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Pelvic organ prolapse

Three women at the gymThis page provides information for women, their partners and families about symptoms and management of prolapse experienced during and after the menopause.

Prolapse problems after the menopause

The organs within a woman’s pelvis (uterus, bladder and rectum) are normally held in place by ligaments and muscles known as the pelvic floor. If these are weakened, the pelvic organs can bulge (prolapse) from their natural position into the vagina. This is known as pelvic organ prolapse. This can sometimes happen at the time of the menopause due to the decrease in estrogen.

While prolapse is not considered a life-threatening condition, and some women can have a prolapse without having any symptoms at all, it may cause a great deal of discomfort and distress. Common symptoms can include:

  • A feeling of dragging or heaviness in the pelvic area
  • A bulge in the front or back wall of the vagina - sometimes, this bulging may extend outside the vagina
  • Difficulties with continence - bladder or bowel, depending on the location of the prolapse
  • Discomfort and lack of sensation during sex

You should see your doctor if you have one or more of these symptoms.

Find out more about pelvic organ prolapse

The links below provide more information about pelvic organ prolapse:

You may also find useful information on the following websites:

Treatment and management of pelvic organ prolapse

Non-surgical options

Non-surgical options can be an effective way of managing symptoms, and include:

  • Pelvic floor muscle training (Kegel exercises)
  • Vaginal hormone treatment (estrogen) - if you have gone through the menopause, your doctor may recommend vaginal estrogen treatment in the form of tablets, cream or a ring
  • Vaginal pessaries - plastic or silicone devices that fit into your vagina to help support the pelvic organs

The links below provide more information about surgical procedures:

Surgical procedures

Your healthcare practitioner may recommend a surgical procedure to treat and manage your prolapse condition. A number of different procedures may be offered, including:

  • A pelvic floor repair - the vagina walls are tightened to support the pelvic organs
  • Vaginal hysterectomy, or removal of the womb, may be suggested - this is sometimes done at the same time as a pelvic floor repair
  • Sacrocolpopexy or sacrospinous fixation - the top of the vagina is attached to a bone or ligament

Some operations involve the use of mesh or tape - see below for more information.

You may be offered a number of different surgical procedures. The links below provide information about the various options:

As with all decisions about your treatment and care, it is important that you discuss all of the options with your healthcare team, including the risks and benefits of each option.

Mesh and tape

In a number of operations for pelvic organ prolapse, mesh or tape (supporting material) is used to provide additional support to tissues. It is currently recommended that operations using mesh are only performed by specialists with expertise in this technique and only after a full discussion about the benefits and risks of such surgery with the woman.

The following leaflets, from the British Society of Urogynaecology, provide information about the use of mesh to treat specific conditions:

The NHS has also developed a leaflet that provides information about the use of mesh in the treatment of pelvic organ prolapse:

For more information about mesh, please visit our mesh page to access a range of resources to support your informed decision-making.

Making a choice about your treatment

There will be choices to make about the type of treatment you wish to receive. You will probably have a lot of questions and may wish to discuss your options with family and friends. To begin with, try to get answers to three key questions:

  • What are my options?
  • What are the pros and cons of each option for me?
  • How do I get support to help me make a decision that is right for me?

For more information about working with your healthcare professional to make the right choice for you, please visit the NHS Shared Decision Making website.

About the links on this page

Some of the information this page links to  is not produced by the RCOG. Our policy on publishing links to third-party sites outlines how we decide which sites to link to, and our terms and conditions include a disclaimer about the RCOG’s responsibility for information on linked sites.

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