Pelvic Organ Prolapse (POP) is one of those conditions many women have heard of… but no one wants to chat about over coffee.

Yet it’s common, completely manageable and much less scary when you understand what is actually going on.

Simply put, POP happens when the pelvic floor, the supportive sling of muscles and connective tissue that holds up the bladder, uterus and bowel, starts to sag or weaken. When that support loses its springiness, those organs can press into the vaginal wall or drop slightly lower than they should. Not dangerous, but definitely annoying, sometimes uncomfortable and occasionally a bit alarming if you don’t know what it is.

Why does it occur?
There are a few well-known culprits. Vaginal childbirth is a big one, especially long labours, large babies or forceps deliveries. Ageing and menopause also play a starring role as oestrogen declines and tissues naturally lose some of their elasticity. Genetics can add to the mix too; if your mother or grandmother had prolapse, there is a good chance your tissues are cut from the same cloth.

Then there’s chronic pressure: constipation, chronic coughing, obesity or years of heavy lifting can all push repeatedly on the pelvic floor. Even high-impact exercise or lifting weights without proper technique can contribute if your pelvic floor isn’t keeping up.

What does it feel like?
The classic signs? A feeling of pressure, heaviness, dragging or “something down there.” Some women describe it as sitting on a small ball or tampon that isn’t quite in the right place. Others notice difficulty emptying their bladder or bowels or a bulge they can see or feel. If your pelvis feels like it’s working overtime, it is worth getting checked.

What to do?
Here’s the good news: prolapse is very treatable.

Pelvic floor physiotherapy is the first-line and often the most effective treatment. A trained physio can help strengthen weak muscles, relax the overactive ones and teach you how to move in ways that support, instead of strain, your pelvic floor.

Lifestyle adjustments make a huge difference too: avoid straining on the toilet, treat constipation early, lift with proper technique, manage chronic coughing and keep a healthy weight.

Many women also benefit from vaginal oestrogen, which improves tissue strength especially post menopause sometimes even during perimenopause too (consult your Dr).

Pessaries (small, comfortable internal supports) can provide excellent relief and allow you to exercise, work and live normally.

Surgery exists for more severe cases, but most women improve without ever needing it.

The bottom line
Pelvic organ prolapse is common, treatable and nothing to be embarrassed about. With awareness, good habits and the right support, your pelvic floor can absolutely make a comeback and stay lifted where it belongs.

Salt Rock resident Tarryn Graham has a BSc in physiotherapy from Stellenbosch University, and has a special interest and further training in women’s health physiotherapy and sexual health. She has 15 years’ experience in women’s health and pelvic floor physiotherapy.

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