patient listening intently to her provider discuss prolapsed uterus treatments

What is a prolapsed uterus?

A prolapsed uterus, or uterine prolapse, is a type of pelvic organ prolapse that happens when the uterus slips out of its usual position and presses into the vagina (like a hernia). This can happen when the muscles and tissues that support your pelvic organs become stretched or weakened. It’s more common after menopause or in women who’ve had more than one vaginal birth, but it can happen to anyone.

Your pelvic floor is a group of muscles, ligaments and tissues that help support your uterus, bladder, rectum and other organs. When these supports lose strength, they can’t hold everything in place the way they used to. That’s when organs like the uterus can shift or drop down.

Talking about pelvic health isn’t always easy, but you’re not alone—and you don’t have to live with uncomfortable symptoms. Your trusted healthcare provider will discuss your symptoms in a caring, compassionate way and find a treatment plan that works for you.

Uterine prolapse stages

A mild prolapsed uterus can cause few or no symptoms. But in more serious cases, your uterus might protrude outside your vagina. Doctors often classify a prolapsed uterus using different stages:

  • Stage 1: Your uterus has moved out of position but is above the vaginal opening
  • Stage 2: Your uterus is slightly above or around the level of your vaginal opening
  • Stage 3: Part of your uterus protrudes slightly out of your vagina (and thus your cervix)
  • Stage 4: A more severe prolapse where the uterus is outside of the vagina

Prolapsed uterus symptoms

Mild uterine prolapse is common after childbirth and often doesn't cause noticeable symptoms. But when the prolapse is moderate to severe, symptoms often develop gradually and can range from mild discomfort to more bothersome changes.

You may notice symptoms more after standing for long periods, lifting something heavy or during physical activity. Resting or lying down often helps relieve the pressure.

Common symptoms include:

  • Bulge in your vagina
  • Pelvic discomfort, pressure or feeling of fullness
  • Difficulty inserting a tampon
  • Difficulty having a bowel movement
  • Feeling of not completely emptying your bladder
  • Urination problems, including leaking (urinary incontinence), the need to go frequently (urinary frequency) or the sudden urge to go (urinary urgency)
  • Lower back pain
  • Bleeding caused by tissue rubbing on your underwear or a pad
  • Pain during sex (dyspareunia)
  • Urinary tract infections (UTI)

What causes a prolapsed uterus?

Your pelvic floor is made up of muscles, ligaments and tissue that form a supportive hammock under your uterus, vagina, bladder, bowel and other pelvic organs. This holds your pelvic organs in place so they can work correctly. However, your pelvic floor can become weakened or damaged, causing these organs to move out of place.

Your uterus is a hollow, muscular organ that is located between your bladder and your rectum. But if your pelvic floor is weakened, your uterus can fall into your vagina.

Prolapsed uterus risk factors

A prolapsed uterus is common in the United States, especially among older women and those who have given birth. In fact, research suggests that 40-50% of women will experience some type of pelvic organ prolapse in their lifetime.

Several factors can increase your risk, including:

  • Aging: As you get older, your pelvic floor can weaken, making prolapse more likely.
  • Menopause: Lower estrogen levels after menopause can weaken the tissues that support your pelvic organs.
  • Vaginal childbirth: The risk is higher if you’ve had multiple vaginal births, especially if they were long or difficult.
  • Being overweight or obese: Excess weight puts additional strain on your pelvic floor.
  • Chronic coughing: Persistent coughing from conditions like asthma or smoking can strain your pelvic muscles.
  • Constipation: Straining to empty your bowels can put pressure on your pelvic floor.
  • Heavy lifting: Repeatedly lifting heavy objects—especially without proper technique—can cause strain or injury.
  • Family history: Genetics may play a role, especially if pelvic organ prolapse runs in your family.
  • Connective tissue disorders: Any condition that weakens your connective tissues and ligaments, such as Marfan or Ehlers-Danlos syndromes, can weaken ligaments and tissues that support the uterus.
  • Pelvic surgery: Past surgeries in the pelvic area can impact how well your organs are supported.

