One of the most common women’s health concerns — especially with age — is pelvic organ prolapse (POP). In fact, one in two women (50%) can expect to experience some degree of POP at some point in life, potentially leading to issues like:
If you don’t know much (or anything) about POP, you’re not alone; most women don’t give pelvic support problems a second thought until they’re suddenly coping with the condition. But as Dr. Rania Ibrahim of New Beginnings OB/GYN explains, several risk factors make POP more likely.
The urinary, reproductive, and digestive organs inside your pelvic cavity — including your uterus, cervix, vagina, bladder, urethra, and lower bowels (rectum) — rest on your pelvic floor, a taut, dynamic “hammock” of support tissues stretching from your pubic bone to your tailbone.
Your pelvic floor isn’t just a passive foundation; it’s a responsive, active muscle group that contracts (tightens) and relaxes (lengthens) with your breathing and daily movement.
Your pelvic floor works in conjunction with your diaphragm, deep abdominal muscles, and lower back muscles to stabilize your core and manage pressure inside your torso.
Your pelvic floor isn’t a single simple layer; it’s a complex, multi-layered structure that’s made up of muscles, fascia, and ligaments that wrap around the urinary, vaginal, and anal openings. It controls the function of these openings while simultaneously supporting your organs.
When something weakens your pelvic floor and compromises its integrity, the organs that rely on its support can shift out of place. Sometimes, they may herniate through the floor, or push into a weakened area or an adjacent area.
POP type is classified based on the organ that herniates through the pelvic floor:
A cystocele — also known as anterior vaginal wall prolapse, or a dropped bladder — occurs when the bladder pushes into the front vaginal wall; it’s the most common POP type.
An urethrocele, which often happens alongside a cystocele, is when the thin tube that carries urine from your bladder out of your body (urethra) also pushes through your pelvic floor.
A rectocele happens when a weakened pelvic floor allows the rectum to herniate into the back wall of the vagina (posterior vaginal wall prolapse).
A dropped uterus, or uterine prolapse, happens when the uterus descends through the pelvic floor and down into the vaginal canal.
POP is such a common women’s health issue because the average woman is affected by one or more of the major risk factors that can weaken the pelvic floor. These include:
Vaginal delivery is the greatest cause of pelvic floor strain. This risk increases with a difficult labor, multiple deliveries, or deliveries involving instruments like forceps or vacuum extractors. A large baby (over 8.5 pounds) can also stretch and strain the pelvic floor during the third trimester and vaginal delivery.
Conditions that place constant downward pressure on the pelvis can strongly weaken pelvic floor support structures over time. Specific risk factors include:
Obesity, or having a high body mass index (BMI), also places the pelvic floor under excessive strain. Studies show that women with a higher BMI are more likely to develop POP than those within a healthy weight range.
Estrogen doesn’t just regulate your menstrual cycle; it also plays a vital role in maintaining the strength of the connective tissues that make up your supportive pelvic floor. When estrogen drops off during menopause, pelvic floor tissues become thinner, weaker, and less resilient.
When these supports weaken, you’re more vulnerable to POP — an effect that’s further amplified by age-related changes that leave muscles and tissues even weaker: More than a third of women with POP are between the ages of 60 and 79, and over half are 80 or older.
Pelvic surgery, most notably a hysterectomy (the removal of the uterus), can alter the natural support architecture of your pelvic bowl, allowing your remaining organs to shift over time.
Fortunately, there’s a lot you can do to protect your pelvic floor and prevent severe POP. You may benefit from weight loss, eating more fiber to manage constipation, or learning how to modify heavy lifting, for example.
And all women can benefit from incorporating pelvic floor exercises (Kegels) into their daily wellness routine. We’re here to help: Contact New Beginnings OB/GYN in Shenandoah, Texas, and schedule a visit with Dr. Ibrahim today.