Although vaginal prolapse (also known as pelvic organ prolapse) affects many women, the early symptoms are often subtle and easy to ignore. Many patients assume their symptoms are simply part of ageing, childbirth, or menopause.
Recognising the early signs of prolapse is important because treatment is often simpler when symptoms are addressed early.
Here are five symptoms that women frequently dismiss but may indicate prolapse.
1. A Feeling of Pelvic Heaviness or Pressure
One of the earliest signs of pelvic organ prolapse is a sensation of heaviness, pressure, or dragging in the pelvis or vagina.
Women often notice that:
• the feeling worsens during the day
This occurs because gravity places increasing strain on weakened pelvic floor support structures.
• it becomes more noticeable after standing or exercise
• symptoms improve when lying down
2. A Vaginal Bulge or the Sensation That Something Is “Coming Down”
Some women notice a small bulge in the vagina or feel that something is sitting lower than it should.
This may be noticed:
• when washing
• when inserting a tampon
• after physical activity
• at the end of the day
A vaginal bulge is one of the most recognisable symptoms of prolapse and should be assessed by a specialist.
3. Difficulty Emptying the Bladder or Bowels
Vaginal prolapse can change how the bladder and bowel function.
Women sometimes experience:
• needing to strain to pass urine
• the feeling that the bladder does not empty completely
• needing to press on the vagina to empty the bowels
• constipation or difficulty with bowel movements
These symptoms occur when the bladder or rectum bulges into the vaginal wall, altering normal pelvic anatomy.
4. Discomfort or Pressure During Sexual Intercourse
Pelvic organ prolapse can sometimes affect sexual comfort.
Some women notice:
• pressure or heaviness during intercourse
• awareness of a vaginal bulge
• discomfort with deeper penetration
These symptoms can feel difficult to talk about, but they are common in women with prolapse and can often improve with appropriate treatment.
5. Recurrent Urinary Tract Infections
When the bladder drops (known as a cystocele), it may not empty completely.
This can lead to residual urine remaining in the bladder, increasing the risk of recurrent urinary tract infections.
Women may notice:
• repeated UTIs
• a sensation of incomplete bladder emptying
• needing to pass urine again shortly after going
If this pattern occurs, pelvic organ prolapse may be contributing.
When Should You Seek Advice?
If you are experiencing symptoms such as pelvic heaviness, vaginal bulging, bladder problems, or bowel difficulties, it may be helpful to seek specialist advice.
Vaginal prolapse can often be treated with:
• pelvic floor physiotherapy
• pessary treatment
• minimally invasive prolapse surgery
Many women are relieved to discover that effective treatments are available and that symptoms can often be significantly improved.
Key Takeaway
Vaginal prolapse is common, but symptoms such as vaginal bulging, pelvic pressure, and bladder problems are not something you simply have to live with.
Recognising the early signs of prolapse allows women to seek assessment and discuss the most appropriate treatment options.
If you are experiencing symptoms, you can read more about vaginal prolapse diagnosis and treatment
Common Questions About Pelvic Organ Prolapse
What are the first symptoms of pelvic organ prolapse?
Early symptoms of pelvic organ prolapse often include a feeling of pelvic heaviness, a vaginal bulge, difficulty emptying the bladder or bowels, or discomfort during intercourse. Symptoms may be mild at first and often worsen towards the end of the day or after standing for long periods.
What causes pelvic organ prolapse?
Pelvic organ prolapse occurs when the muscles and ligaments supporting the pelvic organs become weakened. Common causes include childbirth, ageing, menopause, chronic coughing, constipation, and heavy lifting.
Is pelvic organ prolapse dangerous?
Pelvic organ prolapse is not usually dangerous, but it can cause uncomfortable symptoms such as vaginal bulging, bladder problems, or bowel difficulties. Treatment is available and many women improve significantly with appropriate care..
Does pelvic organ prolapse always require surgery?
No. Many women with pelvic organ prolapse are successfully treated without surgery. Treatment options may include pelvic floor physiotherapy, lifestyle changes, or a vaginal pessary. Surgery may be considered when symptoms are more severe..