If you have one or more of these risk factors, it doesn’t mean you’ll experience a prolapse—but being aware can help you take steps to protect your pelvic health.

How is uterine prolapse diagnosed?

Diagnosing a prolapsed uterus begins with a discussion of your symptoms and a physical exam. Based on your health history and what your doctor observes, they may suggest additional tests to get a more detailed view of what’s happening. These steps help confirm if your uterus has prolapsed and ensure that your treatment plan is tailored to your specific needs.

  • Medical history and exam

    The first step is a detailed discussion with your doctor about your health and symptoms. You’ll be asked questions like:

    • When did your symptoms start?
    • Have you had any pregnancies or vaginal births?
    • Do you have urinary or bowel problems?
    • Have you noticed any changes in sexual function or pelvic discomfort?
    • Do symptoms get worse after certain activities, like standing for a long time or exercising?

    Next, your provider will do a pelvic exam and talk you through the process to help you feel as comfortable as possible. This is usually done while you lie on an exam table, and it involves gently checking the position of your uterus, vaginal walls and other pelvic organs. You may be asked to bear down or cough during the exam, which can help reveal the extent of any prolapse.

    In some cases, the exam might be done with you standing, especially if your symptoms are more noticeable when you're upright.

  • Urodynamic tests

    If you’re having trouble controlling your bladder—such as leaking urine, frequent urges to go or trouble starting to pee—your doctor may recommend urodynamic testing.

    These tests assess how well your bladder, urethra and pelvic muscles are working together. They can show whether the prolapse is interfering with bladder function and help rule out other causes of urinary symptoms.

    Common urodynamic tests include:

    • function tests: These tests measure how much pressure your bladder can hold and how it responds during filling and emptying.
    • Urine flow tests: These track how quickly and completely you’re able to empty your bladder.
    • Post-void residual measurement: This shows how much urine is left in your bladder after you go to the bathroom.
  • Imaging tests

    If more detail is needed to confirm your diagnosis or plan for surgery, an imaging test can help your provider understand how the prolapse is affecting not just your uterus, but nearby organs like the bladder and rectum.

    MR defecography, also known as pelvic floor MRI, is a noninvasive imaging test that uses magnets and radio waves to produce high-resolution images of the pelvic floor. This technique allows your doctor to assess both the structure and function of the pelvic floor muscles and organs, such as the rectum and anus, during a bowel movement. It’s especially useful when symptoms don’t align with findings from a physical exam or when more than one organ may be involved.

Prolapsed uterus treatment

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If you’ve been diagnosed with a prolapsed uterus, you’re not alone—and you have options. The right treatment depends on how severe your symptoms are, your overall health, and your personal preferences. Some women find relief through simple lifestyle changes, while others may benefit from physical therapy, support devices or surgery.

Your doctor will walk you through your options and help you find a treatment plan that fits your life and goals.

Lifestyle changes

For mild prolapse or early symptoms, small changes in your daily habits can help ease discomfort and keep symptoms from getting worse. These may include:

  • Maintaining a healthy weight to reduce pressure on your pelvic floor
  • Avoiding heavy lifting or learning proper lifting techniques
  • Treating constipation with fiber, fluids and regular bathroom habits
  • Managing chronic coughing by addressing smoking, allergies or asthma
  • Doing Kegel exercises at home to gently strengthen your pelvic muscles

Pelvic floor physical therapy

Pelvic floor therapy is a specialized form of physical therapy that focuses on strengthening the muscles and tissues that support your uterus and other pelvic organs.

A trained pelvic floor therapist will:

  • Teach you how to properly do Kegel exercises
  • Guide you through stretches and movements to improve pelvic alignment and strength
  • Help with posture and breathing techniques that reduce strain on your pelvic floor
  • Offer strategies to manage symptoms during everyday activities

Vaginal pessaries

A vaginal pessary is a soft, removable device that’s placed in your vagina to support your uterus and hold it in place. It can be a great nonsurgical option for women who want to avoid or delay surgery, or who aren’t candidates for it.

