---
title: 'Pelvic Organ Prolapse in Menopause: What It Is and How It Can Be Helped'
slug: pelvic-organ-prolapse-menopause-2
lifeStage: menopause
category: Wellbeing
medicalReviewer: 'Dr Clare Bourne, Consultant Pelvic and Digestive Health Physiotherapist'
reviewerId: 'https://blog.bloume.com/menopause/medical-board.md#clare-bourne'
lastUpdated: '2026-08-08'
primarySource: 'Pelvic organ prolapse - NHS 111 Wales'
wordCount: 984
readTimeInSeconds: 246
---

# Pelvic Organ Prolapse in Menopause: What It Is and How It Can Be Helped

Pelvic organ prolapse in menopause can leave you with a steady feeling of heaviness, pressure, or something not quite right low down in the pelvis. As oestrogen levels fall through menopause, the tissues that support your pelvic organs can lose some of their hold, which makes prolapse more likely. Pelvic floor exercises, a few lifestyle changes, and input from a pelvic health physiotherapist are the main ways to ease symptoms. This article covers what prolapse feels like, what helps, and when to speak to your GP.

**Q: Can pelvic organ prolapse in menopause be managed without surgery?**
A: Often, yes. Supervised pelvic floor muscle training for at least four months is the first approach usually offered for prolapse that causes symptoms, and you may find it eases the discomfort a good deal. Lifestyle changes, physiotherapy, and sometimes a vaginal pessary fitted by a specialist are all non-surgical options. Your GP can talk through which suits you.

You may notice a heaviness low down in the pelvis, a dragging feeling inside the vagina, or a vague but persistent sense that something is not quite right. It can show up as pressure around the lower abdomen and genitals, or the feeling of sitting on a small ball. These are common ways pelvic organ prolapse (POP) can feel day to day, and if any of them sound familiar, speaking to your GP is a sensible next step.

What you feel can shift through the day. It often gets more noticeable after you have been standing for a while or by late afternoon, and it may ease once you lie down. You might also feel or see a bulge or lump in or coming out of the vagina, or some discomfort during sex. In milder cases there may be nothing to notice at all, and prolapse is only noticed during a routine internal examination like a cervical screening test.

## What helps with pelvic organ prolapse?

Pelvic floor exercises are the first line treatment for mild or moderate prolapse, and they can lower the chance of things getting worse. Supervised pelvic floor muscle training for at least four months is the first thing usually offered for prolapse that causes symptoms, with a pelvic health physiotherapist building a plan around your needs.

Beyond the exercises, a pelvic health physiotherapist can talk you through other lifestyle factors, including your bowel health, lifting and exercise to help improve your symptoms. Your GP can refer you for physiotherapy.

## Lifestyle factors that reduce pressure on the pelvic floor

A few everyday things shape how much pressure lands on your pelvic tissues. Keeping to a healthy weight, eating plenty of fibre so you don't strain on the toilet, and stopping smoking to cut down on a persistent cough can all take some of that pressure off.

Heavy lifting is something to seek guidance on, including day to day lifting and exercise. There are no blanket rules when it comes to exercise, however low-impact options such as cycling, swimming or pilates can be better suited for some, however higher impact exercise can be something to work up to with the correct support. If you already have a routine you follow, it helps to run any changes past a pelvic health physiotherapist or your GP first.

## Why menopause increases the likelihood of pelvic organ prolapse

Oestrogen helps keep the muscles and connective tissues that hold up your pelvic organs strong, springy. As you move through menopause, oestrogen levels fall, and those supporting tissues can lose some of their strength. That makes prolapse more likely to develop, or more noticeable if it was already there.

After an assessment, a doctor may suggest topical vaginal oestrogen, which comes as a cream, pessary, or ring, to ease symptoms that often sit alongside prolapse, like vaginal dryness and discomfort. Systemic Hormone Replacement Therapy (HRT), hormone treatment that works across the whole body, does not treat the prolapse itself, and any decision about hormone therapy is one to make with your GP or specialist.

## When to seek assessment for pelvic organ prolapse

If you notice a heaviness, a bulge, a dragging discomfort, or a lump in or coming out of the vagina, it is worth booking in to see your GP. The same goes if you have urinary symptoms like a slow stream, a sense of not fully emptying your bladder, leaks, or discomfort during sex.

