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Sarah Mitchell — Reviewed writer, former magazine editor

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How to Master Bladder Control and Manage Pelvic Health

Mastering bladder control is essential for maintaining a high quality of life and confidence. For many, especially women after pregnancy or during menopause, the pelvic floor muscles can weaken, potentially leading to a prolapsed bladder (cystocele) where the bladder drops from its normal position. By focusing on targeted exercises, lifestyle adjustments, and professional medical guidance, you can strengthen your support system and regain control over your bladder health.

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Part 1

Recognizing the Symptoms of a Prolapsed Bladder

1

Feel for a bulge of tissue in your vagina.

In serious cases, you may be able to feel your bladder descend into your vagina, says Board Certified Urologist and Women’s Health Expert Dr. Anika Ackerman. Dr. Anika Ackerman Board Certified Urologist and Women’s Health Expert Expert Interview When you sit down, it may feel like you are sitting on a ball or an egg; this feeling may disappear when you stand up or lie down. This is the most obvious symptom of a cystocele, and you should see your primary care physician or gynecologist as soon as possible.

In serious cases, you may be able to feel your bladder descend into your vagina, says Board Certified Urologist and Women’s Health Expert Dr.
Anika Ackerman.
Anika Ackerman Board Certified Urologist and Women’s Health Expert Expert Interview When you sit down, it may feel like you are sitting on a ball or an egg; this feeling may disappear when you stand up or lie down.
This is the most obvious symptom of a cystocele, and you should see your primary care physician or gynecologist as soon as possible.
In serious cases, you may be able to feel your bladder descend into your vagina, says Board Certified Urologist and Women’s Health Expert Dr.

2

Note any pelvic pain or discomfort.

If you have any pain, pressure, or discomfort in your lower abdomen, pelvic area, or vagina, you should see a doctor. Any number of conditions, including a prolapsed bladder, could cause those symptoms.

If you have any pain, pressure, or discomfort in your lower abdomen, pelvic area, or vagina, you should see a doctor.
Any number of conditions, including a prolapsed bladder, could cause those symptoms.
If you have any pain, pressure, or discomfort in your lower abdomen, pelvic area, or vagina, you should see a doctor.
Any number of conditions, including a prolapsed bladder, could cause those symptoms.
If you have any pain, pressure, or discomfort in your lower abdomen, pelvic area, or vagina, you should see a doctor.

3

Consider any urinary symptoms.

If you tend to leak urine when you cough, sneeze, laugh, or exert yourself, you have what’s known as “stress incontinence.” Women who have given birth are particularly susceptible, and a prolapsed bladder can be a major cause, confirms Dr. Ackerman. Dr. Anika Ackerman Board Certified Urologist and Women’s Health Expert Expert Interview See your doctor to resolve the issue.

If you tend to leak urine when you cough, sneeze, laugh, or exert yourself, you have what’s known as “stress incontinence.” Women who have given birth are particularly susceptible, and a prolapsed bladder can be a major cause, confirms Dr.
Anika Ackerman Board Certified Urologist and Women’s Health Expert Expert Interview See your doctor to resolve the issue.
If you tend to leak urine when you cough, sneeze, laugh, or exert yourself, you have what’s known as “stress incontinence.” Women who have given birth are particularly susceptible, and a prolapsed bladder can be a major cause, confirms Dr.
Anika Ackerman Board Certified Urologist and Women’s Health Expert Expert Interview See your doctor to resolve the issue.
If you tend to leak urine when you cough, sneeze, laugh, or exert yourself, you have what’s known as “stress incontinence.” Women who have given birth are particularly susceptible, and a prolapsed bladder can be a major cause, confirms Dr.

4

Take pain during sexual intercourse seriously.

Pain during sex is called “dyspareunia” and can be triggered by a number of physical conditions, including a prolapsed bladder. If you are dealing with dyspareunia, you should see your primary care physician or gynecologist as soon as possible.

Pain during sex is called “dyspareunia” and can be triggered by a number of physical conditions, including a prolapsed bladder.
If you are dealing with dyspareunia, you should see your primary care physician or gynecologist as soon as possible.
Pain during sex is called “dyspareunia” and can be triggered by a number of physical conditions, including a prolapsed bladder.
If you are dealing with dyspareunia, you should see your primary care physician or gynecologist as soon as possible.
Pain during sex is called “dyspareunia” and can be triggered by a number of physical conditions, including a prolapsed bladder.

