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	Pelvic Organ Prolapse: Should I Have Surgery?

Cause

Pelvic organ prolapse is usually caused by damage to the tissues (muscles, ligaments, and connective tissue) that support the pelvic organs. Damage or stretching of these tissues allows the organs to move out of their normal positions, causing them to press against (and sometimes move) the inside walls of the vagina.

Having a baby makes it more likely that you will have pelvic organ prolapse later. Vaginal childbirth has been strongly linked to weakened and stretched support structures in the pelvic area. This loss of support is the biggest cause of pelvic organ prolapse. Having a cesarean section, on the other hand, seems to be less strongly linked to pelvic organ prolapse.¹ (But having a cesarean section may lead to other problems. For more information, see the topic Cesarean Section.)

Another cause of reduced support in the pelvis is lower levels of the hormone estrogen. Estrogen levels are lower during and after menopause. The lower levels of estrogen in the body mean less collagen, a protein that helps the pelvic connective tissues stretch and return to their normal positions.

Pelvic organ prolapse can also occur after surgical removal of the uterus (hysterectomy) for another health problem, such as endometriosis. Removal of the uterus can sometimes leave the other organs in the pelvic area with less support.

Other conditions that may cause pelvic organ prolapse include:

• Obesity, which can lead to long-term pressure within the abdomen.
• Smoking and/or lung disorders, which are often causes of chronic coughing.
• Conditions affecting the spinal cord, such as muscular dystrophy, multiple sclerosis, and spinal cord injury, that cause paralysis of the muscles of the pelvic floor.