7 Major Risks For Pelvic Organ Prolapse

Pelvic organ prolapse is a very common problem for women.

In fact it’s estimated that up to 1 in 2 women who’ve had a vaginal delivery will experience some degree of pelvic organ prolapse in their lifetime.

Knowing your prolapse risks may help you reduce your risk or prolapse worsening or repeat prolapse after surgery.

Read on now to learn:

  • 7 major risks for pelvic organ prolapse
  • How you can manage your risks 

7 Major Risks For Pelvic Organ Prolapse

The pelvic organs include the bladder, uterus, vagina and rectum.

Pelvic organ prolapse is a condition where one or more of the pelvic organs move out of position and descend, protruding into the vaginal walls and sometimes out of the vaginal entrance.

1. Pregnancy & Childbirth Risks for prolapse

Pregnancy and childbirth can damage the muscles and tissues supporting the pelvic organs contributing to the development of pelvic organ prolapse.

The risk of prolapse increases with:

  • Vaginal delivery
  • Number of deliveries
  • Large birthweight babies
  • Instrumental delivery
  • Damage to pelvic floor supports (muscles and connective tissues)
  • Damage to nerves supplying pelvic floor muscles

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


Pelvic floor exercises after childbirth are very important for rehabilitating pelvic floor tissues after pregnancy and childbirth.

If you’ve suffered pelvic floor damage during childbirth you may benefit from Pelvic Floor Physiotherapy to help restore your pelvic floor supports and reduce your future risk of prolapse.

2. Hormonal Changes

The risk of pelvic organ prolapse increases with the hormonal changes of menopause.

The pelvic floor muscles and some supporting tissues have receptors (sensors) that detect oestrogen.

When oestrogen declines these muscles and strong supports weaken, becoming more susceptible to strain and overload.

Menopause and ageing are associated with decreased collagen. Collagen promotes flexibility and stretch in the pelvic floor tissues. When your tissues lose the ability to stretch they become more prone to injury.


Fortunately muscles can strengthen with exercise at any age. Regular pelvic floor exercises during and after menopause can help you maintain your pelvic floor strength and support long-term.

Some women say that hormone replacement therapy or vaginal oestrogen helps with pelvic floor strengthening however this remains to be supported by research.

3. Straining With Constipation

  • Prolapse Exercises Book by Michelle Kenway Physiotherapist

    Prolapse Exercises Book

    Learn More

Straining with constipation stretches and weakens the pelvic floor. This can set up a cycle where stretched tissues make emptying the bowels even more difficult.

The more you strain to empty your bowels, the greater your risk of pelvic organ prolapse.

Managing your bowels to avoid constipation and straining involves:

4. Inappropriate General Exercise Risks for prolapse jumping

General exercise is great for your health and wellbeing however the wrong kind of exercise for your body can increase your risk of injury.

If your pelvic floor is weak or not working well, your risk of pelvic organ prolapse with some types of exercise is increased too.

Exercises that increase the risk of pelvic organ prolapse include:

  • Heavy lifting e.g heavy weight training
  • High impact exercises e.g. jumping, running
  • Intense core abdominal exercises e.g. some intense Pilates abdominal exercises


Pelvic floor safe exercises can help you maintain your fitness and strength while minimising the load on your pelvic floor. Many women with mild-moderate prolapse continue to exercise without prolapse symptoms or prolapse worsening.

5. Obesity

Obesity is another risk factor for pelvic organ prolapse, especially with excess abdominal fat.

Abdominal (visceral) fat is stored in the abdomen and sits around the abdominal organs such as the intestines. When you’re upright your abdominal fat rests above your organs. Abdominal fat loads the pelvic floor during upright daily activities.


Long-term body weight management and losing unnecessary abdominal fat is an important aspect of holistic prolapse management. Along with appropriate diet for weight loss, appropriate general exercise can help you target and lose abdominal fat.

6. Pelvic Surgery

Pelvic surgery increases the risk of pelvic organ prolapse.

Prolapse surgery may increase the risk of repeat prolapse. The first prolapse surgery is usually the most successful. This is one reason why some gynaecologists delay prolapse surgery in young women.

Other forms of pelvic surgery may also increase the risk of prolapse. Some types of bladder surgery along with hysterectomy may cause defects in the pelvic floor supports.


Managing your particular prolapse risks, using strategies to avoid prolapse worsening and doing regular pelvic floor exercises are important after prolapse surgery.

7. Chronic Coughing Risks for prolapse cough

Coughing forces the pelvic floor downwards, thereby stretching and weakening the pelvic floor supports (including the pelvic floor muscles and ligaments).

Chronic coughing is associated with a range of conditions including:

  • Asthma
  • Allergies
  • Chronic bronchitis
  • Smoking

Prolapse prevention and management involves good chest management along with pelvic floor rehabilitation.

