Prolapse and hypermobility - sometimes your connective tissue plays a big role!
If you live with hypermobility and have wondered why prolapse symptoms show up earlier or feel harder to manage, you’re not imagining it. Let’s break down why this happens and what can help.
What is pelvic organ prolapse and why does it happen?
Pelvic organ prolapse (POP) occurs when the muscles and connective tissues supporting the pelvic organs weaken, allowing the bladder, uterus, or rectum to descend into the vaginal canal. Common risk factors include childbirth and aging—but there’s another piece of the puzzle: connective tissue disorders.
How does hypermobility increase prolapse risk?
Connective tissue disorders like Ehlers-Danlos Syndrome (EDS) or Marfan Syndrome affect the strength and elasticity of collagen, a key structural protein. In people with hypermobile EDS (hEDS), connective tissue is more elastic and fragile than normal.
This means ligaments, fascia, and muscles that usually hold pelvic organs in place may not provide adequate support. As a result, prolapse can develop earlier in those with hypermobility – even in people who haven’t had children or other typical risk factors.
What hypermobility & prolapse symptoms should you look out for?
Prolapse symptoms can include:
+ A heavy or dragging sensation in the pelvis
+ A visible bulge at the vaginal opening
+ Urinary or bowel issues
+ Discomfort during intercourse
For those with hypermobility, these symptoms may fluctuate more and be harder to manage because of underlying tissue laxity.
How is hypermobility prolapse managed?
Management often requires a multidisciplinary approach. Pelvic floor physiotherapy is key—it strengthens muscles that compensate for weak ligaments and helps manage risks like constipation (a major factor in worsening prolapse).
Other options include:
Pessaries: Silicone devices worn in the vagina to support organs. These can be fitted by a pelvic floor physiotherapist and may be more suitable than surgery for those with fragile tissues.
Lifestyle strategies: Managing bowel health, avoiding heavy lifting, and tailored exercise programs.
Surgery is sometimes considered, but outcomes can be less predictable in people with connective tissue disorders.
Why early intervention matters?
If you have a connective tissue disorder and suspect prolapse, speak with a knowledgeable healthcare provider. Early intervention and a tailored plan can significantly improve comfort and quality of life.
References:
Other Blogs in the Hypermobility Series
Deep dive into education written by our pelvic physiotherapist, Courtney, all about hypermobility – including symptoms across a range of pelvic health areas, treatment options for hypermobile patients & emerging research in the hypermobility space.
Do you want to learn more about pelvic health, specialised to your symptoms?
