For 10 years, Rashan Williams lived with a feeling she could not explain, but she knew something inside her body was changing.
The 42-year-old deli manager from St. Petersburg, Florida, first noticed it while lifting heavy boxes at work. As she bent over, she felt something “shift.” It wasn’t painful, but it was unsettling. Eventually, the sensation became impossible to ignore.
When she went to the bathroom, Williams would feel a bulge and realize something was protruding where it shouldn’t be.
“I would wipe. I would feel a bulge, like something was hanging out [of my vagina],” Williams told the New York Post in an exclusive interview.
Over the years, the bulge dropped lower, and Williams learned how to physically maneuver it herself.
“I could maneuver it,” she said. “I can push it out. I can flip it to the side. It was just crazy.”
But despite describing her symptoms to multiple doctors, Williams repeatedly left appointments without answers.
“I kept getting the door shut in my face, because everybody was telling me they didn’t see anything. Nothing was wrong,” she said.
The problem was eventually identified as pelvic organ prolapse, a condition that occurs when the muscles and connective tissues supporting the pelvic organs weaken, allowing organs such as the bladder, uterus, or rectum to shift downward into the vaginal canal.
For Williams, the diagnosis finally put a name to what she had been experiencing for years, a condition that can affect millions of women but is still frequently misunderstood, overlooked, or difficult to detect during a routine medical exam.
Pelvic organ prolapse is part of a broader group of issues known as pelvic floor dysfunction, which occurs when the muscles responsible for supporting the pelvic organs and controlling bladder and bowel function are not working properly. The condition becomes more common with age, but pregnancy, childbirth, changes in body weight and other factors can contribute.
One reason it can go undiagnosed is that symptoms may not always appear during a typical office examination. A woman may feel pressure, a bulge or changes in bladder and bowel habits while standing, lifting or moving, only for the problem to be less obvious when she is lying down on an exam table.
For Williams, the question was never whether something was wrong. She had felt it for years.
“I know something’s down there. Like, I’m not tripping,” she said. “I’m feeling something bulging out of my body.”
How Common Pelvic Organ Prolapse Actually Is
The numbers suggest this is one of the most under-discussed conditions in women’s health. Pelvic organ prolapse affects millions of women worldwide, characterized by the descent of pelvic organs, including the bladder, uterus, rectum, or vaginal apex, into or beyond the vaginal canal due to weakening of the supporting muscles, fascia, and ligaments.
Pelvic organ prolapse affects 1 in 3 women in their 60s, according to the American College of Obstetricians and Gynecologists. But the condition is not confined to older women. Up to 50% of women will develop pelvic organ prolapse over their lifetime. According to Yale Medicine, one in four women over the age of 18 reports suffering from a pelvic floor disorder, including pelvic organ prolapse. Yet a 2025 government review from the National Institutes of Health found that national surveys show approximately 3% of women report symptoms of vaginal bulging, while physical examination reveals that 41 to 50% of women have some degree of prolapse on clinical assessment. That gap between the women who have it and the women who report it is not accidental.
Only 18 to 50% of women experiencing prolapse seek medical attention, largely due to a lack of knowledge, misunderstandings about the condition, and obstacles to accessing healthcare. When they do reach a doctor, the reception is often inadequate. Many women reported that healthcare providers were dismissive or not appreciative of the impact of their condition.
Why Doctors Miss It, and Why Women Stay Silent
The diagnostic gap has two sides. One is the patient who doesn’t come forward. The other is the clinician who doesn’t look.
Yale Medicine notes that despite the high prevalence of pelvic floor disorders, many women never talk to a doctor about the problem. Some are embarrassed, while others believe their symptoms are simply a normal part of aging. A survey from Orlando Health highlighted how common misconceptions about pelvic floor disorders remain. Many women mistakenly believe symptoms such as bladder leakage are an unavoidable part of aging, while others are unaware that pelvic organ prolapse can occur outside the traditional risk factors they associate with the condition. Experts say recognizing symptoms early can help women seek evaluation and treatment sooner.
On the clinical side, research published in 2025 via the National Institutes of Health found that primary care providers offer limited screening, particularly for pelvic organ prolapse, and may not be familiar with current diagnostic or treatment pathways. Urogynecologists at the Icahn School of Medicine at Mount Sinai have noted that patients sometimes arrive in the emergency room believing they have discovered a tumor, when in fact they are experiencing a prolapse their regular gynecologist had observed but never named or explained.
