Vaginal Heaviness, Pressure or a Bulge?

Pelvic organ prolapse occurs when pelvic organs move downward and create symptoms such as vaginal heaviness, pressure or a bulge sensation. Many people with mild to moderate prolapse can improve symptoms with pelvic floor physiotherapy, education and lifestyle strategies, including through online consultations without internal examination.

If this sounds familiar

You may notice:

• A heavy, dragging or pressure feeling in the vagina
• Symptoms that worsen by the end of the day
• A sensation of something “falling down”
• A bulge or fullness at the vaginal opening
• Symptoms appearing after birth, during exercise, or around menopause
• Discomfort with standing, walking or lifting

These symptoms can feel worrying - but they do not automatically mean surgery or that things will inevitably get worse.

What is pelvic organ prolapse?

Pelvic organ prolapse happens when the support system of the pelvic floor is under strain, allowing one or more pelvic organs (such as the bladder, uterus or bowel) to descend slightly.

Common contributing factors include:

• Pregnancy and vaginal birth
• Forceps or vacuum delivery
• Perineal tears
• Repeated heavy lifting or high-impact exercise
• Chronic constipation or straining
• Menopause-related tissue changes
• Poor pressure management and breathing strategies

Prolapse exists on a spectrum. Many people have prolapse on imaging or examination without severe symptoms.

Can prolapse be helped with pelvic floor physiotherapy?

Yes - very often.

Pelvic floor physiotherapy focuses on:

• Improving pelvic floor support and coordination
• Reducing excessive downward pressure
• Teaching safe movement, lifting and exercise strategies
• Managing symptoms so you can stay active and confident
• Slowing or preventing symptom progression

Physiotherapy is recommended as first-line treatment for prolapse symptoms.

Can prolapse be treated online?

For many people, yes.

Online pelvic floor physiotherapy is appropriate if:

• Symptoms are mild to moderate
• You want conservative management
• You need guidance on what is safe vs aggravating
• You are postpartum or menopausal and noticing changes
• You want expert input without an internal exam

Online care focuses on what can be assessed safely:

• Detailed symptom analysis
• Breathing and pressure strategies
• Posture and movement patterns
• Exercise modification and progression

Your physiotherapist will support you every step of the way - and if you need extra care or an in-person assessment, they’ll guide you clearly on what to do next.

What happens in an online prolapse consultation?

Your pelvic health physiotherapist will:

• Take a detailed history of your symptoms and triggers
• Discuss birth history, lifestyle and activity levels
• Assess breathing, posture and movement
• Explain your symptoms in clear, reassuring terms
• Create a personalised plan, which may include:
  • Pelvic floor strengthening or coordination work
  • Strategies to reduce heaviness and pressure
  • Guidance on exercise, lifting and daily activities
  • Education on symptom monitoring and progression

You’ll leave knowing what to do - and what to avoid.

When should you book an assessment?

Book an online consultation if:

• Heaviness or pressure is limiting your activity
• Symptoms are new, worsening or unpredictable
• You feel unsure what exercise is safe
• You’ve been told you have prolapse but given no guidance
• You want to avoid symptoms escalating

Early, personalised support can make a real difference - and help you feel more comfortable, sooner.

When online care may not be appropriate

You should seek in-person or urgent care if you have:

• Severe prolapse symptoms outside the vaginal opening
• New, severe pelvic pain
• Unexplained bleeding
• Signs of infection
• Rapid symptom deterioration

Why Mothercore?

• Specialist pelvic health physiotherapists who truly understand what you’re going through
• UK-registered clinicians you can feel confident and safe with
• Evidence-based, personalised care - built around your body, your symptoms, and your life
• Clear, supportive explanations (no shame, no guesswork, no “just live with it”)
• Flexible online appointments that fit around work, pregnancy, and childcare

Frequently Asked Questions

Is prolapse normal after childbirth?

It is common, but symptoms should not be ignored. Many postpartum prolapse symptoms improve with appropriate pelvic floor physiotherapy.

Does prolapse always get worse over time?

No. With the right management, many people stabilise symptoms and remain active long-term.

Can exercise make prolapse worse?

Women can absolutely - and often should - keep exercising with prolapse. Pelvic organ prolapse isn’t a reason to stop exercising, but it does mean choosing pelvic floor–friendly options and scaling back high-impact activities, so you can move confidently and safely. Your therapist will be able to give you information tailored to your medical history, symptoms and goals.

Will I need surgery?

Many people manage prolapse symptoms conservatively without surgery. Physiotherapy is recommended before considering surgical options depending on the symptoms.

Book your online pelvic floor consultation

Confidential, one-to-one support with a specialist physiotherapist.

Useful links:

Tight Pelvic Floor

Weak Pelvic Floor

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