Fixing Pelvic Organ Prolapse (That Kegels Could Make Worse!)

Dr. Amy Konvalin explains why a lot of popular advice can do more harm than good, and what to do instead:

Gently does it

A pelvic organ prolapse occurs when organs in the abdominal cavity shift downwards due to weakened connective tissue or altered pelvic floor function, and it is common after pregnancy and during perimenopause or menopause.

To describe what’s going on physically, here are the three main categories of pelvic organ prolapse:

• Bladder prolapse (cystocele): the bladder drops into the front wall of the vagina, often causing vaginal heaviness or pressure that worsens after standing, along with urinary leakage or difficulty fully emptying the bladder.
• Rectal prolapse (rectocele): the rectum bulges into the vaginal wall, leading to difficulty with bowel movements, a sense of pelvic fullness, and sometimes the need to press on the vaginal wall to complete a bowel movement.
• Uterine prolapse (no special name): the uterus descends into the vaginal canal, often described as feeling like everything is falling out, sometimes with visible tissue at the vaginal opening, and commonly associated with lower back or hip pain.

Not only are none of them fun individually, but also, to make matters worse, they often occur together. This is because the pelvic organs are closely connected by fascia, so when one organ shifts, it can pull others with it.

While kegels are a well-known way to “keep things tight down there”, actually in many cases this can harm rather than help, as it’s very common to have a tight rather than weak pelvic floor, and repeated kegel exercises can increase tension, pulling organs further down and worsening things.

Inconveniently, tightness can be misdiagnosed as weakness: when the pelvic floor is already fully contracted, testing may show poor additional contraction, leading clinicians to label it as weak and prescribe more kegels that increase tension and, as discussed, ultimately make things worse.

Note: sometimes it really is weakness, and some people do improve with kegel exercises. But worsening symptoms over time are a strong signal that this approach is not the right one.

Instead, for most people, Dr. Konvalin recommends:

• First, breathing and relaxation: deep diaphragmatic breathing helps calm your nervous system, reduces pressure in the abdominal cavity, and can lessen prolapse symptoms by allowing your pelvic floor to relax.
• Balanced pelvic floor movement: gentle, coordinated pelvic floor contraction and relaxation is important, focusing on restoring awareness and movement rather than constant tightening.

A whole-body approach is important, because prolapse is often a sign of broader issues such as posture, alignment, or strength imbalances, so treatment should extend beyond the pelvic floor alone.

With this in mind, some tweaks to help your body heal itself more quickly and easily:

• Keep your head stacked over your shoulders and your shoulders over your hips when sitting, with equal weight through your feet, and with both feet on the ground.
• Engage your glutes, your abdominal muscles, and your lower back to reduce stress on your pelvic floor.
• Limit straining, high-impact activities, heavy lifting, and temporarily pause running to give your body a chance to heal and regain pelvic floor coordination.

For more on all of this and certainly no visual demonstrations this time, enjoy:

Click Here If The Embedded Video Doesn’t Load Automatically!

Want to learn more?

You might also like:

Body Fat & Pelvic Floor Problems: What Matters Most Is Where The Fat Is ← for another angle from which to approach this, if applicable (i.e., it will be relevant if your fat distribution is a certain way, and not otherwise).

Take care!