Prolapse: 3 Ways To Heal Beyond Kegels
Authored by the Bodyful Team
Pelvic Organ Prolapse (POP): Understanding Your Symptoms & Options Beyond Surgery
Are you looking for how to manage a pelvic organ prolapse (POP) without surgery?
Are you newly postpartum and noticing pelvic floor prolapse symptoms?
Have you heard the term prolapse but feel confused by the advice you’ve found online?
You’re not alone. Pelvic organ prolapse is common, especially postpartum, and there is a wide spectrum of experiences—from people who have no symptoms at all, to those who feel heaviness, pressure, or changes in bladder or bowel function.
There is a lot of information on the internet, and unfortunately, much of it is overly simplistic or fear-based. This blog is meant to offer clarity, nuance, and reassurance. You can also explore our dedicated pelvic organ prolapse page for more support.
What Is Pelvic Organ Prolapse?
Pelvic organ prolapse occurs when one or more organs within the pelvic bowl—such as the bladder, uterus, or rectum—descend from their usual resting position.
This most often happens during or after pregnancy, but prolapse can also develop over time due to factors like:
Repeated straining with bowel movements
Chronic breath holding during effort
Heavy lifting without coordinated intra-abdominal pressure management
Connective tissue hypermobility
Hormonal changes
Prolapse is often described as “weak pelvic floor,” but that explanation is incomplete.
A helpful image is to think of your pelvic organs like a boat docked in water:
The organ is the boat
The pelvic floor is the water
The ligaments are the ropes
The water supports the boat, but the ropes keep it positioned. If pressure, posture, breathing, or ligament tension isn’t well managed, symptoms of prolapse can show up—even if you are strong.
This is why doing endless kegels is rarely the full solution.
Common Pelvic Organ Prolapse Symptoms
Prolapse symptoms vary widely. You may notice:
Vaginal heaviness or pressure
A sensation like a tampon is falling out
Difficulty fully emptying your bladder or bowels
Worsening symptoms at the end of the day
Symptoms that change with posture, lifting, or fatigue
Many people have a mild or low-grade prolapse and experience no symptoms at all.
Prolapse is common.
Prolapse is not a failure.
Prolapse does not automatically mean surgery or that it is destined to worsen.
Managing Prolapse Without Surgery: Beyond Kegels
Some people can manage pelvic organ prolapse without surgery. Others benefit from pelvic floor physical therapy before or after a surgical repair. The key is individualized care.
Here are three foundational strategies beyond kegels that often help reduce prolapse symptoms:
1. Support Tissue Health (Especially Postpartum or Perimenopause)
If you are postpartum, breastfeeding/chest-feeding, perimenopausal, or on long-term hormonal birth control, estrogen levels may be lower than baseline.
Lower estrogen affects the elasticity and tensile support of the ligaments and tissues around the pelvic organs. Some people benefit from discussing topical vaginal estrogen with their medical provider to support local tissue health.
It’s also important to know:
Estrogen levels may remain low throughout lactation
It can take several months after weaning for hormones to normalize
2. Address Constipation & Abdominal Pressure Management
Prolapse is closely related to how pressure moves through your abdomen.
If you strain and breath hold during bowel movements, pressure increases downward on the pelvic floor and ligaments. Over time, this can worsen prolapse symptoms.
Supportive bowel habits include:
Eating 25–30 grams of fiber daily from food
Staying hydrated
Using a footstool or squatty potty
Breathing during bowel movements (no breath holding)
Avoiding prolonged straining
If coordinating breath and pelvic floor relaxation during bowel movements feels challenging, pelvic floor physical therapy can help retrain this pattern.
3. Reduce Pelvic Floor Strain
Many people with prolapse unknowingly hold their pelvic floor too tensing and are not coordinating their movements with breathing.
This matters because of biotensegrity—the idea that uneven tension in connective tissue creates slack elsewhere. When some pelvic floor muscles are held tight, other tissues may become more strained, contributing to prolapse symptoms.
Internal pelvic floor therapy (when appropriate and consensual), combined with coordination training and breathing work, can help redistribute tension more evenly and improve symptom management.
When to Monitor More Closely
If you have mild prolapse symptoms, continue to communicate with your provider if you notice:
Significant urinary retention
Severe bowel dysfunction
Hydronephrosis
Most mild prolapse does not progress to these complications, but track it over time so you can be aware of any changes.
Prolapse, Postpartum Pilates & Long-Term Recovery
Tailored movement can help.
Postpartum Pilates, when done with attention to intra-abdominal pressure management, breath coordination, and pelvic floor dynamic strengthening, can be incredibly supportive for people with prolapse.
Pelvic physical therapy can also help:
Improve posture and core coordination, power, strength, and endurance
Reduce pelvic heaviness
Support return to exercise safely
Address symptoms after prolapse surgery and prevent risk of surgical failure
If you’ve had prolapse surgery, pelvic floor physical therapy can support recovery, address scar mobility, and help with symptoms like back pain, urinary changes, constipation, or pain with sex—once cleared by your surgeon.
A Final Reframe
Prolapse does not mean you are broken.
Prolapse does not mean your body has failed you.
And prolapse does not automatically mean surgery is required.
With individualized care, many people experience meaningful improvement in symptoms and function.
Ready for Support?
If you’d like guidance specific to your body, symptoms, and postpartum timeline, we invite you to book with us! We’re here to help you move forward with clarity, compassion, and evidence-based care.
