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Pelvic health 

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NHS England: surgical treatments for pelvic organ prolapse

​Pelvic organ prolapse

Pelvic organ prolapse is when your womb, bladder or bowel bulge into the vagina. Treatments and lifestyle changes can help manage it.

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Symptoms of pelvic organ prolapse

Pelvic organ prolapse is common in women over 50. It can affect anyone with a vagina.

It may not cause symptoms, but if you do have symptoms they can include:

  • a feeling of heaviness, discomfort or pressure in your lower tummy or vagina

  • feeling or seeing a bulge or lump inside (or coming out of) your vagina

  • pain, discomfort or numbness during sex

  • problems pooing, such as constipation

  • problems peeing, such as feeling like your bladder is not emptying fully, needing to go to the toilet more often, or leaking a small amount of pee when you cough, sneeze or exercise

Sometimes pelvic organ prolapse may only be found during tests done for another reason, such as cervical screening.​

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Conditions that can affect your pelvic area and how to do pelvic floor exercises to stop leaks

See a GP if:

  • you have a lump in or around your vagina

  • you have any other symptoms of pelvic organ prolapse

Things you can do to help with pelvic organ prolapse

There are things you can do yourself to help with pelvic organ prolapse.

Do

  • Maintain a healthy weight

  • Eat more fibre, drink plenty of water and do gentle exercise like walking regularly to avoid constipation

  • Avoid physical activities that put a lot of strain on the pelvic floor, like heavy lifting, running and trampolining

  • Do regular pelvic floor exercises

Don't

  • Do not smoke – stopping smoking means you're less likely to have a persistent cough that can put pressure on your pelvic floor

Help and support for pelvic organ prolapse

If you have pelvic organ prolapse, you’ll be supported by your doctor or specialist. You may also find it helpful to get support online.

There are national charities that can offer support and information about pelvic organ prolapse.

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 Bladder and Bowel UK

 Information and support for anyone affected by bladder or bowel problems.

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Pelvic Pain

Pelvic pain is felt in the lower part of your tummy. The type of pain varies, and it may be sudden and severe (acute pelvic pain) or last 6 months or longer (chronic pelvic pain).

 Symptoms of pelvic pain

 Pelvic pain varies. It may affect a small area around your pelvis (your lower tummy), your lower back or the whole area. Types of pelvic pain include:

  • a sharp, stabbing or burning pain that happens suddenly

  • a pain that comes on slowly but does not go away

  • a dull or heavy ache, or feeling of pressure

  • a twisted or knotted feeling

  • a cramping or throbbing pain, which may come and go

  • pain only when you're doing something, like exercising, having sex or peeing

  Pelvic pain in women

  Pelvic pain is more common in women and common causes include:

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See a GP if:

  • you have pelvic pain that comes and goes or does not go away

  • you have bloating that comes and goes or does not go away

  • you're losing weight without trying to

  • you feel full quickly or have no appetite

  • you have constipation or diarrhoea that does not go away

Get help from NHS 111 if:

  • You have pelvic pain and:

  • you find it difficult to pee or poo

  • there's blood in your pee or poo

  • you have unusual discharge, fluid or bleeding from your vagina

  • you have pain when peeing or need to pee more than usual

  • you have a very high temperature (or you feel hot, cold or shivery)

  • you have vomiting and diarrhoea, or you feel sick

  • you are pregnant or may be pregnant

  • You can call 111 or get help from 111 online.

  • If you are 20 weeks pregnant or more, contact your midwife or maternity unit.

Call 999 or go to A&E if:

You have pelvic pain and:

  • it's severe, getting worse, or hurts when you move or touch the area

  • you feel faint, dizzy or lightheaded, or pass out

  • you have pain in the tip of your shoulder

  • you have difficulty breathing

  • you have heavy bleeding from your vagina

  • you suddenly feel confused

Do not drive to A&E. Ask someone to drive you or call 999 and ask for an ambulance.

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Bring any medicines you take with you.

Pelvic inflammatory disease

Pelvic inflammatory disease (PID) is an infection that affects a woman's womb, fallopian tubes and ovaries. It can affect anyone with a womb. If it's diagnosed early, it can be easily treated with antibiotics.

