Quick Answer
Hypopressives can meaningfully improve pelvic organ prolapse symptoms. In my experience teaching Hypopressives, many clients see significant, sometimes life-changing, improvement, and for some the change in day-to-day symptoms is dramatic. A small study of women with grade 1-2 prolapse found real improvements in pelvic floor strength and symptom scores after a supervised programme. How much changes depends on your prolapse grade and presentation, so if your prolapse feels significant, or your symptoms are getting worse rather than settling, see a pelvic health physiotherapist for an assessment before starting any exercise programme.
Pelvic organ prolapse occurs when one or more of the organs (uterus, bladder, or rectum) in the pelvis slip down from their normal position & bulge into the vagina.
Pelvic organ prolapse is common, common enough that many women who experience it are surprised to learn how many others have too, even though it isn’t often talked about openly.
What causes pelvic organ prolapse?
With the extra weight of your baby and hormone changes your pelvic floor is weakened during pregnancy, and then again after giving birth. This weakening or loosening of the muscles and tissues supporting your pelvic organs allows one or more of the pelvic organs to drop or press into or out of the vagina.
How Hypopressives Can Genuinely Help With Prolapse
A 2021 study followed 20 women aged 35 and over with grade 1-2 pelvic organ prolapse through a six-week, physiotherapist-supervised Hypopressives programme. It found statistically significant improvements in pelvic floor muscle strength (measured on the Modified Oxford Scale and by perineometer) and in a validated symptom questionnaire, the Pelvic Floor Distress Inventory (Parle, Shahmalak & Irkar, 2021, Nepal Journal of Obstetrics and Gynaecology).
This is a small study, 20 women, no stated control group, and it looked specifically at grade 1-2 prolapse. It doesn’t tell us what happens with more advanced prolapse, and it isn’t evidence that the prolapse itself moves back into place. What it suggests is that, for milder prolapse, a properly supervised programme may help the muscles around it work better and may ease some symptoms.
Exercise, including Hypopressives, works by improving how the surrounding muscles function and manage pressure. In my experience teaching for many years, part of this is about the fascial system, the connective tissue running through the pelvis and abdomen, since restriction there can also reduce the support the area gets. Pelvic floor and abdominal strength consistently improve with a regular practice, and this isn’t a quick fix, it takes consistency over time, but it’s a genuine, achievable outcome for many women, not just a hopeful story.
We used to think that the organs of the pelvis simply “fell out” as a result of weakness in the pelvic floor, and that the answer was a great number of Kegel exercises to target those muscles. What we now understand is that the pelvic organs don’t “fall out”, they’re pushed down, by increased intra-abdominal pressure. That’s why we look at the whole pressure system in the core canister, not just pelvic floor strength on its own. Standard “core” or abdominal exercises like crunches and sit ups increase intra-abdominal pressure, effectively pushing the pelvic organs down or out. Hypopressives are designed to work with the pelvic floor and deep core without adding that downward pressure.
Setting Realistic Expectations
Prolapse is a structural change, and how much it improves varies from person to person. In my experience, many clients see meaningful, sometimes dramatic, improvement in their symptoms and in how their prolapse feels day to day with consistent practice, and for some this is genuinely transformative. Exercise, including Hypopressives, works primarily by improving how the surrounding muscles function and manage pressure, which is a different mechanism from what surgery does. Whatever combination of exercise, a pessary or surgery makes sense for you is worth discussing with a pelvic health physiotherapist, so you can make that decision with a clear, accurate picture of your own situation. If you want to look more broadly at exercise options, see our guide to effective exercises for prolapsed uterus relief.
Getting started: Relieve Prolapse through hypopressives
For the Hypopressives classes it is important that you learn the Apnea technique properly so that you can get the most out of the classes and the time you invest in yourself. Each week I run Fundamentals sessions on Zoom where I explain the technique and guide you through all the steps. I will also give you feedback to make sure that you’re doing it correctly. For some, the technique may come more quickly than others. Some of my clients, who are tighter in the ribs and thoracic spine, do tend to take a little longer.
And here’s the golden rule: for impactful change, I recommend at least three 15 to 20-minute workouts per week. Consistency is your best friend on this journey towards wellness.
