles on prolapse exercise which detail gym exercises to choose and those to avoid, or refer to my book Inside Out which lists in detail the exercises to choose and those to avoid with pelvic floor dysfunction, plus provides you with a safe pelvic floor friendly gym workout. I think the main thing to remember that exercise is fantastic for women, and most women with pelvic floor issues like yourself can exercise safely and effectively – it’s just a matter of knowing what to do and how to do it. Thank you so much for raising this important issue. Good luck Christine, Michelle