Symptoms of pelvic inflammatory disease (PID)

Not everyone with pelvic inflammatory disease (PID) will have symptoms.

If you do have symptoms, these may include:

  • pain in the area between your tummy and thighs (pelvic pain) or in your lower tummy

  • pain felt deep inside when you have sex

  • heavy or painful periods that are unusual for you

  • bleeding between periods or after sex

  • vaginal discharge that looks, smells or feels unusual for you

Your symptoms may start quickly over a few days or develop slowly and get worse over time.​​​​​​​​​​​​

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Ask for an urgent GP appointment or get help from NHS 111 if:

  • you think you have symptoms of pelvic inflammatory disease (PID)

  • you have pain in the area between your tummy and thighs (pelvic pain) that comes and goes

  • you have symptoms of PID and you're pregnant or think you might be pregnant

  • you've been diagnosed with PID and do not feel better after 3 days of taking antibiotics

  • You can call 111 or get help from 111 online.

Call 999 or go straight to A&E if:

You think you have symptoms of pelvic inflammatory disease (PID) and you:

  • have pain in the area between your tummy and thighs (pelvic pain) that's severe, getting worse, or hurts when you move or touch the area

  • have pelvic pain and heavy bleeding from your vagina

  • have a sharp, sudden and intense pain in your lower tummy

  • have pain under your ribs on the right side and in your right shoulder

  • feel dizzy or faint

  • have a very high temperature, or feel hot, cold or shivery

  • are feeling or being sick, or are feeling very unwell

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   Find your nearest A&E

Urinary incontinence

For many people with urinary incontinence, the following self-help tips and lifestyle changes are enough to relieve symptoms.

Do daily pelvic floor exercises 
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Pelvic floor exercises can be effective at reducing leaks. It's important to do them properly and include short squeezes and long squeezes.

You can feel your pelvic floor muscles if you try to imagine stopping yourself peeing and farting.

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To do pelvic floor exercises:

  1. Squeeze your pelvic floor muscles quickly – try not to pull your tummy in.

  2. Hold the squeeze for 2 seconds.

  3. Relax the muscles.

  4. Repeat 10 times.

Breathe normally and relax while you’re doing pelvic floor exercises. Aim to gradually increase the hold to 10 seconds with each squeeze.

You may have to do pelvic floor exercises for a few months before you see any benefits.

Stop Smoking 

If you smoke, you put yourself at risk of incontinence, because coughing puts strain on your pelvic floor muscles.

Find out more about how to stop smoking.

Do the right exercises

High-impact exercise and sit-ups put pressure on your pelvic floor muscles and can increase leaks.

To strengthen your pelvic floor to relieve symptoms, replace high-impact exercise, such as jogging and aerobics, with strengthening exercise, such as pilates.

Pilates strengthens your core muscles, which is beneficial for stress incontinence.

Avoid lifting

Lifting puts strain on your pelvic floor muscles, so avoid it whenever you can.

When you do need to lift something, such as picking up children or shopping bags, tighten your pelvic floor muscles before and during the lift.

Lose excess weight

Being overweight can weaken your pelvic floor muscles and cause incontinence because of the pressure of fatty tissue on your bladder.

Your symptoms may improve, and could go away completely, if you lose any excess weight.

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Use the healthy weight calculator to check you're a healthy weight for your height.

Find out more about managing your weight.​​

Drink plenty of water

Drink 6 to 8 glasses of fluid a day (but no more) unless your doctor advises you otherwise.

 

Many people with urinary incontinence avoid drinking fluids, as they feel it causes more problems. However, limiting your fluid intake makes incontinence worse, because it reduces your bladder's capacity.

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Not drinking enough fluid can also cause constipation or make it worse.

Find out more about water, drinks and your health.

Eat the right foods

Avoid spicy and acidic foods, such as curries and citrus fruits, as they can irritate the bladder and make leaks and other incontinence symptoms worse.

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Other useful pages 

  • Your GP practice can advise and book an appointment for you to discuss your options.

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