Pelvic Organ Prolapse [Heaviness, pressure in the vagina]

Do you have feelings of heaviness or pressure in the vagina? Do you feel like there is a tampon too low in the vagina – but you have no tampon in? Do you feel like things move downward or ‘fall out’ when you lift? Maybe these sensations go away when you lie down, or they get worse through the day or with activity. 

These symptoms line up with Pelvic Organ Prolapse (POP). POP occurs when one of the pelvic organs (bladder, uterus or rectum) is bulging into the vagina or past the vaginal opening. Prolapse symptoms can occur due to a combination of an increase in abdominal pressure (ie chronic cough, pregnancy or vaginal childbirth, lots of heavy lifting), decreased connective tissue support through the organs (read: stretchier tissue that hold up the organs), poor pelvic floor muscle support, and sensitivity in the vaginal tissues.

Take Louise – she had two children aged 15months and 3.5 years old. She had vaginal births for both with some tearing. Louise felt some pressure in the vagina after her first birth but that went away after two weeks. In her second pregnancy she felt some vaginal heaviness in the second trimester and moreso in the third trimester. After her second birth, she noticed the vaginal heaviness took longer to go away, and she still felt pressure throughout the day that got worse after longer walks with the carrier, on days when she had to carry her eldest more often, and after working out. 

Louise came in for a Pelvic Health Physiotherapy assessment, where we worked on a couple of things:

  • Changing how her abdominal muscles and her pelvic floor muscles worked together during activity 
  • Strategies for managing symptoms on days where things felt worse
  • Education so that Louise knew what was going on for her body and what different symptoms and sensations through the pelvis meant for her 

Louise found that the pressure improved a lot, but she still felt some pressure with long family hikes or after doing a particularly heavy HIIT workout – both of which were activities that were really important for Louise to be able to continue. We went through a pessary fitting and now Louise uses a pessary for support on those days where she is doing heavier activities. Learn more about pessary fittings.

Do you relate to parts of Louise’s story?

Here are some things you can address at home:

  1. address constipation and decrease straining/pushing with bowel movements
  2. address stress levels – our body automatically holds tension through the abdomen, ribs, shoulders and pelvic floor muscles with stress, which can influence how tissues are responding through the pelvis.
  3. try exhaling with movement/lifting – breathing out tends to decrease abdominal pressure and signals the pelvic floor muscles to activate. This doesn’t work for everyone but feel free to try it out!
  4. offload/rest as needed through the day – lying down may help decrease symptoms temporarily 

Is prolapse something you are concerned about? Let’s find out what is going on and work towards a solution together!

Prolapse Lingo

Types of Prolapses:

  • Cystocele: Prolapse of the bladder
  • Rectocele: Prolapse of the rectum
  • Urethrocele: Prolapse of the urethra
  • Uterine prolapse: Prolapse of the uterus
  • Vaginal Vault prolapse: Prolapse of the top of the vagina after a hysterectomy
  • Enterocele: Prolapse of the intestine

Not sure where to start?

Let’s chat! Contact us and we can arrange for a Free Consultation with our Pelvic Health Physiotherapist to speak with you about your individual case.


  • We are able to help individuals of all ages and at all activity levels (recreational to competitive). 
  • We offer direct billing to most major insurance companies for the convenience of our clients.

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