Common, but not normal
At the end of the day, after standing for a long time or lifting, you feel a heaviness deep in your vagina. Sometimes it feels as though “something is coming down”, or you can feel a small “bulge” when washing. Many women are frightened by it — and many more keep quiet out of embarrassment.
What you describe may be a pelvic organ prolapse: the bladder, uterus or rectum drops slightly from its usual position and presses on the vaginal wall. It is common after vaginal births and in menopause. Common, but not something to ignore: in many cases, especially milder ones, there is a lot you can do to ease symptoms and help stop them getting worse.
What may be at the root
- Pelvic floor support. The muscles and ligaments that hold the organs may have been stretched or weakened by pregnancy and birth.
- Pressure management. Holding your breath when you strain, coughing a lot or lifting without coordinating your breathing pushes the organs downwards.
- Constipation and straining. One of the most frequent causes of repeated overload.
- Hormonal changes. In menopause, tissues lose elasticity and firmness.
- Posture and visceral mobility. The position of your pelvis and ribcage and tension in your abdomen influence how pressure reaches the pelvic floor.
How we can help
In the first session we listen to your symptoms and your daily life, and assess posture, breathing and — with your consent — the pelvic floor, to understand the degree of descent and how the muscles respond.
Pelvic physiotherapy is often the recommended first step for mild to moderate prolapse: guided muscle training, learning to manage pressure on effort, and adapting exercise and everyday tasks. Visceral osteopathy can complement this by working on the mobility of the abdomen and pelvis. In some cases your gynaecologist may suggest a pessary or surgery; our work complements those options.
What you can do now
- Breathe out on effort. When lifting or standing up, let the air out slowly rather than holding it.
- Avoid straining on the toilet. A small footstool, knees higher than hips, helps the bowel empty with less pressure.
- Lie down for a while when you feel more heaviness at the end of the day — it usually helps.
If this sounds like you, get in touch. We will look at your situation together, calmly.