Pelvic Heaviness or Bulging? Understanding Pelvic Organ Prolapse

Sep 26, 2025
3 min read

Updated: 5 hours ago

If you’ve ever felt a heavy sensation “down there,” a dragging feeling, or noticed a bulge in the vagina, you’re not alone. These are common signs of pelvic organ prolapse (POP) a condition that affects around 1 in 2 women who’ve given birth.

At Praxis Rehab Physiotherapy at Signal Health Tusmore, we provide compassionate, evidence-based physiotherapy to help women manage prolapse symptoms and regain control of their pelvic health without fear, shame, or confusion. Let’s explore what prolapse really is, why it happens, and how pelvic physio can help you feel more comfortable and confident again.

Diagram explaining pelvic organ prolapse and pelvic floor support Adelaide

What Is Pelvic Organ Prolapse?

Pelvic organ prolapse happens when one or more of the organs in your pelvis (bladder, uterus, rectum) drop down from their usual position and press into the walls of the vagina.

This occurs when the muscles, ligaments and connective tissue that support your pelvic organs become weakened or stretched.

Common types of prolapse:

Anterior Vaginal Wall Prolapse (cystocele) – front wall of the vagina bulges
Uterine or Apical Prolapse – the uterus drops down into the vaginal space
Posterior Vaginal Wall Prolapse (rectocele) – back wall of the vagina bulges
Vaginal vault prolapse – the top of the vagina collapses after hysterectomy

What Does Prolapse Feel Like?

Everyone’s experience is different, but common symptoms include:

A feeling of heaviness, dragging, or pressure in the pelvis
A bulge or lump you can feel inside or at the entrance of the vagina
Urinary symptoms – frequency, urgency, leaking, difficulty emptying
Bowel symptoms – constipation, incomplete emptying
Symptoms that worsen after standing long or at the end of the day
Lower back pain

These symptoms can feel scary or even embarrassing but please know they’re very common and very treatable.

What Causes Pelvic Organ Prolapse?

Some of the most common contributing factors include:

Pregnancy and vaginal childbirth (especially forceps, long labour, or large babies)
Chronic straining (e.g., from constipation or heavy lifting)
Hormonal changes during menopause (reduced oestrogen = less tissue support)
High-impact exercises without pelvic floor support
Genetic factors some women naturally have more laxity in their tissues
Hysterectomy or pelvic surgery that disrupts support structures

How Can Pelvic Health Physiotherapy Help with Prolapse?

Pelvic organ prolapse doesn’t always mean surgery; in fact, many women find that

pelvic floor physiotherapy significantly improves their symptoms, quality of life, and confidence.

At Praxis Rehab Physiotherapy, we work with you to:

✅ Assess your pelvic floor

We evaluate the strength, tone, coordination, and endurance of your pelvic floor muscles, as well as your posture, breathing, and daily movement patterns.

✅ Teach effective muscle activation

We help you find and properly engage the right muscles many people unknowingly bear down rather than lift up, which can make prolapse worse.

✅ Design a tailored exercise plan

Your rehab might include:

Pelvic floor muscle training
Core retraining
Education on bladder and bowel habits
Lifestyle modifications (lifting, coughing, etc.)
Support tools (like pessaries, if needed)

✅ Offer ongoing support

Prolapse management is a journey. We check in, adjust your plan, and celebrate your progress along the way.

Can Prolapse Be Managed Without Surgery?

Many women can manage or reduce prolapse symptoms without surgery, especially if caught early. Physiotherapy can:

Improve pelvic floor support
Relieve pressure and bulging sensations
Reduce incontinence or urgency
Help you safely return to exercise or daily activities

In some cases, prolapse may be more severe and surgery might be considered. But even then, pre- and post-operative physiotherapy is highly recommended to improve outcomes and prevent recurrence.

You’re Not Broken and You’re Not Alone

It’s common for women to feel embarrassed or alone when dealing with prolapse. You might think, “Why didn’t anyone tell me about this?” or “Is this just part of getting older or being a mum?” But we want to reassure you: prolapse is common, not something to be ashamed of, and absolutely treatable.

If you suspect you might have a pelvic organ prolapse, don’t wait. The earlier we start, the better we can help.