Pelvic Organ Prolapse - What Happens
pelvic organs are kept in place by the muscles and connective tissues of the
pelvis (pelvic diaphragm). The vagina of an adult woman is normally a
round-topped, muscular tube that also supports the other pelvic organs. The
pelvic muscles and tissues can be stretched or damaged, most commonly by
childbirth. When they don't recover, they lose their ability to support the
The location and severity of
pelvic organ prolapse is related to where in the
pelvis the injury or muscular damage has occurred. You may have several areas
of injury that contribute to prolapse. Prolapse may occur after surgery to
remove the uterus (hysterectomy) if the procedure removes
or damages support of the bladder, urethra, or bowel wall. If other conditions,
such as childbirth, damage muscles or nerves in the pelvis, the pelvic
diaphragm may lose its dome shape. It may become more like a funnel and then bulge
down into or out of the vagina.
Pelvic organ prolapse may increase
pressure on the vagina and interfere with sexual activity, sometimes leading to
sexual dysfunction. For more information, see the topic
Sexual Problems in Women.
Lower estrogen levels during and after
menopause make pelvic organ prolapse more likely.
Estrogen helps your body to make collagen, a protein that enables the
supportive tissues of the pelvis to stretch and return to their normal
positions. When estrogen levels go down, so do collagen levels. Less collagen makes it more likely that those supportive tissues
organ prolapse may be a progressive condition, gradually getting worse and
causing more severe symptoms. But in many cases it does not progress and may
improve over time.