Vaginal prolapse occurs when the muscles and tissues that support the pelvic organs weaken, causing one or more of these organs to drop (prolapse) into the vagina. This condition can lead to symptoms such as a feeling of pressure or fullness in the pelvic area, discomfort, urinary or bowel problems, and sometimes a bulge that can be felt or seen at the vaginal opening.

Several types of vaginal prolapse exist, depending on which organs are involved, such as the bladder (cystocele), rectum (rectocele), or uterus.

Risk factors for vaginal prolapse include childbirth, menopause, aging, obesity, and chronic coughing or straining.

At Golden Gate Urology, we understand how sensitive and disruptive vaginal prolapse can feel. Our team is here to listen to your concerns and help you regain comfort and confidence. Please speak with your doctor if you experience symptoms of vaginal prolapse.

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Causes

Vaginal prolapse results from weakening or damage to the muscles, ligaments, and connective tissue of the pelvic floor that hold the pelvic organs in place.
Common causes and risk factors include:

  • Vaginal childbirth, especially with large babies, forceps delivery, or prolonged labor
  • Menopause, as decreased estrogen weakens pelvic tissue
  • Aging, which naturally reduces muscle tone
  • Obesity, which adds pressure to the pelvic floor
  • Chronic coughing (such as from smoking or lung disease)
  • Heavy lifting or straining with constipation
  • Prior pelvic surgery, including hysterectomy

While mild prolapse may not cause noticeable symptoms, moderate to severe prolapse can lead to discomfort and impact quality of life.

Diagnosis

Your doctor can usually diagnose vaginal prolapse during a pelvic exam. You may be asked to bear down, cough, or strain while your provider examines the vaginal walls and surrounding organs to assess the degree and type of prolapse.
In some cases, additional imaging tests like ultrasound or MRI may help to evaluate the pelvic floor and plan treatment.

Treatment

Treatment for vaginal prolapse depends on the severity of symptoms and your preferences. Many women with mild prolapse don’t require treatment if they are not experiencing discomfort.
Options include:

  • Lifestyle changes: Maintaining a healthy weight, avoiding heavy lifting, and managing chronic coughing or constipation can help reduce symptoms.
  • Pelvic floor exercises: Strengthening the pelvic muscles through exercises (like Kegels) can improve mild prolapse.
  • Pessary device: A removable device inserted into the vagina to support the prolapsed organs, offering a nonsurgical solution.
  • Surgery: In more severe cases, surgery may be recommended to repair the pelvic floor and reposition organs.

Your doctor will help you choose the right approach based on your needs and health goals.

FAQs

What are the symptoms of vaginal prolapse?

You may feel pressure, fullness, or a bulge in the vagina, experience urinary or bowel difficulties, or have discomfort during intercourse.

Who is at risk of vaginal prolapse?

Women who have given birth vaginally, are postmenopausal, overweight, or have chronic coughing or constipation are at higher risk.

How is vaginal prolapse diagnosed?

Your doctor will perform a pelvic exam and may ask you to bear down during the exam to check for prolapse.

Can vaginal prolapse improve on its own?

Mild prolapse may not worsen and can sometimes improve with pelvic floor exercises and lifestyle changes.

Is surgery the only treatment?

No — nonsurgical options like pessaries and exercises are effective for many women. Surgery is reserved for more severe or bothersome cases.