Pelvic Organ Prolapse: A Common Condition Affecting Older Women

This often overlooked health issue can be part of aging, but many doctors fail to tell patients they have it in the early stages

Meghan Holohan,

AARP

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Published March 27, 2026

illustration of an older woman with long, white hair looking out a window with a somber expression

Tara Jacoby

Key takeaways

Pelvic organ prolapse is common with age, affecting 1 in 3 women in their 60s and half in their 80s.
Early-stage prolapse often has no symptoms, and many doctors do not mention it to patients.
Treatments range from pelvic floor therapy and pessaries to surgery when symptoms disrupt daily life.

A vaginal bulge can be an alarming discovery. Many women first notice it in the shower or bathroom and assume the worst.

“[They] run to the emergency room because they think they have some tumor,” says Dr. Charles Ascher-Walsh, division director of urogynecology in the Raquel and Jaime Gilinski Department of Obstetrics, Gynecology and Reproductive Science at the Icahn School of Medicine at Mount Sinai in New York City. “That is because their gynecologist probably never even mentioned they were seeing some degree of prolapse.”

Pelvic organ prolapse is a common condition that becomes more common with age, affecting 1 in 3 women in their 60s, according to the American College of Obstetricians and Gynecologists (ACOG). Half of women in their 80s experience it, the organization notes.

Even so, there is a stigma associated with it, and some doctors hesitate to mention the condition.

“Some gynecologists probably have the perspective that since it’s normal, they don’t want to alarm their patients and make them preoccupied with something that, to some degree, is inevitable,” Ascher-Walsh says. “It’s such a common problem that we really don’t discuss.”

It’s not only doctors who shy away from talking about it. Pelvic organ prolapse feels taboo for many women as well.

“There’s a lot of shame because we’re talking about vaginas. People don’t like talking about that,” says Dr. Lopa K. Pandya, a urogynecologist and reconstructive pelvic surgeon at the University of Illinois, Chicago. “People do have a fear and a shame.”

What is pelvic organ prolapse? Pelvic organ prolapse occurs when the pelvic floor muscles weaken, making it difficult for certain organs, such as the bladder, rectum and uterus, to stay in place.

“Pelvic organ prolapse is — in its most basic form — a loss of support of the vaginal tissue,” says Pandya. “Some people describe it as a herniation of the pelvic organs through the vagina.”

It occurs more often in older women because “to some degree, it’s a normal part of aging,” Ascher-Walsh says. Our muscles lose strength with age; plus, declining estrogen levels in menopause can weaken the connective tissues that support the pelvic floor. ACOG notes that pelvic organ prolapse symptoms most frequently occur in women in their 70s.

Doctors diagnose pelvic organ prolapse using stages from 1 to 4, from least severe to most severe.

“It’s rare that stage 1 prolapse is symptomatic at all,” Ascher-Walsh says.

Stage 2 prolapse occurs when the bulge “is right around the vaginal opening,” says Dr. Lauren Giugale, director of the Postpartum Pelvic Floor Healing Clinic at UPMC Magee-Womens Hospital in Pittsburgh. “Stage 3 is more beyond the vaginal opening, and then stage 4 is when it’s as [bad] as it can be.”

Pandya says stage 4 is considered “complete prolapse, [where] maybe the vagina has almost flipped inside out.”

While this sounds scary, she assures that the organs will not slip out of the body.

“That is a common misconception,” says Pandya, who is also the chair of the public education committee for the American Urogynecologic Society. “We never want people to think that something is going to fall out of them.”

What are the symptoms of pelvic organ prolapse?

The telltale sign of pelvic organ prolapse is a “vaginal bulge,” Giugale says.

People feel “the sensation of something falling out of the vagina. Sometimes they feel, like, a little bulge, almost like a water balloon,” she explains. “Some people describe it as feeling like an uncomfortable tampon or like a tampon is falling out.”

Pandya says some of her patients characterize it as feeling “like they’re sitting on a ball.” Other common symptoms include pressure in the pelvic floor and urinary incontinence.

“A lot of women, 40 percent who have prolapse, have stress incontinence,” Ascher-Walsh says. “If you do leak when you cough or sneeze or laugh, that could be an indication that you may have some prolapse.”

What are the risk factors for pelvic organ prolapse?

“The biggest risk factors for pelvic organ prolapse are having vaginal childbirth,” Giugale says. “It is related to the number of vaginal births as well. So the more vaginal births, the [greater the] risk of pelvic organ prolapse.”

Genetics also play a role. “If someone’s mom had prolapse and someone’s grandmother had prolapse, they might be at an increased risk,” Giugale says.

People with chronic coughs, chronic constipation and obesity are also more likely to develop it because these conditions can cause extra stress on the pelvic floor muscles.

Types of pelvic organ prolapse

There are three types of pelvic organ prolapse, based on the organ that’s affected.

One type is bladder prolapse, or a cystocele, Pandya says. The bladder rests at the top of the vagina, and when the front vaginal muscles weaken, the bladder can slip down and press against the front of the vagina. Some women with later-stage bladder prolapse need to use their hand to press on the bulge to empty their bladder completely, Ascher-Walsh says.

If the vaginal muscles in the back of the pelvis weaken, the rectum can fall, a condition called a rectocele. People with later-stage rectoceles can have trouble pooping.

“The classic [technique] is something called splinting, and that’s where a woman will actually push down with [her] hand in the vagina, on the back wall, to help the stool come through,” Ascher-Walsh says. “Instead of [stool] easily coming through the anus, it’ll actually go into the bulge that’s bulging into the vagina.”

Finally, uterine prolapse occurs when the uterus sags through the vagina.

It’s possible to experience more than one type of pelvic organ prolapse. “Those three different types of prolapse can all happen at the same time,” Giugale says. “You can have just one and not the other[s].”

Treatment options for pelvic organ prolapse

Most people with pelvic organ prolapse visit a urogynecologist, a doctor who specializes in treating pelvic floor disorders, the experts say. Pelvic floor physical therapy can help people improve their pelvic floor strength, which can better support the pelvic organs.

“We have very good data that pelvic floor [physical therapy] works,” Pandya says. “There’s data that you can go from stage 3 to stage 2 [pelvic organ prolapse].”

Many people find relief with a pessary, a removable silicone disc or ring.

“There’s a bunch of different shapes and sizes that are placed in the vagina,” Giugale says. “They hold everything up.”

Women can use pessaries for a short period of time, such as before surgery, or indefinitely. Sometimes people feel better after wearing it for a few weeks and stop using it. Just know that symptoms can return.

“It’s a treatment, not a cure,” Pandya says. “You might say, ‘OK, I’m going to try taking it out and seeing how I do.’ The prolapse might stay in place for a day, but it’s going to come back down.”

Surgery is another option. During a procedure, surgeons move the organs into place to eliminate the vaginal bulge. ACOG estimates that 13 percent of women will undergo surgery for pelvic organ prolapse and expects that the number of women with the condition will double by 2050.

“The need for urogynecologists is only going to increase in the future” as the population ages, Giugale says.

But because surgery carries risks, experts say the women who benefit most from it are those whose symptoms significantly disrupt daily life.

“The goal of surgery, at least from my perspective, is to make the patient comfortable,” Ascher-Walsh says. “They’re feeling uncomfortable because they feel that bulge coming out, and so if we make the bulge go away, that usually makes them feel comfortable.”

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Meghan Holohan is an award-winning health journalist. Her work has appeared on Today.com and NBC News and in Salon, Mental Floss and other publications.