How We Talk About Pelvic Organ Prolapse Matters

The diagnosis of Pelvic Organ Prolapse (POP) can be validating for some and devastating for others. In my experience, no two responses are the same. For some patients, it’s a huge relief to finally have someone acknowledge their symptoms and offer a plan. For others—especially those without symptoms or with strong pre-existing beliefs about POP, it can be really confronting.

That’s why, as pelvic floor physios, we need to take a considered and compassionate approach right from the first appointment. It starts with listening. Truly listening. Understanding what the patient is feeling, what they think is causing it, and what they believe might help. Then we can begin to gently explore what a diagnosis (or potential diagnosis) might mean to them.

It’s normal for us to feel a bit uncomfortable disclosing something like prolapse—especially if we know it might worry the patient. But if we hold back information, we’re not empowering them to make informed choices. It’s not our job to decide what they can or can’t handle. It is our job to deliver the information in a clear, compassionate, and supportive way.

Once we’ve listened and gained their trust, we can ask if they’d be open to hearing a different perspective. This can be a turning point—using education to gently shift unhelpful beliefs. I find it’s really useful to start with clear, simple explanations of anatomy. Avoiding phrases like “organs falling out” or “muscle ripped from the bone” is crucial. I like to use comparisons with more familiar body changes—for example, “Just like our breasts change position over time, our pelvic organs can too.”

It’s important to help the patient stop focusing so much on where things sit, and start focusing on how they feel and what they can do to support their body. Most people are surprised to learn that prolapse severity doesn’t always match how it feels. Some people with a higher-grade prolapse feel fine, while others with a very mild one feel very symptomatic. This can be influenced by how the brain processes symptoms, especially in people with other chronic pain conditions.

That’s why it’s powerful to shift the conversation to what can change—even if the prolapse itself doesn’t. For many, pelvic floor muscle training is a game changer. It not only supports the organs better but also helps with things like bladder and bowel symptoms or painful sex. And when those things improve, so does confidence, body image, and overall wellbeing.

I also like to explain support options like pessaries in a very down-to-earth way. Just like we might use a bra for comfort or support, a pessary can do something similar internally—giving the tissues a lift and helping people feel more comfortable day to day.

When we take this kind of patient-centred, practical approach, we give people the tools to understand and support their own bodies. We’re not just treating a condition—we’re helping reshape someone’s whole experience of it.

And in my view, that’s what great pelvic health physio is all about.