How to Strengthen Pelvic Floor Prolapse

Pelvic organ prolapse (POP) occurs when pelvic organs (bladder, uterus, or bowel) bulge into or through the vagina due to weakened supportive tissues. It is common after pregnancy and vaginal birth.

While exercise alone cannot reverse moderate-to-severe prolapse, correct pelvic floor muscle training (not just generic Kegels), core pressure management, and lifestyle changes can significantly reduce symptoms, slow progression, and help many women avoid or delay surgery.

Always see a pelvic floor physiotherapist or specialist for a proper diagnosis first.

Pelvic organ prolapse affects millions of women worldwide. Pregnancy and vaginal childbirth are the leading risk factors because they stretch and can injure the pelvic floor muscles, fascia, and ligaments that support the bladder, uterus, and bowel.

Symptoms often appear or worsen during pregnancy or in the postpartum period and can impact daily life, exercise, and confidence.

Early Signs and Symptoms of Pelvic Organ Prolapse

Early Signs and Symptoms of Pelvic Organ Prolapse

Common symptoms include:

• A feeling of heaviness, pressure, or dragging in the pelvis (often worse later in the day or after standing).
• A visible or palpable bulge at the vaginal opening.
• Difficulty emptying the bladder or bowel completely.
• Urinary leakage (especially with coughing, sneezing, or lifting).
• Lower back or pelvic pain.
• Discomfort or pain during sex.

Symptoms can fluctuate and may improve with rest or worsen with activity, constipation, or coughing.

Types of Pelvic Organ Prolapse

• Cystocele (anterior wall / bladder prolapse), the most common type
• Rectocele (posterior wall / bowel prolapse)
• Uterine prolapse
• Enterocele (small bowel)
• Vaginal vault prolapse (after hysterectomy)
• Many women have a combination of types.

Step 1: Get the Right Diagnosis

See a pelvic floor physiotherapist or urogynecologist for an internal examination. They will assess:

• Which organ(s) are involved.
• The stage (1-4).
• Whether your pelvic floor is weak, tight, or both.
• Related issues such as diastasis recti.

Important: Up to 40% of women perform Kegels incorrectly (bearing down instead of lifting), which can worsen prolapse. Generic online instructions are not enough.

Step 2: The Evidence-Based 3-Part Approach

1. Correct Pelvic Floor Training

• First learn to fully relax the pelvic floor (many women with prolapse hold chronic tension).
• Then practice gentle lifts (not hard squeezes).
• Include both long holds (5-10 seconds) and quick flicks.
• Typical dosage: 8-12 slow reps + 20-30 fast reps, 3-5 times per day.

2. Core and Pressure Management

• Engage the deep core (transversus abdominis) before lifting, coughing, or sneezing.
• Exhale on effort 'blow before you go').
• Manage constipation and chronic coughing to reduce downward pressure.

3. Lifestyle Modifications

• Avoid or modify heavy lifting.
• Use correct toilet posture (feet elevated, lean forward, brace).
• Maintain a healthy weight where possible.
• Treat constipation proactively.

These strategies are supported by clinical guidance from organisations such as ACOG and pelvic health specialists. They improve symptoms for many women with mild-to-moderate prolapse, even if the anatomical bulge does not fully reverse.

Best Exercises for Pelvic Organ Prolapse

Start gently and stop any movement that increases bulging or heaviness. Prefer side-lying or semi-reclined positions initially.

1. Diaphragmatic Breathing. Inhale so the belly rises and pelvic floor gently lengthens; exhale and allow a natural lift. (2-3 minutes, several times daily)

2. Pelvic Floor Lengthening + Lift. On the exhale, gently lift (imagine picking up a blueberry); fully relax on the inhale. No bearing down.

3. Heel Slides with Deep Core Brace. Lying on your back or side, exhale, gently draw the lower belly in, and slide one heel out and back.