A GP assessment usually means an internal examination, much like a cervical screening test. Prolapse is common, and getting it looked at early means support can start sooner, when a simple approach often works best.

> **INFO**: If you recognise any of the symptoms in this article, speak to your GP. They can carry out an assessment and talk through the options that suit you best.

**Q: Can pelvic organ prolapse in menopause be managed without surgery?**

Often, yes. Supervised pelvic floor muscle training for at least four months is the first approach usually offered for prolapse that causes symptoms, and you may find it eases the discomfort a good deal. Lifestyle changes, physiotherapy, and sometimes a vaginal pessary fitted by a specialist are all non-surgical options. Your GP can talk through which suits you.

**Q: Do prolapse symptoms stay the same throughout the day?**

Not always. What you feel is often stronger after you have been standing for a while or towards the end of the day, and it can ease once you lie down. This shifting through the day is common and does not mean the prolapse itself is changing hour to hour. If symptoms are getting in the way of your day, it is worth raising with your GP.

**Q: Can you have a prolapse with no symptoms?**

Yes. A mild prolapse can be there without you noticing anything, and may only come to light during a routine internal examination like a cervical screening test. If you do have symptoms, it is still worth getting an assessment rather than waiting for them to settle on their own.

**Q: What exercises are best if you have a pelvic organ prolapse?**

This is very individual and specific to your prolapse, symptoms and lifestyle. Low impact options can be a good place to start, for example cycling or pilates, however high impact options should not be taken off the table, but be reviewed and considered with the correct support. Before you change your routine, it helps to speak to a pelvic health physiotherapist or your GP, since what suits you varies.

**Q: Does HRT help with prolapse?**

Systemic HRT does not treat the prolapse itself. After an assessment, though, a doctor may suggest topical vaginal oestrogen to help with symptoms that often come alongside it, like vaginal dryness and discomfort. This is a decision led by your doctor and based on your own situation, so talk it through with your GP or specialist.

### Clinical Sources
- [Pelvic organ prolapse - NHS 111 Wales](https://111.wales.nhs.uk/encyclopaedia/p/article/pelvicorganprolapse/)
- [Pelvic organ prolapse - NHS inform (Scotland)](https://www.nhsinform.scot/illnesses-and-conditions/sexual-and-reproductive/pelvic-organ-prolapse/)
- [Recommendations | Urinary incontinence and pelvic organ prolapse in women: management | Guidance | NICE](https://www.nice.org.uk/guidance/ng210/chapter/recommendations)
- [Physiotherapy - Pelvic Obstetric and Gynaecological](https://elht.nhs.uk/services/physiotherapy-pelvic-obstetric-and-gynaecological/physiotherapy-pelvic-obstetric-and-gynaecological-1)
- [Pelvic organ prolapse - NHS inform (Scotland)](https://www.nhsinform.scot/illnesses-and-conditions/sexual-and-reproductive/pelvic-organ-prolapse/)
- [Pelvic organ prolapse (POP)](https://www.cuh.nhs.uk/patient-information/pelvic-organ-prolapse-pop/)
- [Pelvic organ prolapse - NHS inform (Scotland)](https://www.nhsinform.scot/illnesses-and-conditions/sexual-and-reproductive/pelvic-organ-prolapse/)
- [Pelvic organ prolapse - NHS inform (Scotland)](https://www.nhsinform.scot/illnesses-and-conditions/sexual-and-reproductive/pelvic-organ-prolapse/)
- [Pelvic organ prolapse - NHS inform (Scotland)](https://www.nhsinform.scot/illnesses-and-conditions/sexual-and-reproductive/pelvic-organ-prolapse/)
- [Pelvic organ prolapse - NHS inform (Scotland)](https://www.nhsinform.scot/illnesses-and-conditions/sexual-and-reproductive/pelvic-organ-prolapse/)

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Reviewed by Dr Clare Bourne, Consultant Pelvic and Digestive Health Physiotherapist | [Medical Board](https://blog.bloume.com/menopause/medical-board.md) | August 2026