Vaginal Prolapse

Vaginal Prolapse

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Vaginal prolapse, also known as vaginal vault prolapse, occurs when the top of the vagina weakens and collapses into the vaginal canal. In more serious cases of vaginal prolapse, the top of the vagina may bulge outside the vaginal opening.
Symptoms of vaginal prolapse include the feeling of vaginal pressure or fullness — like you’re sitting on a small ball — and the sensation that something has fallen out of your vagina.
A cystocele or rectocele usually occurs with vaginal prolapse.
Mild cases of vaginal prolapse do not require treatment. Moderate to severe symptoms require nonsurgical therapies or minimally invasive surgeries, such as vaginal prolapse repair.

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Prolapse occurs when a woman’s pelvic floor muscles, tissues and ligaments weaken and stretch. This can result in organs dropping out of their normal position. Vaginal prolapse refers to when the top of the vagina — also called the vaginal vault — sags and falls into the vaginal canal. In severe cases, the vagina can protrude outside of the body.
There are no direct causes of vaginal prolapse. However, women are at an increased risk of developing vaginal prolapse if they:
Hysterectomy, a surgery to remove a woman’s uterus, is sometimes performed to treat uterine prolapse. However, vaginal prolapse can occur after hysterectomy (regardless of the reason for hysterectomy). This is called “vaginal prolapse after hysterectomy.”
Vaginal prolapse is relatively common. About one-third of women will experience some degree of prolapse during their lifetime. If you have more than one risk factor, your chances of developing vaginal prolapse increase.
Women with vaginal prolapse often report feeling pressure in the vaginal area, described as a throbbing pain in the vagina. Women also report:
The pelvic organs are all supported by each other. When one organ prolapses, it can affect the functioning of other nearby organs. Thus, some women also experience:
Your doctor will review your medical and surgical history and complete a physical exam. Additional tests, such as ultrasound or MRI, are rarely needed. In some cases, your doctor may also recommended urodynamics testing, a group of tests that evaluate bladder function.
Our team of compassionate urogynecologists uses the latest research and advanced technologies to treat a range of pelvic floor disorders.
Treatment for vaginal prolapse varies, depending on the severity of the symptoms. Many cases will not require treatment. In mild cases, your physician may recommend pelvic floor exercises to strengthen the muscles. In moderate cases, your doctor may insert a vaginal pessary to support your vaginal wall. In the most severe cases, you may benefit from surgery, such as colposuspension , a minimally invasive surgical procedure, where the vaginal wall is attached to a stable ligament in the pelvis.
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How do you know if you have a prolapse?

What happens if you do not treat a prolapse?

Can you fix a prolapse on your own?

How do I know if my prolapse is severe?

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

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Nancy LeBrun is an Emmy and Peabody award-winning writer and producer who has been writing about health and wellness for more than six years
Peter Weiss, MD, is a board-certified OB/GYN and expert in women's health.

Vaginal prolapse, also known as vaginal hernia, is when the vagina slips out of place in the body. Sometimes the vagina moves only slightly or it can shift significantly. In the most severe cases, it can protrude from the body. Vaginal prolapse can cause discomfort but can be treated with vaginal physical therapy, medication, or surgery, if necessary.

This article discusses the signs, causes, and treatment of vaginal prolapse.

Many women do not have any symptoms of vaginal prolapse. Healthcare providers may discover it during a gynecological exam. Women who experience signs and symptoms may have: 1

In severe cases, an organ may protrude through the vaginal opening.

Vaginal prolapse is more common in women who:

There are two types of vaginal prolapse, categorized by how much the vagina has moved.

When the prolapse is small and the vagina has dropped only partway into the vaginal canal, it is called an incomplete prolapse. Larger prolapses are called complete prolapses, in which some vaginal tissue can protrude from the body.

Prolapses are also categorized by the affected organs: 2

As many as a third of all women will have some sort of vaginal prolapse at some point in their lives. 2 The most common causes are: 1

There are some other rare medical conditions, such as a tumor or a congenital bladder condition, that can cause prolapse.

Healthcare providers diagnose a vaginal prolapse from a physical examination. They may ask you to move muscles like you are having a bowel movement or as if you are stopping urination.

They will also ask about any symptoms, such as incontinence , that you may be experiencing.

If a complete prolapse is suspected, they may order an imaging test such as an ultrasound to see how the prolapse may be affecting or affected by other organs.

