A prolapse is a weakening in the web of muscles at the base of the pelvis. These muscles, called the pelvic floor muscles, hold the organs of the pelvis in place. If these muscles are weakened in one area, the organ they support will shift position and begin to press against the vagina. This is called a prolapse. The organs that can be affected include the bladder, urethra, uterus, vagina, small bowel and rectum.

Weaknesses in the pelvic floor muscles are most often caused by strain during a vaginal birth. This is more likely if the baby was very large, or if the labour was long and difficult.

Pelvic prolapse can also result from a hysterectomy (an operation to remove the uterus). After the uterus is removed, other organs, such as the bladder, may drop.

Although it is possible for a younger woman to have a prolapse, a woman is most likely to experience a prolapse after menopause. Lower levels of the hormone estrogen can make the ligaments and muscles of the pelvis weaker and less elastic, which makes prolapse more common in post-menopausal women.

The muscles of the pelvic floor may also be damaged by:

• obesity
• chronic coughing
• chronic constipation

A prolapse can cause pain during intercourse and can also affect the functioning of the organ involved. For example, if the bladder is prolapsed, it can cause urinary incontinence or difficulty emptying your bladder and/or bowel. It may also increase your risk of urinary tract infections. Women with any kind of prolapse often report a feeling of heaviness in the pelvis or a sensation that they are sitting on something. In severe cases, the prolapse may push tissue out through the vaginal opening.