A pessary is a removable device placed in the vagina to support the pelvic organs. Pessaries come in different shapes and sizes and are fitted to you.

Pelvic health

Physical therapy for pelvic organ prolapse

Feeling a bulge, pressure, or heaviness “down there”? It may be pelvic organ prolapse. It’s more common than most women realize, and pelvic floor physical therapy can help.

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A physical therapist working on a patient’s abdomen during a pelvic floor session

What is pelvic organ prolapse?

Pelvic organ prolapse happens when the muscles and tissues that hold up the pelvic organs (the bladder, uterus, or rectum) become weak or loose. One or more of those organs can then drop and press into the vagina.¹

Prolapse can happen even if you’ve never had children or had a C-section.¹

You are not alone

of U.S. women have symptoms of pelvic organ prolapse²: About 3%
U.S. women have prolapse surgery by age 80³: 1 in 8

Signs of prolapse

Common signs include:¹⁴

A bulge, or a feeling that something is coming out of the vagina
Pressure or heaviness that gets worse when you stand or cough, or as the day goes on
Trouble fully emptying your bladder
Leaking urine, or trouble having a bowel movement

What raises the risk

Pregnancy and vaginal childbirth are the main cause.⁴ Other things that put extra pressure on the pelvic floor raise the risk too: being overweight, chronic constipation or straining, heavy lifting, a long-term cough, and getting older.⁵

How physical therapy helps

In a large trial, women with stage I to III prolapse who did one-on-one pelvic floor muscle training had fewer prolapse symptoms than women who only got an advice leaflet.⁶ UK national guidelines suggest at least 16 weeks of supervised pelvic floor muscle training as a first option for women with symptomatic stage 1 or 2 prolapse.⁷

Pelvic floor muscle training

A program built around your body: how to find, strengthen, and coordinate your pelvic floor muscles.

Pressure management

Breathing, lifting, and bracing strategies that take strain off your pelvic floor during daily life.

Bowel habits

Toileting posture and constipation care, so you aren’t straining.

A team approach

With your permission, we collaborate with your healthcare team to aid you in your health and healing journey.

Dr. Jazma explains

Pelvic Organ Prolapse, explained

Short videos from Dr. Jazma’s TikTok, where 175K+ people follow her for straight talk about pelvic health.

Questions we hear

Can prolapse get better without surgery?

For many women, symptoms improve. In a large trial, one-on-one pelvic floor muscle training reduced prolapse symptoms,⁶ and a pessary is another non-surgical option.¹ Your therapist and your doctor can help you decide what fits you.

What is a pessary?

A pessary is a removable device placed in the vagina to support the pelvic organs.¹ Pessaries come in different shapes and sizes and are fitted to you.⁸

Should I see my doctor?

Yes. If you notice a bulge or other signs of prolapse, let your doctor know.⁹ Pelvic floor physical therapy works alongside your medical care.

Sources

Pelvic organ prolapse. Office on Women’s Health (U.S. Department of Health and Human Services). Accessed November 2026. (opens in a new tab)
Prevalence of symptomatic pelvic floor disorders in US women. JAMA (Nygaard et al.), 2008. (opens in a new tab)
Lifetime risk of stress urinary incontinence or pelvic organ prolapse surgery. Obstetrics & Gynecology (Wu et al.), 2014. (opens in a new tab)
Pelvic Support Problems. American College of Obstetricians and Gynecologists. Accessed November 2026. (opens in a new tab)
What causes pelvic floor disorders?. Eunice Kennedy Shriver National Institute of Child Health and Human Development (NIH). Accessed November 2026. (opens in a new tab)
Individualised pelvic floor muscle training in women with pelvic organ prolapse (POPPY): a multicentre randomised controlled trial. The Lancet (Hagen et al.), 2014. (opens in a new tab)
Urinary incontinence and pelvic organ prolapse in women: management (NG123). National Institute for Health and Care Excellence (UK), 2019. (opens in a new tab)
Frequently Asked Questions. American Urogynecologic Society (Voices for PFD). Accessed November 2026. (opens in a new tab)
Uterine prolapse. MedlinePlus (U.S. National Library of Medicine). Accessed November 2026. (opens in a new tab)