Pessary, Women's HealthUnderstanding the Stages of Pelvic Organ Prolapse: A Guide from Women’s Health Physical Therapists Posted on March 3, 2025March 5, 2025 by Physiofit Understanding the Stages of Pelvic Organ Prolapse: A Guide from Women’s Health Physical Therapists PhysioFit’s Women’s Health Team Pelvic organ prolapse (POP) is a common condition that affects many women, especially after childbirth, menopause, or due to chronic pressure on the pelvic floor. As women’s health physical therapists, we work with patients experiencing prolapse symptoms, helping them understand their condition and find effective, non-surgical ways to manage it. One of the key things to know about pelvic organ prolapse is that it occurs in stages, ranging from mild to more severe. In this blog, we’ll walk you through the four stages of prolapse, how they are diagnosed, and what treatment options are available. What Is Pelvic Organ Prolapse? Pelvic organ prolapse happens when the muscles and connective tissues supporting the pelvic organs (bladder, uterus, rectum, or vaginal walls) weaken, causing one or more organs to shift downward. This can result in a feeling of heaviness, bulging, or discomfort in the pelvic region. Prolapse is categorized into four stages based on how far the organ descends into or beyond the vaginal canal. The Four Stages of Prolapse Stage 1: Mild Prolapse 🔹 What happens? The pelvic organ has begun to shift downward but remains above the vaginal opening.🔹 Symptoms: Often asymptomatic, but some women may experience mild pressure or fullness in the pelvic area.🔹 Treatment: Strengthening the pelvic floor muscles through targeted exercises (like Kegels), improving posture, and avoiding heavy lifting can help prevent worsening. Stage 2: Moderate Prolapse 🔹 What happens? The organ descends further but does not reach the vaginal opening.🔹 Symptoms: Some women begin to notice pressure, discomfort, or difficulty with urination or bowel movements. A feeling of something “falling down” inside the pelvis may appear.🔹 Treatment: Pelvic floor therapy is highly effective at this stage. We focus on muscle strengthening, breathing techniques, and lifestyle modifications to manage symptoms and prevent progression. Stage 3: Advanced Prolapse 🔹 What happens? The organ has moved to or slightly beyond the vaginal opening.🔹 Symptoms: More pronounced pressure, difficulty emptying the bladder or bowels, and noticeable vaginal bulging. Some women experience discomfort with intimacy.🔹 Treatment: A pessary fitting (a supportive device inserted into the vagina) can help. Physical therapy still plays a role in strengthening the remaining pelvic support and teaching strategies to manage symptoms. Surgery may also be discussed for symptom relief. Stage 4: Severe Prolapse 🔹 What happens? The organ fully protrudes beyond the vaginal opening.🔹 Symptoms: Significant discomfort, difficulty with urination or bowel movements, and difficulty with daily activities.🔹 Treatment: At this stage, surgery is often recommended. However, post-surgical pelvic floor therapy is essential to rebuild strength and prevent recurrence. How Can Physical Therapy Help at Any Stage? Even if you have mild to moderate prolapse, seeking treatment early can prevent progression and improve symptoms. As women’s health physical therapists, we offer: ✅ Pelvic floor muscle training to strengthen and support the pelvic organs✅ Breathwork and posture education to reduce pressure on the pelvic floor✅ Lifestyle modifications to help with bladder and bowel function✅ Pessary fittings for non-surgical support✅ Pre- and post-surgical rehab for those who need surgical intervention Take Control of Your Pelvic Health If you’re experiencing symptoms of pelvic organ prolapse, you’re not alone! The team at PhysioFit of North Carolina is here to help. Book an appointment today to learn how we can support your pelvic health at any stage of prolapse. Physiofit What Is a Pessary, and How Does It Work? How Do I Know If I Need a Pessary or Another Treatment?
