Early Signs of Prolapse Every Woman Should Know
Pelvic organ prolapse is a common condition, yet it remains widely misunderstood and often under-discussed. Many women are surprised to learn that prolapse can develop gradually over time, with early symptoms that are subtle and easy to dismiss. Recognising these early signs is important, as timely assessment and management can significantly improve comfort, function, and long-term outcomes.
As a women’s health physiotherapist, I often see women who say, “I wish I’d known this earlier.” This blog post outlines what prolapse is and the early signs every woman should be aware of.
What Is Pelvic Organ Prolapse?
Pelvic organ prolapse occurs when one or more of the pelvic organs — such as the bladder, uterus, or bowel — descend into the vaginal canal due to reduced support from the pelvic floor muscles and connective tissues. It can affect women of all ages, although it is more common after pregnancy and childbirth, during menopause, or following periods of increased strain on the pelvic floor.
A Feeling of Heaviness or Pressure
One of the earliest and most common signs of prolapse is a sensation of heaviness, pressure, or dragging in the vagina or pelvis. Many women describe it as feeling “weighted” or “like something is sitting low.” This sensation often worsens throughout the day, after long periods of standing, or following physical activity, and may ease when lying down or resting.
A Vaginal Bulge or Change in Sensation
Some women notice a subtle change in how the vaginal area feels, such as increased awareness or fullness. In early stages, this may not be visible but can be felt when showering, wiping, or inserting a tampon. As prolapse progresses, a bulge may become more noticeable, particularly during straining or after prolonged activity.
Bladder Changes
Early prolapse can affect bladder function. Signs may include difficulty fully emptying the bladder, a slow urinary stream, increased urinary frequency, or needing to change position on the toilet to finish urinating. Some women experience new or worsening urinary leakage, particularly with coughing, sneezing, or exercise.
Bowel Symptoms
Changes in bowel habits can also be an early indicator. This may include constipation, a feeling of incomplete emptying, or the need to press on the perineum or vaginal wall to assist bowel movements. These symptoms are often subtle initially and may be attributed to diet or stress, but persistent changes warrant assessment.
Discomfort During Exercise or Daily Activities
Women with early prolapse often report discomfort during activities that increase intra-abdominal pressure, such as running, jumping, lifting, or prolonged walking. You may notice that activities you previously tolerated well now feel uncomfortable or lead to pelvic pressure or heaviness afterward.
Pain or Discomfort with Intercourse
Some women experience discomfort, reduced sensation, or a feeling of obstruction during vaginal intercourse. While this can have multiple causes, pelvic organ prolapse should be considered, particularly if it is a new symptom or accompanied by other pelvic changes.
When to Seek Professional Advice
If you notice any of these symptoms — even if they seem mild or intermittent — it is worth seeking assessment from a qualified women’s health physiotherapist or healthcare provider. Early prolapse does not automatically mean surgery is required. In many cases, conservative management such as pelvic floor muscle training, education on bladder and bowel habits, pessary use if appropriate and guidance around exercise and load management can be highly effective.
The Importance of Early Intervention
Prolapse is not an inevitable or untreatable part of ageing or childbirth. Early identification allows for tailored strategies to reduce symptoms, prevent progression, and support your pelvic health long term. With the right care, many women continue to exercise, work, and live actively and comfortably.
If something doesn’t feel quite right, trust your body and seek advice — early support can make a meaningful difference.
Please see below a link to an informative resource by the Australian Commission on safety and quality in Health Care with further information about pelvic organ prolapse and potential treatment options.