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Are my organs falling out?

I’ve heard women comment that they felt like their organs are falling out ever since they had a baby. Is this a real phenomenon? Do your organs truly fall out?

The term prolapse can be used to describe the condition of your pelvic organs dropping down into your pelvis. Prolapse occurs when the muscles, ligaments, and connective tissues supporting the pelvic organs weaken over time or with a trauma. Think of it this way; the elastic waistband on our underwear gives out over time and becomes very stretchy. Eventually it can not provide the right level of support needed.

As the organs descend and move lower into your pelvis, it causes a bulge into your vagina or rectum. The severity of the weakening of these structures determines how far down the organ has descended and how much it will affect your function.

Pelvic organ prolapse commonly occurs following vaginal childbirth. It can also develop during menopause or after a hysterectomy. Heavy weight-lifting, high impact activities, chronic straining secondary to constipation, chronic coughing, and aging are all possible causes of pelvic organ prolapse.

The pelvic organs which can be involved include:

  • Vagina

  • Uterus

  • Bladder

  • Urethra

  • Small intestine

  • Rectum

Signs and symptoms of pelvic organ prolapse (POP) vary based on which organ is involved and how much the organ has descended from its original position. POP can result in bladder, bowel, and sexual symptoms.

Common symptoms include:

  • Leaking urine

  • Pelvic pressure or heaviness

  • Feeling or seeing a vaginal bulge

  • Painful sex

  • Straining to have a bowel movement

  • Constipation

  • Inability to evacuate stool

Pelvic Organ Prolapse Stages

  • Stage 1-mild prolapse, still good support present

  • Stage 2-organs have started to descend, but are still inside the vagina

  • Stage 3-organs have dropped to the level of the vaginal opening or beyond

  • Stage 4-pelvic organ have descended completely outside the vagina

Types of Prolapse

  • Cystocele- weakness in the front/anterior aspect of the vaginal wall

  • Rectocele-weakness in the back/posterior aspect of vaginal wall

  • Enterocele- weakness in the top/ceiling of the vagina

Treatment Options

  • Pelvic floor strengthening-a women’s health or pelvic health specialist can help you learn how to strengthen the muscles of your pelvic region to help create more support for your organ. If your muscles are extremely weak they can use biofeedback and electrical stimulation to help awaken these weak muscles.

  • Support Devices-pessaries are devices placed inside the vagina which provide support of the organs which are descending. Some gynecologists and pelvic health therapists are trained to help with placement of your pessary.

  • Surgery-surgical fixation and correction of the prolapsed organs and tissues.

Pelvic floor physical therapy is a great conservative option for individuals with early and moderate signs of prolapse. Learning how to activate your pelvic floor muscles, utilize good breathing techniques, and prevent straining during bowel movements and other daily activities are crucial to managing your pressures in your body and thus managing your symptoms of prolapse.

Katy Girlinghouse and Miranda Morris at The Fit Pelvis are pelvic health physical therapists with expertise treating individuals with pelvic organ prolapse. If you suspect you may have pelvic organ prolapse they can help you learn what you can do to manage it and prevent any loss of function.


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