Holistic Management of Pelvic Organ Prolapse

Gravity Assisted Pelvic Balancing Exercise

Pelvic organ prolapse occurs when the muscles, ligaments and connective tissues supporting the pelvic organs weaken, allowing the organs to fall out of place. It is estimated that as many as 50 percent of women over age 50 have organ prolapse. The degree or amount of prolapse is on a continuum with grade I being mild and grade IV being severe, often requiring surgery. Prolapse of the bladder is known as cystocele. Prolapse of the urethra is known as urethrocele. Prolapse of the upper vagina below the cervix is known as vaginal vault prolapse. Bowel prolapse through the vagina is known as rectocele, whereas a rectal prolapse can occur through the rectum. In many cases, more than one organ has descended.

The risk of developing pelvic organ prolapse increases with faulty breathing patterns. Breath holding increases downward pressure on vulnerable tissues that are healing or weakened during pregnancy, childbirth (especially in births requiring forceps or a vacuum), chronic constipation, forceful coughing and with decreasing estrogen levels during perimenopause and menopause. Women with hypermobility or Ehler's Danlos Syndrome (EDS) are also at risk. Pelvic organ prolapse is preventable, which is why we recommend pelvic floor therapy if you have any of these risk factors as incoordination of the deep core and pelvic floor muscles is present in most individuals with organ prolapse.

Prolapse symptoms can include urinary leakage, urgency, or the feeling of an object in the vagina, similar to a marble or a stuck tampon. These symptoms can fluctuate, with some days being better than others. Pelvic floor therapy is a conservative treatment option for grades I to III prolapse. Unfortunately, many women opt for surgery as a first choice, which can increase the risk of developing adhesions and further dysfunction and it does not resolve the root issue that led to prolapse in the first place. At our clinic, if symptoms of bother do not improve after 4 or 5 sessions, we recommend consulting a urogynecologist. However, it is crucial to address any underlying musculoskeletal dysfunction.

Here are some recommendations for pelvic organ prolapse prevention and treatment:

1. Refrain from straining and holding your breath, particularly due to constipation or heavy lifting.

2. Exhale with Exertion (an audible exhale) during ALL daily activities, not just when lifting weights.

3. Utilize gravity to assist in repositioning your organs with restorative positions.

4. Activate the hip rotators to lift the pelvic floor from the sides, akin to drawing up the ends of a hammock.

5. Release myofascial trigger points in the pelvic floor and obturator internus muscles that can act like a paper weight.

6. Improve deep core muscle activation to create atmospheric pressure inside the core canister.

7. Restore mobility of the thoracic spine and breathe into your ribs as it is related to pressure management.

8. Be aware of your limitations in strength. Learn how to activate muscles in your lower body to support the pelvic floor.

9. Manage nervous system dysregulation. Continuously being in a fight or flight state, referred to as sympathetic dominance, leads to improper breathing patterns and abnormal tension in the pelvic floor muscles.

10. Maintain an active sex life to promote the health of your pelvic floor muscles and assist in repositioning the organs.

At Healthy Core, we empower women in their bodies for lifelong management of prolapse. If surgery is the only option, pelvic floor prehab before surgery and pelvic floor rehab after surgery can improve long-term surgical outcomes and prevent prolapse from returning. If you have myofascial pelvic pain, limitations in hip mobility or have tried the above recommendations without improvement of symptoms, seek the help of an expert pelvic floor therapist who specializes in the treatment of pelvic organ prolapse.

Pelvic floor therapy can help, whether you already have prolapse or are at risk. Call our office at (330)528-0034 to schedule a FREE consultation with one of our pelvic floor experts. Don't let pelvic organ prolapse drag you down!

Disclaimer: the exercises and advice in this blog are not meant to replace individual medical advice or treatment.

written by Janine Laughlin, revised October 2025