The uterus and the bladder are held in their normal positions just above the inside end of the vagina by a "hammock" made up of supportive muscles and ligaments. Wear and tear on these supportive structures in the pelvis can allow the bottom of the uterus, the rear of the bladder or both to sag through the muscle and ligament layers. When this happens, the uterus or bladder can create a bulge into the vagina. In severe cases, it is possible for the sagging uterus or bladder to work its way down far enough that the bulge can appear at the vagina's opening or even protrude from the opening. When the uterus sags downward, it is called uterine prolapse. When the bladder sags, it is called bladder prolapse, also known as a cystocele.

Various stresses can cause the pelvic muscles and ligaments to weaken and lead to uterine or bladder prolapse. The most significant stress on these muscles and ligaments is childbirth. Women who have had multiple pregnancies and vaginal delivery are more likely to develop prolapse. Obesity also can strain the pelvic muscles. Support problems in the pelvis become worse after menopause because the pelvic tissues depend on oestrogen to help them keep their tone, and oestrogen levels drop after menopause.

Some doctors estimate that half of all women have some degree of uterine or bladder prolapse in the years following childbirth. For most women, these conditions remain undiagnosed and untreated. Only 10% to 20% of women with pelvic prolapse seek medical evaluation for symptoms.
This can be corrected both surgically and non-surgically.

For mild cases, exercises known as Kegel exercises are a great way to increase your pelvic support. To perform Kegel exercises, you need to squeeze the pelvic floor muscles that you would use if you were trying to stop urinating when your bladder was only partly empty. Most doctors advise women with pelvic muscle weakness to tighten these muscles and hold them tight for a few seconds at a time. Repeat the exercise ten times in each session and do approximately four sessions each day. Over time, most women notice improvement in bladder control and may have less pain or fewer symptoms.

Other non-surgical treatment of these conditions involves placing an object (pessary) into the vagina to support surrounding structures. The gynaecologist fits a rubbery, ring-shaped device called a pessary into the upper portion of your vagina. Pessaries can help to prop up the uterus and bladder and prevent them from sagging into the vagina. They are removable so they can be washed periodically.

A prolapsed bladder or uterus may need to be corrected with surgery, which can be done through the vagina or the abdomen. The procedure that is chosen depends on the woman's age, severity of the symptoms, medical history, desire for future fertility and desire to be able to have sex. The goals are to restore normal anatomy, relieve symptoms, restore normal bowel and bladder function, and restore the ability to have sex. In some severe cases, surgical removal of the uterus (hysterectomy) is recommended.