Pelvic Organ Prolapse Symptoms: What Vaginal Pressure/Heaviness Means + What Helps
Feeling heaviness in the vagina, pelvic pressure, or like things “aren’t where they used to be” can be unsettling. You’re not alone — and you’re not broken.
These sensations can be signs of pelvic organ prolapse (POP). Prolapse happens when the tissues that support the pelvic organs (like the bladder, uterus, and bowel) lose some support and pressure shifts downward into the vaginal canal.
The good news: many women can reduce symptoms with the right strategies, and pelvic floor physical therapy can help you stop guessing and start improving.
What does pelvic organ prolapse feel like?
The most common prolapse symptoms include:
Vaginal heaviness, pressure, or fullness (often worse later in the day)
A bulge or “something falling out” sensation
Feeling like a tampon won’t stay in
Urinary changes: leaking, urgency/frequency, trouble emptying fully
Bowel changes: constipation, straining, trouble emptying
Discomfort with sex
Sometimes: low back or pelvic aching
Quick reality check
Prolapse symptoms often fluctuate. Many women feel better in the morning and worse after being on their feet, lifting, or during constipation/straining.
What causes prolapse?
Prolapse is rarely about “one thing.” Common contributors include:
Pregnancy and childbirth
Chronic constipation and straining
Breath holding or heavy lifting with poor pressure management
Repetitive high-pressure activities without the right strategy
Changes over time (age, tissue changes, etc.)
A big theme we see clinically: pressure management. When pressure repeatedly pushes down — especially with breath holding and straining — symptoms often flare. Here are a few tips we recommend to everyone which can really help decrease your symptoms!
Do Kegels help prolapse?
Sometimes — but not always. Pelvic floor exercises (often called Kegels) can be part of prolapse care, but they’re not a one-size-fits-all solution. Kegels are most helpful when the pelvic floor is truly underactive and you can fully relax between contractions.
Kegels may backfire if your pelvic floor is already tight/overactive (common when pain, guarding, constipation, or urgency are present), because adding more “squeezing” can increase tension.
Not sure? Start with breathing + coordination first (below), or check out: Tight vs Weak Pelvic Floor: When Kegels Help (and When They Hurt)
3 ways to get prolapse symptom relief today
These are “starter strategies” we commonly recommend — and they’re also the same themes we build on in pelvic floor PT.
1) Add support (external or internal)
If your symptoms feel better when you apply gentle pressure externally (like supporting the perineum), your body may respond well to added support.
Options to discuss with your provider/PT:
Pessary (a device that supports pelvic organs)
Bladder support products (for specific symptoms)
Supportive garments (for certain activities)
Important: the “right” support depends on your type of symptoms and your anatomy — this is where an evaluation matters.
2) Build pelvic + core stability (without pushing pressure down)
Your pelvis often craves stability — especially in pregnancy and postpartum — but stability should feel like support, not strain.
A few generally well-tolerated options (done with smooth breathing):
Bridges (consider a gentle ball squeeze if it feels good)
Clamshells with a band
Side-lying hip work
Core stability focused on exhale with effort (not breath holding)
Rule of thumb: if an exercise increases heaviness/pressure, scale it back (range, load, impact) and focus on breath + control.
3) Use gravity to your advantage (especially at the end of the day)
If symptoms build as the day goes on, try a “reset” position:
Legs up the wall
Supported bridge (not during pregnancy)
Supported child’s pose (if comfortable)
Aim for 5–15 minutes after a workout or before bed.
The two biggest “prolapse flares” to fix first
Constipation + straining
If you’re constipated or pushing to pee/poop, prolapse symptoms often worsen. (And the pelvic floor has a harder time doing its job.). Try this:
Use a stool under your feet (squatty-potty style)
Think “exhale and soften” — avoid breath holding
Don’t force it. If nothing happens, reset and come back later
Address stool consistency (fiber + fluids, as appropriate for you)
Breath holding with lifting/exertion
Breath holding spikes downward pressure. Instead:
Exhale through the hardest part (“blow as you go”)
Keep ribcage stacked over pelvis
Reduce load/impact until symptoms settle
When should you see a pelvic floor PT for prolapse?
If you have:
Persistent heaviness/pressure or bulging
Leaking + prolapse symptoms
Pain with sex, constipation/straining, or trouble emptying
Symptoms that limit workouts or daily life
Questions like “Am I making it worse?”
A pelvic floor PT can assess tone, strength, coordination, and pressure management, then build a plan that fits your body and your goals — including safe return-to-exercise progressions.
Ready for a clear plan?
Schedule your pelvic floor evaluation — Atlanta, Alpharetta, or Denver
FAQ
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Pelvic organ prolapse is when the support tissues for pelvic organs (bladder, uterus, bowel) lose some support and pressure shifts into the vaginal canal. Prolapse can vary by type and severity, so an evaluation can clarify what’s actually happening for your body.
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Often, yes. Many women improve symptoms with pelvic floor muscle training, pressure-management strategies, bowel habit changes, and support options (like a pessary when appropriate). The best approach depends on your symptoms, daily activities, and how your pelvic floor is functioning—so a personalized assessment helps.
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Sometimes. Kegels can help if your pelvic floor is truly underactive and you can fully relax between contractions. But if your pelvic floor is already tight/overactive or you can’t let go after contracting, Kegels may worsen symptoms. If you’re unsure, it’s best get evaluated so you’re not guessing.
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There isn’t a universal “never do this” list—because it depends on your symptoms and pressure management. A good rule of thumb: if an exercise increases heaviness, pressure, or bulging, it needs modification (load, impact, range of motion, breath strategy, or progression). A pelvic floor PT can help you keep exercising safely with the right adjustments.
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Prolapse often feels like vaginal heaviness, pressure, or a bulging sensation. Some women also notice urinary leakage/urgency, constipation or difficulty emptying, discomfort with sex, or symptoms that worsen later in the day. Because symptoms overlap with other pelvic floor issues, an evaluation is the best way to confirm the cause and map out next steps.