Does a Mild Prolapse Always Get Worse?What Studies Show, and What Helps
Bladder & Pelvic FloorArticleBeing told you have a 'dropped' bladder or uterus can feel like the start of a downhill slide. In a study that examined postmenopausal women every year, mild prolapse often improved on its own. And a large trial found one-to-one pelvic floor training reduced prolapse symptoms compared with an advice leaflet.
In this article
Pelvic organ prolapse happens when the bladder, uterus or rectum sags into the vagina. It’s common and strongly linked to childbirth and age.1 Our guide to what prolapse is explains the types. A common fear is that it will only get worse.
What a yearly-exam study found
Researchers examined postmenopausal women every year for 2 to 8 years.2
- About 32% had some prolapse at the start.2
- New prolapse was linked to more births and a larger waist.2
- Mild (grade 1) prolapse progressed in some women each year, but regression was more common than progression:2
| Grade 1 prolapse, per 100 women a year | Got worse | Got better |
|---|---|---|
| Bladder (cystocele) | 9.5 | 23.5 |
| Rectum (rectocele) | 13.5 | 22 |
| Uterus | 1.9 | 48 |
The authors concluded prolapse isn’t always chronic and progressive, and spontaneous improvement is common for mild cases.2
Does pelvic floor training help?
In the POPPY trial, 447 women with newly diagnosed, symptomatic prolapse got either one-to-one pelvic floor muscle training or an advice leaflet.1 At 12 months, women who trained reported fewer prolapse symptoms.1 Long-term benefits still need study.1
Our guides to pelvic floor exercises, doing Kegels correctly and pelvic floor therapy costs can help you start.
Other options if symptoms bother you
- A pessary supports the tissues without surgery. See pessary questions.
- Surgery is an option when symptoms are significant. See vault prolapse repair options.
Questions to ask
- What grade is my prolapse, and which organ is involved?
- Can I start with supervised pelvic floor training?
- What changes would mean it’s progressing, and when should we recheck?
Try: “I was told I have a mild cystocele but it doesn’t bother me much. Can we watch it and try pelvic floor therapy rather than doing anything else now?”
Laugh, Sneeze, Jump includes an appointment prep sheet. Use it to note when you feel pressure or a bulge and what makes it better or worse.
This article is for general educational purposes only and is not medical advice. It isn't a substitute for diagnosis or treatment from a qualified healthcare professional who knows your health history. Please don't ignore professional advice or delay getting care because of something you read here. Tissue that stays outside the vaginal opening, bleeding or sores on a bulge, inability to pee, or kidney pain needs prompt care. If you think you may be having a medical emergency, call 911 or your local emergency number right away. This article discusses published research. Girl Playbook does not endorse any specific product, test, or provider.
Girl Playbook sells this book. It provides education and worksheets, not individualized medical care.
Sources
The research behind this article, in the order it’s cited. How we source our articles.
- The Lancet (abstract via PubMed), 2014Individualised pelvic floor muscle training in women with pelvic organ prolapse (POPPY): a multicentre randomised controlled trial (opens in a new tab)abcd
- American Journal of Obstetrics and Gynecology (abstract via PubMed), 2004Progression and remission of pelvic organ prolapse: a longitudinal study of menopausal women (opens in a new tab)abcdef
Spotted something out of date? Tell us and we’ll check it.