4. Seated or Side-Lying Marches. Exhale and brace while lifting one knee a few inches.

5. Glute Bridges or Kneeling Hip Thrusts. Only if they do not increase bulge sensation. Focus on controlled glute and pelvic floor engagement.

6. Side-Lying Clams. Strengthens the glute medius for better pelvic stability.

Movements to avoid or heavily modify:

• Crunches
• full planks
• jumping
• running
• heavy lifting
• wide deep squats without support (especially if they increase symptoms).

For structured, progressive pelvic floor and core programming designed for pregnancy and postpartum, explore our pelvic floor exercise resources and diastasis recti guidance.

Causes and Risk Factors

The primary cause is pregnancy and vaginal birth (especially forceps/vacuum delivery, large baby, or prolonged pushing).

Additional factors include:

• Multiple vaginal deliveries.
• Chronic constipation or coughing.
• Obesity.
• Ageing and connective tissue changes.
• Heavy lifting.

Treatment Options

Australian guidelines (RANZCOG, Continence Foundation of Australia) recommend non-surgical management unless severe.

First-line: Supervised pelvic floor muscle training + lifestyle changes (most effective for mild symptoms).

Pessary: A removable silicone device that supports the organs and can provide immediate symptom relief for many women.

Surgery: Considered when conservative measures do not sufficiently improve quality of life, particularly for more advanced stages.

Treatment is individualized. Many women manage well long-term with conservative care.

How PregActive's Hug & Wrap Technique Helps Pelvic Organ Prolapse

Pelvic organ prolapse symptoms are often worsened by downward pressure on the pelvic floor. PregActive's 'Hug & Wrap' technique teaches coordinated deep-core and pelvic-floor engagement to manage this pressure.

On the exhale, you gently draw the lower belly inward while allowing a natural lift of the pelvic floor. This creates an upward-and-inward response instead of the bearing-down force that can increase heaviness or bulging.

The technique helps by:

• Reducing downward pressure during lifting, coughing, and exercise.
• Retraining the pelvic floor to lift rather than push.
• Preventing breath-holding and incorrect bracing.

Built into short 10-12 minute workouts, Hug & Wrap becomes a practical daily habit.

Consistent use can ease symptoms such as heaviness and a feeling of bulging, particularly in milder stages of prolapse.

It is not a cure and does not replace assessment by a pelvic floor physiotherapist. It does, however, give you a structured way to move with less strain on vulnerable tissues. Always stop any exercise that increases bulging and seek individual guidance if symptoms are significant.

Frequently Asked Questions

Can pelvic organ prolapse be reversed with exercise?

Exercise and pelvic floor training can dramatically improve symptoms and slow progression, especially in milder stages. They do not typically 'cure' moderate-to-severe anatomical prolapse, but they often reduce the need for surgery.

Is prolapse common after pregnancy?

Yes. Pregnancy and vaginal birth are the leading risk factors. Symptoms can appear during pregnancy or in the months afterward.

Should I stop exercising if I have prolapse?

No, but you should modify. Low-impact activities and correctly performed pelvic floor and core work are usually beneficial. High-impact or high-pressure movements may need to be adjusted.

When should I see a specialist?

If you notice a bulge, heaviness that affects daily life, difficulty emptying the bladder or bowel, or symptoms that worry you. Early assessment leads to better outcomes.

Will pelvic organ prolapse go away on its own?

Mild symptoms can improve after birth as hormones settle and the pelvic floor recovers, but prolapse does not usually disappear completely without support. Correct pelvic floor training, pressure management, and lifestyle changes can significantly reduce symptoms for many women.

More advanced stages generally need ongoing management (exercises, pessary, or surgery).

Can I have another baby if I have prolapse?

Yes, many women with prolapse go on to have successful pregnancies. Symptoms often worsen during pregnancy due to added pressure and hormonal changes, but they frequently improve after delivery.

Discuss your options with a pelvic floor specialist or obstetrician early, some women benefit from a pessary during pregnancy, and birth planning can be tailored.