If the prolapse is minor and you are not having symptoms, you may not need treatment. If it is causing discomfort, treatment includes:

Vaginal prolapse is a condition in which the vagina slips down in the body. It's more common in women who have delivered several children vaginally, and in older, post-menopausal women. Vaginal prolapse may not cause any symptoms, but if it does, physical therapy and possibly surgery (if the prolapse is severe) can strengthen the pelvic muscles and help support the vagina.

Vaginal prolapse can cause discomfort. If you notice a feeling of heaviness or like you are sitting on something that bulges, you may have a prolapse. Contact your healthcare provider or gynecologist if you experience symptoms so you can get treated.

If you feel pressure, like you may be sitting on something that bulges, or feel heavy or full, you may have a prolapse. A healthcare provider can diagnose you and treat the prolapse if you need it.
Most prolapses don't need treatment or respond well to treatment. It's possible for a prolapse to recur after surgery, but it's unlikely.
Pelvic muscle exercises can help strengthen the muscles that support the vagina. Have a professional show you how to do them properly and how often.
If you have difficulty with bowel movements or urination, or if you notice tissue protruding from your vagina, you may have a severe prolapse, which typically responds well to treatment.
Johns Hopkins Medicine. Vaginal prolapse .
John Muir Health. Vaginal prolapse .

By Nancy LeBrun

In addition to her extensive health and wellness writing, Nancy has written about many general interest topics for publications as diverse as Newsweek, Teen Vogue, abcnews.com, and Craftsmanship Quarterly. She has authored a book about documentary filmmaking, a screenplay about a lost civil rights hero, and ghostwritten several memoirs.

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Change your activities to prevent stress to the vaginal walls. [2]
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If you have only mild vaginal prolapse, your doctor will likely recommend modifying your activities to avoid heavy lifting and/or straining. This will reduce the stress on your pelvic floor muscles, and may help to improve (or at least to prevent worsening of) your vaginal prolapse.
Keep in mind that surgery is not necessary with vaginal prolapse. You can leave the prolapse untreated without any negative impact on your health.

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Consider trying a device meant to support the vaginal walls. [3]
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Something called a "vaginal pessary" is a circular device, usually made of soft plastic or rubber, that is inserted into your vagina. The pessary will hold your vaginal structures in place, thus preventing symptoms of prolapse and/or worsening of your prolapse. You will need to see your doctor to discuss this treatment option and to have it inserted into your vagina.

A vaginal pessary must be removed and cleaned at regular intervals.
Your physician can instruct you on how to do this, as well as the frequency at which it needs to be done.
Some women find vaginal pessaries uncomfortable, or find that they fall out and have difficulty keeping them in place.
Try a pessary and to see how you feel with it in. You can evaluate from there whether you find it a helpful mode of treatment.
Vaginal pessaries are more successful in women who are not sexually active than in women who are. If you are sexually active, you or your partner can remove the pessary for intercourse. [4]
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Perform Kegel exercises to strengthen your pelvic floor muscles. [5]
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Kegel exercises strengthen the pelvic floor muscles - these function to support the uterus and vagina, as well as the bladder, the small intestine, and the rectum. Do Kegel exercises at least 3 times per day, ultimately aiming for 10 repetitions each time. Here's how to effectively perform Kegel exercises:

To identify your pelvic muscles (the ones you will be flexing during Kegel exercises), stop urinating mid-stream. Notice which muscles you used to do this task - this feeling of muscle tightening is what you will be aiming for when you perform the exercises (which is recommended to do when you are not urinating - the urination test is simply used to allow you to identify the muscles).
When lying down or sitting comfortably, contract your pelvic muscles and hold the contraction for 5 seconds. Then, release for 5 seconds, and then repeat this 5 times. Ultimately, you will want to aim to hold the contraction for 10 seconds, to release for 10 seconds, and to repeat this 10 times.
Stay relaxed as you perform the exercise and do not hold your breath. Rather, continue to breathe deeply as you perform the exercises.
Kegel exercises are not meant to be tiring; they are more about focus, as you keep your mind focused on the contractions that will effectively strengthen these muscles.
If you have difficulty performing Kegels, then let your doctor know. You may need a referral to see a physical therapist for help.
Kegels are also useful for preventing uterine prolapse .

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Ask your doctor about estrogen replacement therapy as a method to treat vaginal prolapse. [6]
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