Physical Therapy’s Role In Treating Pelvic Organ Prolapse

June is pelvic organ prolapse awareness month. 

Here are a few facts about pelvic organ prolapse (POP): 

• Two in five postmenopausal women will experience a degree of POP. 

• In the United States, the prevalence of POP among community-based women is 2.9 to 5.7%, and this number is expected to increase by 46% by the year 2050. 

• 11%  of Dutch women, 8.3% of Swedish women, and 8.8% of Australian women in a 2015 study reported feeling or seeing a vaginal bulge. 

• In lower-income countries, such as Ethiopia, Nepal, and India, the prevalence of POP ranged from 3.4% to 56.4% with an average of 19.7%.

It is clear that Pelvic organ prolapse (POP) is a global women’s health problem that impacts women of varying demographics. POP can affect a woman’s occupational, mental, and social well-being, causing significant emotional stress and even depression.

And most women don’t even know what POP is or that it can happen to them. 

In a 2014 study, a group of English and Spanish-speaking women interviewed by a group of researchers stated that they lacked the basic knowledge of the anatomy and prevalence of POP. 

This lack of knowledge led to feelings of embarrassment, shame, and self-blame. In addition, the Spanish speakers in the group noted concerns about not being able to adequately form the words that would express their health needs related to prolapse. 

The group as a whole indicated that they were surprised at how common POP was and felt relieved that they were not alone. They were of the opinion that having more information on POP would help them be better able to discuss their conditions with their families, friends, and healthcare providers, and would also help decrease their fears.

Access to accurate and culturally important information is an important step in improving the health of women worldwide. At GWHI we believe that both health professionals and communities should have access to education and resources on women’s health issues. 

Women should be empowered with information about the prevalence of their conditions, signs, and symptoms of the conditions, options available to manage their conditions, including physical therapy, and how to access those resources.

Physical therapy, specifically training of the pelvic floor, is an effective treatment of pelvic organ prolapse according to a systematic review by Dumoulin et al.  They found training the pelvic floor muscles improves strength, endurance, and coordination of the pelvic floor muscles.  This in turn improves the structural support and coordination of the pelvic floor during periods of increased intra-abdominal pressure. 

Another systematic review, The efficacy of pelvic floor muscle training for pelvic organ prolapse: a systematic review and meta-analysis, looked at 13 different studies of women receiving pelvic floor manual therapy.  Based on their analysis, women who received pelvic floor therapy showed a greater subjective improvement in prolapse symptoms and an objective improvement in POP severity. 

Research is still scarce on the long-term effects of pelvic floor muscle training on symptom reduction of pelvic organ prolapse compared to surgical outcomes without conservative interventions.  

But there certainly is supportive research out there that with an individualized approach to care, physical therapists can have a tremendous impact on symptom reduction of women living with POP. 

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