Is it safe to exercise with pelvic organ prolapse?

Yes, with modifications. Low-impact activities and correctly performed pelvic floor and core exercises are usually beneficial.

Avoid or heavily modify high-impact movements (running, jumping), heavy lifting, and exercises that increase downward pressure or bulging (such as traditional crunches or full planks) if they worsen symptoms.

A pelvic floor physiotherapist can guide safe progression.

How do I know if my prolapse is getting worse?

Signs that symptoms may be progressing include increased heaviness or dragging that lasts longer, a more noticeable bulge, greater difficulty emptying the bladder or bowel, or symptoms that start interfering with daily activities or exercise.

Track changes and get reassessed if you notice worsening, early intervention helps.

Can a pessary help with prolapse during pregnancy or postpartum?

Yes. A pessary is a removable silicone device that supports the pelvic organs and can provide immediate relief from heaviness and bulging.

Many women use them successfully during pregnancy or in the postpartum period while they strengthen their pelvic floor. A specialist fits the correct size and type.

Does pelvic organ prolapse affect sex?

It can cause discomfort, reduced sensation, or a feeling of laxity for some women. Correct pelvic floor training often improves comfort and function. A pessary can also help during sex for many people.

Open communication with a pelvic health specialist is useful if symptoms are affecting intimacy.

How long does it take for pelvic floor exercises to help prolapse symptoms?

Many women notice reduced heaviness or better control within 4–12 weeks of consistent, correctly performed training.

Results vary depending on the stage of prolapse, consistency, and whether other factors (constipation, high-impact activity, etc.) are also addressed. Supervised guidance from a pelvic floor physiotherapist improves outcomes.

Is surgery the only option for stage 3 or 4 prolapse?

No. Even with more advanced prolapse, many women manage well with a pessary and pelvic floor training. Surgery is typically considered when conservative options no longer provide enough symptom relief or when quality of life is significantly affected.

The decision is individual and based on symptoms, not just the stage number.

Can weight loss or treating constipation improve prolapse?

Yes. Extra body weight and chronic straining increase downward pressure on the pelvic floor. Losing weight (if indicated) and preventing constipation with fibre, fluids, and good toilet habits can meaningfully reduce symptoms for many women.

Should I stop lifting my baby or doing daily activities?

No. Complete avoidance is usually unnecessary and can lead to weakness. Instead, learn to brace your deep core and pelvic floor before lifting ('blow before you go'), use good posture, and avoid breath-holding.

A pelvic floor physiotherapist can teach you safe lifting techniques.

Don't let Pelvic Organ Prolapse hold you back any longer.

Educate yourself and empower your body today!

I will be discussing pelvic organ prolapse during pregnancy, a common but often overlooked issue that many women face during this special time.

I will explore the causes, symptoms, and treatment options for pelvic organ prolapse, as well as provide helpful tips and advice for pregnant women dealing with this condition.

Whether you are currently pregnant or planning to have a baby in the future, this guide will provide valuable information to help you navigate through pelvic organ prolapse with confidence.

Pelvic Organ Prolapse Exercise Video 1

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Pelvic Organ Prolapse Exercise Video 2

In this short 7-minute Gentle postpartum exercise routine focused on assisting recovery from a POP particularly after birth.

Pelvic Organ Prolapse Exercise Video 3

Building on from Pelvic Organ Prolapse Exercise Video 2; this workout is longer at 9-minutes including all four kneeling exercises to help progress your recovery.

The 10-Minute Daily Hip Stretch Routine for Prolapse Relief

References

Pelvic Support Problems | ACOG

Pelvic Organ Prolapse: Types, Causes & Treatment

Pelvic Organ Prolapse | Continence Health Australia

The PregActive Method

The 12-Minute Proven Method that 60,000+ Mamas Use to Stay Strong, Leak-Free and Pain-Free Through Pregnancy and Motherhood. Article review: Article updated and reviewed by Kerryn Boyle on 30/10/2026.