5

Know that some women have no symptoms at all.

If your case is a mild one, you may not notice any the above symptoms. Some cystoceles are first discovered during routine gynecological examinations.

If your case is a mild one, you may not notice any the above symptoms.
Some cystoceles are first discovered during routine gynecological examinations.
If your case is a mild one, you may not notice any the above symptoms.
Some cystoceles are first discovered during routine gynecological examinations.
If your case is a mild one, you may not notice any the above symptoms.

Part 2

Understanding the Causes of a Prolapsed Bladder

1

Know that pregnancy and childbirth is the most common cause of a prolapsed bladder.

During pregnancy and childbirth, your pelvic muscles and supportive tissues are strained and stretched, notes Dr. Ackerman. Dr. Anika Ackerman Board Certified Urologist and Women’s Health Expert Expert Interview Since these are the muscles that hold your bladder in place, serious stress or weakness on them can allow the bladder to slip down into the vagina.

During pregnancy and childbirth, your pelvic muscles and supportive tissues are strained and stretched, notes Dr.
Anika Ackerman Board Certified Urologist and Women’s Health Expert Expert Interview Since these are the muscles that hold your bladder in place, serious stress or weakness on them can allow the bladder to slip down into the vagina.
During pregnancy and childbirth, your pelvic muscles and supportive tissues are strained and stretched, notes Dr.
Anika Ackerman Board Certified Urologist and Women’s Health Expert Expert Interview Since these are the muscles that hold your bladder in place, serious stress or weakness on them can allow the bladder to slip down into the vagina.
During pregnancy and childbirth, your pelvic muscles and supportive tissues are strained and stretched, notes Dr.

2

Recognize the role of menopause.

Postmenopausal women are at significant risk for a prolapsed bladder due to reduced levels of the female sex hormone estrogen. Estrogen is partly responsible for maintaining the strength, tone, and resilience of your vaginal muscles. As a result, the low levels of estrogen accompanying the transition into menopause cause these muscles to become thinner and less elastic, which leads to overall weakening.

Postmenopausal women are at significant risk for a prolapsed bladder due to reduced levels of the female sex hormone estrogen.
Estrogen is partly responsible for maintaining the strength, tone, and resilience of your vaginal muscles.
As a result, the low levels of estrogen accompanying the transition into menopause cause these muscles to become thinner and less elastic, which leads to overall weakening.
Postmenopausal women are at significant risk for a prolapsed bladder due to reduced levels of the female sex hormone estrogen.
Estrogen is partly responsible for maintaining the strength, tone, and resilience of your vaginal muscles.

3

Be aware of muscle strain as a factor.

Intense straining or heavy lifting can sometimes trigger a prolapse. When you strain the muscles of your pelvic floor, you risk triggering a prolapsed bladder (especially if the muscles of your vaginal wall have already been weakened by menopause or childbirth), warns Dr. Ackerman. Dr. Anika Ackerman Board Certified Urologist and Women’s Health Expert Expert Interview Types of straining that can cause a cystocele include:

Intense straining or heavy lifting can sometimes trigger a prolapse.
When you strain the muscles of your pelvic floor, you risk triggering a prolapsed bladder (especially if the muscles of your vaginal wall have already been weakened by menopause or childbirth), warns Dr.
Anika Ackerman Board Certified Urologist and Women’s Health Expert Expert Interview Types of straining that can cause a cystocele include:
Intense straining or heavy lifting can sometimes trigger a prolapse.
When you strain the muscles of your pelvic floor, you risk triggering a prolapsed bladder (especially if the muscles of your vaginal wall have already been weakened by menopause or childbirth), warns Dr.

4

Consider your weight.

If you are overweight or obese, your risk of a prolapsed bladder is increased. The extra weight places additional strain on the muscles of your pelvic floor.

If you are overweight or obese, your risk of a prolapsed bladder is increased.
The extra weight places additional strain on the muscles of your pelvic floor.
If you are overweight or obese, your risk of a prolapsed bladder is increased.
The extra weight places additional strain on the muscles of your pelvic floor.
If you are overweight or obese, your risk of a prolapsed bladder is increased.

