I’m sure you have all heard the term “prolapse” brought up at some point. I feel like as soon as we hear the word prolapse, everyone freaks out!

What is it?
Are my organs falling out — never to be seen again?!
Do I have this forever?!

We see so many ladies coming in having been told (by someone or Dr Google) that yes, they’ve got a prolapse — come and see us, we will sort it out. But often, they’re not told what it is, what is actually prolapsing, or why. Now that is scary.

Real Client Story: Menopause & Bladder Prolapse

One lady, who was postmenopausal, came in to see us with a long history of constipation and a new onset of prolapse symptoms, including a feeling of a bulge when she wiped and a sense of heaviness.

She was very lucky to have the support of her daughter, who encouraged her to seek help early.

On assessment, we determined that she had a Grade 2 bladder prolapse.

What Does That Mean?

This is where it can get confusing.

Her bladder was lacking support from the connective tissue and pelvic floor muscles. Simply put, the pelvic floor muscles act like a sling underneath the pelvic organs (bladder, uterus, and bowel). These muscles are supported by connective tissue, like ropes holding up a hammock.

These “ropes” provide strength but also allow some natural movement. Over time, too much strain can stretch them, reducing their ability to support the organs — causing them to sit lower in the pelvis.

If the muscles themselves are also weak, this further reduces support. This is what we call prolapse.

One, two, or even all three pelvic organs can be affected, which is why it’s important to understand what is prolapsing and why.

What Contributed to Her Prolapse?

For this lady, key factors included:

• Excessive straining during bowel movements
• Long-term constipation
• Moderate pelvic floor strength

These all contributed to increased pressure and stretch on the support structures over time.

How We Managed Her Symptoms

1. Bowel Health

This is extremely important for prolapse symptoms.

We worked on:

• Proper toilet positioning
• Breathing techniques
• Increasing fibre (2 kiwi fruits in the morning!)
• Adequate fluid intake
• A slow, intentional morning routine

2. A Holistic Approach

This isn’t just about doing pelvic floor exercises and calling it a day.

We also looked at:

• Stress management (breathing, sleep, mindfulness)
• Breathing patterns (no breath holding, exhale on effort)
• Pelvic floor coordination (not just strength)
• Posture and whole-body mobility
• Strength training (to support the pelvic floor)
• Bladder and bowel habits
• Hormonal changes post-menopause

For this lady, continuing her strength classes and keeping herself active was a huge goal, and one that we can maintain with a prolapse! We encouraged her to continue exercising 4x/week, and how we can tweak certain exercises and positions to reduce the load on the pelvic floor, until we have enough strength and tone to help support a gradual return to these. 

She was also prescribed our app-based program – an individualised follow-along program that was tailored to her after we completed the internal vaginal exam as well as general musculoskeletal exam. This included breathing exercises, pelvic floor exercises, strength work (core, glutes etc), release work and yoga flows, plus more education in video format. This was adjusted and updated after each visit to progress as her symptoms improved.

Now this patient was VERY compliant !! Which meant her symptoms improved quite quickly.

After 4 weeks:

• Bowel movements improved from 0–1/day (hard, painful) to 2–3/day (easy and soft)
• No more straining
• Hemorrhoids improved
• Less fear around going to the toilet

She was so happy with how simple lifestyle changes and proper techniques made such a big difference.

Prolapse symptoms also improved:

• 4 weeks: Less frequent and less intense bulge and heaviness
• 8 weeks: Further improvement
• 12 weeks: No more noticeable bulge, only mild and occasional heaviness

She then went on an overseas holiday (which is generally a really good test for the bowels!) and she did not experience any flare up of bowel or prolapse symptoms for the 10 days overseas!

This is just one example of why tailored examination, advice, education, and management is so important when dealing with prolapse. We are so passionate about changing the narrative that prolapse means you can’t continue being active, or that it’s purely because you are weak in your pelvic floor. Prolapse is multi-modal, and it IS manageable! 

Need Support?

Do you have pelvic health symptoms that need checking?

👉 Book an appointment with our Women’s Health Physios
👉 Or book a free discovery call to see how we can help