Current antenatal education, postpartum care, and primary care screening for pelvic floor dysfunction were identified by women as deficient, and many highlighted delays in accessing specialist care. That delay has real consequences. For some women, getting answers can take nearly a decade, leaving them frustrated and at times depressed.
What Prolapse Feels Like from the Inside
The clinical descriptions of prolapse don’t always match what the experience feels like to live with. Pelvic organ prolapse is the herniation of the pelvic organs to or beyond the vaginal walls, and most women with it experience symptoms that impact their quality of life, including sexual function and daily activities.
According to the NHS, symptoms include a feeling of heaviness, discomfort, or pressure in the lower abdomen, as well as seeing or feeling a bulge in or around the vaginal area. The pushing-down sensation and the feeling that something is inside you are most noticeable when walking, standing, or going to the toilet, and they often improve when lying down. That positional difference is exactly why a woman may arrive at an appointment describing debilitating symptoms, lie down on the exam table, and leave with a “normal” finding.
Sometimes the organs slip down so far that the vagina bulges outward or part of the uterus visibly comes out of the vaginal opening. Yale Medicine confirms that some women describe pushing the bulge back to help with urination or bowel movements. For these women, this manual maneuver has become a routine, private part of their daily lives. Mild cases of pelvic organ prolapse often don’t cause any symptoms at all, which is part of why the condition exists on such a wide and confusing spectrum.
Bladder prolapse, known medically as cystocele, is the most common type, occurring when the bladder pushes down and against the vaginal wall. But the bladder, uterus, rectum, and vaginal apex can all be involved, and because the connective tissue supports several organs, they frequently descend together.
What Actually Causes the Pelvic Floor to Fail
The pelvic floor is a group of muscles and connective tissue that functions like a hammock, holding the pelvic organs in position. Several well-documented factors weaken it over time.
Vaginal childbirth remains the single largest risk. Pelvic organ prolapse particularly affects those with a history of vaginal childbirth, pelvic surgery, pelvic floor trauma, or connective tissue weakening. According to UpToDate, prolapse occurs in up to 50% of women who have given birth vaginally. The 2025 National Institutes of Health government review found that the risk climbs further with high parity (multiple births), large infant birthweight, forceps-assisted delivery, and prolonged labor, all of which create more mechanical stress on the pelvic floor during delivery.
Menopause adds another layer. Prolapse predominantly affects multiparous and postmenopausal women and can significantly impair quality of life through pelvic pressure, urinary dysfunction, and sexual discomfort. Decreasing estrogen levels during and after menopause, according to Hinge Health, may contribute to weakening connective tissue, making the pelvic floor less able to maintain support over time.
Body weight matters too. Research cited by Hinge Health shows that overweight and obese women are more likely to develop pelvic organ prolapse compared to those with a normal BMI. Some women remain asymptomatic, while others experience pelvic pressure, a sensation of vaginal bulging, urinary or fecal incontinence, and sexual dysfunction. Obesity contributes by adding chronic downward pressure on the pelvic floor.
The same mechanism explains why a 2025 StatPearls review found that chronic increases in intra-abdominal pressure, due to persistent coughing, constipation, or heavy lifting, accelerate prolapse development. A chronic cough from smoking, years of straining with constipation, or a job requiring repeated heavy lifting can all progressively damage pelvic support structures even in women who have never given birth.
How Prolapse Is Diagnosed and Graded
When a woman does reach a specialist, the evaluation follows a standardized process. Diagnosis relies on clinical history, pelvic examination, and standardized staging using either the Baden-Walker grading system or the Pelvic Organ Prolapse Quantification (POP-Q) system. The POP-Q system, according to Liv Hospital’s urology department, is the standardized medical examination used to measure and grade prolapse severity with precise anatomical measurements rather than subjective clinical impression.
The examination must be performed with the patient straining or standing, not simply lying flat, because gravity is a key component of how prolapse presents. A woman who has been told her exam was normal after a standard gynecological check in the supine position has often simply not been examined in the correct position for prolapse detection. Asking specifically for a prolapse assessment, with straining and ideally in a standing position, is one of the most effective things an affected woman can do at her next appointment.