Chest management for prolapse may include:

  • Chest physiotherapy to learn effective chest clearance techniques for chronic conditions
  • Management of acute chest infections and acute cough with appropriate medication
  • Pre-bracing the pelvic floor muscles for coughing
  • Not smoking

Key Points For Risks For Pelvic Organ Prolapse

Some of the main risks for pelvic organ prolapse include:

1. Pregnancy and childbirth
2, Hormonal changes
3. Straining with constipation
4. Inappropriate general exercise
5. Obesity
6. Pelvic surgery
7. Chronic coughing

If you’re at increased risk of pelvic organ prolapse, you may be able to modify your risks through appropriate management including lifestyle changes, weight management and regular pelvic floor exercises.

Yes I'd like to receive Michelle's FREE monthly NEWSLETTER with her latest exercise, health and wellness videos
Your email address will never be shared and your security protected.

We Welcome Your Comments


  1. Can long distance fast walking cause prolapse of the bladder?

    • Michelle Kenway Physiotherapist says

      This will depend upon the impact of walking and the condition of the pelvic floor. Fast walking is obviously less likely to cause prolapse than running. It would depend on many combined factors including abdominal adiposity, other activities, pelvic floor function, coexisting general health problems likely to impact on the pelvic floor too.

  2. I do a lot of cycling. Could this increase risk of prolapse?

    • Michelle Kenway Physiotherapist says

      Hi S
      Cycling is a low impact exercise so not likely to increase prolapse risk compared with high impact running/jumping exercises

  3. I am pregnant with baby #3 and am worried about causing further damage. If vaginal delivery is a risk factor, is a c section birth a better option to help reduce likelihood of a more severe prolapse? My OBGYN doesn’t seem to have an opinion or a lot of knowledge regarding prolapse.

    • Michelle Kenway Physiotherapist says

      Hi Camie
      This is the million dollar question isn’t it. We know that in most cases most of the pelvic floor damage occurs in the initial delivery so that’s a potential plus for you in favour of another vaginal delivery. Having said this we know many factors come into play that increase the risk of pelvic floor damage with vaginal delivery; baby size and baby weight, length of pushing stage, instrumental delivery, any preexisting pelvic floor conditions and more. As you know c/section comes with surgical risk (and prolonged recovery) versus vaginal delivery where the risk of pelvic floor injury is increased. This really is a discussion to have with your OBGYN and you should be able to expect answers to your very real concerns. Unfortunately at the end of the day this comes down to the two of you deciding the best course for you based upon your risks and other factors already mentioned here.
      All the best

  4. Hi Michelle,

    I had a posterior repair and perineum reconstruction three weeks ago. I’m only 28 years old. I really hope another prolapse won’t happen to me in future. I ordered your book and DVD.

    Can you please give me some advice on when and how should I lift my seven months old baby? He’s about 10kgs.

    Thank you very much!

    • Michelle Kenway Physiotherapist says

      Hi Lu
      Yes carrying and lifting a heavy baby is challenging with a prolapse. This article on safe lifting should help answer your question on how to lift safely. Lu try to nurse sitting where possible, get on the ground with your baby to rest and play, rest when your baby rests to help take the load of your pelvic floor & promote recovery, try to avoid prolonged standing nursing where possible, recruit help for lifting where possible and use a pram rather than carrying where you can.

      All the best for your recovery

  5. Can a man organ help to pushed back cystocele?

  6. I wonder if unlubricated sex 1 to 2 times a day can cause vaginal prolapse?

  7. Hi, I was just wondering if you could offer me any advice as I’m having a hard time dealing with this situation. I had a mild prolapse after the birth of my second daughter but after kegals for a year was not symptomatic. 3 years later I’ve just started my own business carpet cleaning which I’ve spent alot of money on and the third job in my prolapse is back. I’ve been to a urogynecologist who wasn’t very good, He diagnosed a front wall and my cervix had dropped but no need for surgery yet. I asked him for a pessary which he fitted and told me to come back in 4 months. Well it didn’t fit right so now I’ve booked in with another doctor who is more willing to try different sizes etc. But that’s in a month. I haven’t worked since it happened and have started pelvic floor exercises again. I have modified my equipment so it’s alot easier now and I’m worried that all the work and money I’ve put into starting my business is wasted. If a pessary works and then I go back to work will this hide the symptoms of me making it worse. I definitely don’t want to make it any worse and will take the loss if I have to. I know when I had the prolapse last time it was easier to deal with when I stopped obsessing about but this time it’s harder and I feel embarresed and a fool, everyone’s going to think why I’ve spent all this on a business I can’t do. My husband is supportive but I still don’t think he understands he keeps asking me if it’s painful.So I know you can’t give me all the answers but any advice I would really appreciate.

    • Michelle Kenway Physiotherapist says

      Hi Mel
      I think you’re taking good action in seeing a doctor to help refit your pessary – this would seem to be a very good alternative to surgery that should help you with your work and business. As you know cleaning involves heavy work and this will undoubtedly increase the load on your pelvic floor. If this is what you want to do, the best way forward will be to do your pelvic floor exercises regularly, minimise your heavy lifting, use safe lifting techniques, modify your workload where possible even if it means taking on less work or you might even think about employing help to assist you if you get busy enough. Try to focus on what you can do and this might mean being selective about the jobs you choose to take on, some jobs will definitely be lower risk than others. You might be interested in reading this article on housework and cleaning with prolapse too.

      All the best Mel