Pelvic Organ Prolapse: What It Is, Why It Happens, and How a Pessary Can Help
Pelvic organ prolapse (POP) can feel overwhelming, confusing, and even isolating. But at Tonic & Phasic Holistic Pelvic Health, we want to start by saying this: you’re not alone, and there are effective, empowering solutions. One of the most underutilized tools in the prolapse care toolkit is the pessary—and this blog will help you understand what prolapse is, why it happens, and how a pessary might help support your healing.
Whether you’re just hearing the word “prolapse” for the first time, or you’ve been living with symptoms like pelvic pressure, heaviness, or urinary issues, we’re here to offer clarity and compassionate care. Schedule an appointment with Dr. Allea Francis, PT, DPT, and let’s navigate this together.
What Is Pelvic Organ Prolapse?
Pelvic organ prolapse occurs when one or more pelvic organs—such as the bladder, uterus, or rectum—descend or bulge into the vaginal or rectal wall. This usually happens when the supporting structures (muscles, fascia, and ligaments) weaken due to various factors, including pregnancy, childbirth, chronic straining, heavy lifting, or hormonal changes.
Common symptoms of prolapse include:
A feeling of heaviness or pressure in the pelvis
Visible or felt bulging at the vaginal opening
Difficulty inserting or retaining tampons
Urinary incontinence or urgency
Constipation or difficulty with bowel movements
Pain during or after intercourse
Symptoms worsening as the day goes on
Why Does Prolapse Happen?
To visualize prolapse, imagine standing in a room where the floor represents your pelvic floor muscles and the walls are your pelvic bones. Suspended from the ceiling is a heavy ball—representing a pelvic organ—held in place by ligaments and fascia (like thick rubber bands). Over time, due to pressure or weakened support, those bands stretch, and the organ begins to descend (just like an overstretched hair-tie).
While some movement of pelvic organs is normal, when descent reaches the lower vaginal area (around 1–2 cm from the vaginal opening), that’s when symptoms often begin. As this is one of the most sensitive parts of our body. Hence, heightened sensation equals more symptoms.
In response, the pelvic floor often over-activates, trying to support the organs. This compensatory response may lead to:
Muscle fatigue
Pelvic pain or aching
Difficulty relaxing the pelvic floor
Why Is Prolapse Different for Everyone?
Pelvic organ prolapse isn’t a one-size-fits-all condition. There are typically three contributing categories:
Fascial defects (overstretched connective tissue)
Ligamentous laxity (weakened ligaments)
Muscular imbalances (weak or overactive pelvic floor muscles)
At Tonic & Phasic, we take a whole-body, individualized approach. During your assessment, Dr. Allea Francis, PT, DPT, will evaluate posture, breathing, core engagement, pelvic muscle tone, hormonal factors, stress levels, and bowel/bladder habits. Based on this assessment, your care plan may include:
Pelvic floor retraining
Manual therapy
Breathwork and nervous system regulation
Hormonal support (e.g., estrogen creams)
Bowel and bladder optimization
And when appropriate—a pessary fitting
What Is a Pessary—and Why Might It Help?
A pessary is a small, removable device inserted into the vagina to support prolapsed organs. Think of it like an ankle brace for your pelvic floor: it gives your body the stability it needs while allowing time for healing and rehab to occur.
Back to our “ ball in a room” analogy—imagine placing a shelf beneath the suspended ball, taking the load off the rubber bands and floor. A pessary gives your muscles and connective tissues a break and can make movement and daily life far more comfortable.
Benefits of a pessary may include:
Decreased pelvic pressure and bulging
Improved support during walking, lifting, and exercise
Reduced urinary leakage
Increased confidence during intimacy
Prevention of symptom progression
An enhanced ability to perform pelvic floor exercises effectively
What You Should Know About Pessaries
At Tonic & Phasic, we provide customized pessary fittings based on your anatomy, symptoms, and lifestyle. Here’s what we often share with patients:
Pessaries can be worn short-term or long-term
They come in different shapes and sizes
A well-fitted pessary should not hurt
They are non-invasive, removable, and empower you to stay active
Many people say, “I don’t even feel it!”
Have questions? You’re not alone. Some common concerns include:
“Isn’t that just for older women?” – No, prolapse can occur at any age.
“Will it fall out?” – Not when fitted properly.
“Can I still have sex?” – Yes! Some pessaries are compatible with intercourse.
“Do I have to wear it forever?” – Not at all. Many use pessaries as part of a transitional rehab phase.
We understand that choosing to try a pessary can feel vulnerable—that’s why our approach prioritizes comfort, privacy, and informed choice. Dr. Allea Francis, PT, DPT, has completed advanced pessary training through Tarryn Hallam’s Advanced Women’s Health Training Associates, ensuring a high level of care and precision with fittings.
Schedule your personalized pessary fitting assessment today and explore if this supportive tool is right for you.
Final Thoughts: Empowerment Through Education & Support
Pelvic organ prolapse doesn’t have to limit your life. With the right tools, care, and understanding, healing is absolutely possible. A pessary is one of many empowering, non-surgical options to help you reclaim comfort, strength, and confidence.
Whether you're looking to explore treatment options, confirm a diagnosis, or get a pessary fitting, we invite you to schedule with Dr. Allea Francis, PT, DPT at Tonic & Phasic Holistic Pelvic Health. We’re here to support you, every step of the way.
You deserve to feel strong, supported, and at home in your body.
