6 tips for managing pelvic organ prolapse symptoms

Do you experience any of these symptoms:

a heaviness or pressure sensation “down there?”
a bulge or a feeling that something is coming out?
difficulty emptying your bladder or bowel?

If you said yes to one or more of these questions, you may have some degree of pelvic organ prolapse (POP).

Pelvic organ prolapse occurs when the tissues and muscles of the pelvic floor no longer support the pelvic organs (vagina, cervix, uterus, bladder, urethra). When you lose strength and tone in the pelvic floor, you lose support to the pelvic organs. As a result, the pelvic organs drop from their normal position.

It’s estimated that between 10-50% of women have some degree of POP. Pregnancy, childbirth, pelvic surgery (ie. a hysterectomy), frequent constipation, obesity, and COPD are among the many risk factors for pelvic organ prolapse. Not all women experience symptoms. Common symptoms include pelvic pain, urinary incontinence and other urinary symptoms.

Treatment options range from conservative treatments to surgical solutions and depend on the severity of prolapse. The Voices for PFD website is an excellent resource for women who want to learn more. In addition, there are many self-care measures that may help reduce symptoms by strengthening the pelvic floor muscles. Here are 7 tips from our on-staff pelvic floor physical therapists.

Learn to breathe

Avoid intraabdominal pressure through straining and voiding. Don’t hold your breath and bear down while exercising, bending, lifting, or emptying your bladder or bowels. Instead, exhale on exertion.

Reduce the force of gravity

It is helpful to rest the pelvic floor when you are experiencing prolapse symptoms, especially toward the end of the day. Start by lying on your back with a pillow or a wedge under your pelvis. You can go one step further and put your legs up on a chair, couch, or an exercise ball. Rest in this position and take deep, relaxing breaths for 5 -15 minutes.

This same position can also be used for pelvic floor strengthening. These hip-elevated exercises reduce the demand on the pelvic floor. This improves your ability to contract the pelvic floor muscles (i.e., Kegel exercises) and put your POP in a better position for exercise. This is because one of the functions of the pelvic floor is to support the internal organs, so rebuilding strength and tone in these muscles will help ease prolapse symptoms.

Use “the Knack”

The knack is a helpful technique to protect prolapse, reduce prolapse symptoms, and improve bladder control for women with stress urinary incontinence. (It may also help prevent prolapse.) Think of it as a quick Kegel contraction. Squeeze the pelvic floor muscle and think to yourself “all the way up and all the way down” to fully contract. The knack can be used with events and activities that put pressure on your pelvic floor muscles, including coughing, sneezing, blowing your nose, and moving from a seated position to standing. Simply squeeze the pelvic floor muscle immediately before and during the activity, then fully relax the muscle. A great way to remember this is “squeeze before you sneeze”.

Coordinate your core and pelvic floor

Learning to activate and coordinate the deep core muscle, the transversus abdominus, with a pelvic floor muscle contraction is important. Here’s how: Sit or stand tall. Take a long, deep breath in and feel your ribs expand out. Now as you exhale, gently squeeze the pelvic floor muscles while you imagine you are blowing out 100 candles on a birthday cake. Aim for a smooth, long exhale. As you blow, you should feel your core tighten and draw inwards as you engage your deep core muscle.

Use safe lifting techniques

Lifting properly is a key aspect of managing POP symptoms. Always use “the knack” and exhale on exertion, described earlier, to engage the right muscles and distribute pressure equally through the abdomen. Avoid lifting heavy objects and use lighter loads where you can.

Prevent constipation

Over time, chronic constipation can cause or worsen prolapse. It’s important to keep constipation in check with fiber, water, and exercise. These 3 key ingredients help to keep our bowels moving efficiently. And while we’re on the subject, practicing safe toileting techniques is also important. One tip you can practice is called “big belly, hard belly”. Take a deep breath in (“big belly”), tighten your stomach muscles (“hard belly”), and exhale through your mouth while pushing out your bowel movement. If struggle with chronic constipation, consult with your doctor.

If you’re concerned about POP symptoms, talk to your doctor or seek the help of a qualified pelvic floor physical therapist. Pelvic floor therapists are highly skilled in treating POP. They can teach you exercises and techniques, if you find you are having difficulty. Pelvital can refer you to one of our partners, including our newest partner, Agile Virtual PT. Learn more here.

In some situations, a pessary may be indicated, and as of January 2022, the American Physical Therapy Association (APTA) has endorsed pessary fitting and management can now be done by a qualified pelvic floor physical therapist in the US.

Looking for something to use at home to strengthen and tone your pelvic floor muscles? Learn more about Flyte. Or connect with our Customer Care Manager and on-staff pelvic floor physical therapist to learn if Flyte is right for you. Reach Leah at support@flytherapy.com or 1-866-735-8482.