Your doctor will fit you with the right type and size of pessary, and teach you how to insert, remove and clean it. This fitting is done at your doctor’s office. Some women wear a pessary all the time, while others use it only during certain activities, like exercise.

Pessaries work best when symptoms are moderate and the vaginal tissues are healthy. Regular follow-ups with your doctor are important to ensure the pessary continues to fit well and function properly.

Surgery

If your symptoms are severe or other treatments haven’t helped, surgery may be recommended to repair the prolapse and restore your quality of life. There are a few different surgical options, depending on your health, age, and whether you want to preserve your uterus.

  • Ligament suspension surgery: This surgery restores support by repositioning the uterus or vaginal vault (if the uterus has already been removed) and securing it to strong ligaments in your pelvis. It helps keep your pelvic organs in their proper position and is often done at the same time as a hysterectomy, or in place of one if you want to preserve your uterus.
  • Colpocleisis is a vaginal closure procedure often recommended for older women who no longer want to have vaginal intercourse. The vaginal canal is partially or fully closed to support the pelvic organs and prevent prolapse. It’s a less invasive surgery and can be very effective at relieving symptoms.

A hysterectomy, a procedure that involves removing the uterus, is rarely performed on its own for a prolapsed uterus. However, a hysterectomy combined with another procedure, such as a ligament suspension surgery or sacrocolpopexy, may be a surgical option. 

Find specialized care for a prolapsed uterus

We offer a variety of locations across North and Central Texas to provide you with the care and treatment you need for a prolapsed uterus. Whether you're seeking a diagnosis, need assistance on how to manage symptoms or are considering surgical options, we’re here to help you at a location close to home.

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Baylor Scott & White OB/GYN Clinic - Waco

Baylor Scott & White OB/GYN Clinic - Waco

120 Hillcrest Medical Blvd Office Building 2, Ste 201-2, Waco, TX, 76712
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  • Friday: 8:00 am - 5:00 pm

Frequently asked questions

  • What does a prolapsed uterus feel like?

    A prolapsed uterus can feel different for everyone. You might feel pain, pressure or discomfort in your pelvic area and lower back. Some women report feeling a sensation like sitting on a ball.

  • Can you get pregnant with a prolapsed uterus?

    You can still get pregnant if you have a prolapsed uterus. Talk to your OBGYN if you are worried about a prolapse while you are pregnant.

  • Can a prolapsed uterus cause bleeding?

    You might experience bleeding from exposed skin rubbing on your underwear or pads. Tell your doctor about any bleeding in your pelvic area when you do not have your period.

  • Can a prolapsed uterus make you look pregnant?

    A prolapsed uterus doesn’t usually make your belly appear pregnant. It can cause a bulge in your vagina that may feel like a small ball or pressure in the area. Some women also experience bloating or abdominal discomfort, which might make their stomach look or feel fuller at times—but the prolapse itself doesn't cause a pregnant-looking belly.

  • How common is uterine prolapse?

    Uterine prolapse is fairly common, especially as women get older. Around 50% of women will experience some form of pelvic organ prolapse, including uterine prolapse, by the time they reach their 50s and beyond. However, not all women will notice symptoms—only about 10 to 20% of women with prolapse experience symptoms that are bothersome or require treatment. Many women may not have any noticeable symptoms at all.

  • Can you have a prolapse without a uterus?

    Yes, you can still have a prolapse even after a hysterectomy (removal of the uterus). After the uterus is removed, the top part of the vagina and other pelvic organs can still shift or drop if the supporting tissues become weak. This is called "vaginal vault prolapse" or "post-hysterectomy prolapse."

  • Does a prolapsed uterus hurt?

    A prolapsed uterus may or may not cause pain. Some women feel pressure, fullness or heaviness in the pelvis, while others have no discomfort. If pain occurs, it’s often in the lower abdomen, pelvic area, back or during sex. The intensity depends on the severity of the prolapse.

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