Treatment Options That Actually Work
The good news is that pelvic organ prolapse is genuinely treatable. The choice of treatment depends on symptom severity, the specific compartments involved, and what the patient wants from her care.
For mild to moderate cases, pelvic floor muscle training is first-line. While some women remain asymptomatic, others experience notable symptoms including pelvic pressure, vaginal bulging, urinary or fecal incontinence, and sexual dysfunction, all of which can improve meaningfully with targeted exercise. A 2022 systematic review published in PLOS ONE found that pelvic floor muscle training demonstrated improvements in symptoms associated with prolapse, in pelvic floor function, and in quality of life in women who undertook it consistently. According to a 2025 government health review, these exercises can improve symptoms in mild and moderate cases and sometimes also prevent organs from slipping further. Ideally, a pelvic floor physiotherapist should supervise the program, since many women perform the exercises incorrectly without guidance.
For women whose symptoms are not resolving with exercise alone, a vaginal pessary is a practical, non-surgical option. According to WebMD, vaginal pessaries are soft, removable devices that help relieve the pressure and discomfort caused by pelvic organ prolapse. They come in multiple shapes and sizes, are fitted by a gynecologist or urogynecologist, and can be worn daily, providing mechanical support to the prolapsed organs without surgery. In clinical follow-up, approximately 96.7% of women with a successful pessary fitting were satisfied and reported significant improvement in symptoms after about six months.
Surgery is available for women with severe prolapse or those whose symptoms have not responded to conservative management. Minimally invasive procedures are available, including surgical repair using stitches and a mesh sling to support the pelvic organs. Pelvic organ prolapse is not a life-threatening condition. If symptoms do not affect quality of life, monitoring the prolapse over time is a reasonable option. The condition may stay the same, or it could worsen over time.
Smoking cessation is also relevant. Stopping smoking is recommended as it doubles the risk of developing a pelvic floor disorder. Managing constipation by increasing dietary fiber reduces the chronic straining that worsens prolapse, and maintaining a healthy weight decreases the downward pressure on pelvic support structures.
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For Rashan, The Answer Came After 10 Years
For Williams, the biggest change was not just the surgery — it was finally having an explanation for what she had been feeling for a decade.
After meeting with Dr. Nyarai Chinyani Mushonga, a urogynecologist at Orlando Health Bayfront Hospital, Williams learned that the bulge, pressure and constant trips to the bathroom were symptoms of pelvic organ prolapse, not something she had imagined or misunderstood.
“I have pure relief that there was an option to fix the situation,” Williams said.
Mushonga treated Williams’ prolapse with a hysterectomy and reconstructive repair, restoring support to the pelvic organs and relieving the pressure that had been affecting her daily life. Williams said her recovery was straightforward and that she was walking again about a week after surgery.
The experience also highlights an important message for women experiencing similar symptoms: pelvic organ prolapse is common, diagnosable and treatable.
Women who notice a vaginal bulge, pelvic pressure, difficulty emptying their bladder or bowel, or the need to manually push tissue back into place should bring those symptoms directly to a healthcare provider. If prolapse is suspected, an evaluation by a urogynecologist, a specialist who focuses on pelvic floor conditions, may provide answers that a routine examination misses.
Early-stage prolapse may have few symptoms, and the condition can sometimes be harder to identify during an exam performed while a patient is lying down. Because symptoms may become more noticeable with standing, lifting or straining, describing exactly when and how they occur can help guide the evaluation.
Treatment depends on the severity of the prolapse and the individual patient. Some women benefit from pelvic floor physical therapy or supportive devices called pessaries, while others may need surgical repair.
For Williams, the turning point came when someone finally listened.
After years of being told nothing was wrong, she now has a diagnosis, a treatment plan and something she had been searching for all along: confirmation that what she felt was real.
Disclaimer: This information is not intended to be a substitute for professional medical advice, diagnosis, or treatment and is for information only. Always seek the advice of your physician or another qualified health provider with any questions about your medical condition and/or current medication. Do not disregard professional medical advice or delay seeking advice or treatment because of something you have read here.
AI Disclaimer: This article was created with the assistance of AI tools and reviewed by a human editor.
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