Part 3

Diagnosing a Prolapsed Bladder

1

Make an appointment with a physician.

If you think you may have a prolapsed bladder, schedule an appointment with your primary care physician or gynecologist.

If you think you may have a prolapsed bladder, schedule an appointment with your primary care physician or gynecologist.
If you think you may have a prolapsed bladder, schedule an appointment with your primary care physician or gynecologist.
If you think you may have a prolapsed bladder, schedule an appointment with your primary care physician or gynecologist.
If you think you may have a prolapsed bladder, schedule an appointment with your primary care physician or gynecologist.
If you think you may have a prolapsed bladder, schedule an appointment with your primary care physician or gynecologist.

2

Have a pelvic exam.

As a first step, your doctor will probably perform a routine gynecological exam. In this exam, the cystocele is detected by applying a speculum (a tool for inspecting body orifices) against the posterior (back) vaginal wall while you lie back with your knees bent and ankles supported by stirrups. The physician will likely ask you to "bear down" (as if you were pushing during childbirth or having a bowel movement) or cough. If a cystocele is present, the doctor will see or feel a soft mass bulging into the anterior (front) vaginal wall when you strain.

As a first step, your doctor will probably perform a routine gynecological exam.
In this exam, the cystocele is detected by applying a speculum (a tool for inspecting body orifices) against the posterior (back) vaginal wall while you lie back with your knees bent and ankles supported by stirrups.
The physician will likely ask you to "bear down" (as if you were pushing during childbirth or having a bowel movement) or cough.
If a cystocele is present, the doctor will see or feel a soft mass bulging into the anterior (front) vaginal wall when you strain.
As a first step, your doctor will probably perform a routine gynecological exam.

3

Have further testing if you are experiencing bleeding, incontinence, or sexual dysfunction.

Your doctor will likely recommend tests known as cystometrics or urodynamics.

Your doctor will likely recommend tests known as cystometrics or urodynamics.
Your doctor will likely recommend tests known as cystometrics or urodynamics.
Your doctor will likely recommend tests known as cystometrics or urodynamics.
Your doctor will likely recommend tests known as cystometrics or urodynamics.
Your doctor will likely recommend tests known as cystometrics or urodynamics.

4

Talk to your doctor about additional testing.

In some cases, usually when your prolapse is more severe, your doctor may recommend additional tests. Common additional tests include:

In some cases, usually when your prolapse is more severe, your doctor may recommend additional tests.
Common additional tests include:
In some cases, usually when your prolapse is more severe, your doctor may recommend additional tests.
Common additional tests include:
In some cases, usually when your prolapse is more severe, your doctor may recommend additional tests.

5

Get a specific diagnosis.

Once your doctor confirms the presence of a prolapsed bladder, you should ask for a more detailed diagnosis. Cystoceles are divided into categories based on severity. The best course of treatment will depend on what kind of cystocele you have, as well as the symptoms it is causing in your life. Your prolapsed bladder may fall into any of the following “grades”:

Once your doctor confirms the presence of a prolapsed bladder, you should ask for a more detailed diagnosis.
Cystoceles are divided into categories based on severity.
The best course of treatment will depend on what kind of cystocele you have, as well as the symptoms it is causing in your life.
Your prolapsed bladder may fall into any of the following “grades”:
Once your doctor confirms the presence of a prolapsed bladder, you should ask for a more detailed diagnosis.

Part 4

Treating a Prolapsed Bladder

1

See if you need treatment.

A Grade 1 prolapsed bladder usually requires no medical treatment as long as it is not accompanied by pain or discomfort for the sufferer. Check with your physician as to whether she recommends medical treatment or more of a "wait-and-see" approach. If your symptoms do not bother you very much, your doctor is likely to recommend basic treatment approaches including Kegel exercises and physical therapy.

A Grade 1 prolapsed bladder usually requires no medical treatment as long as it is not accompanied by pain or discomfort for the sufferer.
Check with your physician as to whether she recommends medical treatment or more of a "wait-and-see" approach.
If your symptoms do not bother you very much, your doctor is likely to recommend basic treatment approaches including Kegel exercises and physical therapy.
A Grade 1 prolapsed bladder usually requires no medical treatment as long as it is not accompanied by pain or discomfort for the sufferer.
Check with your physician as to whether she recommends medical treatment or more of a "wait-and-see" approach.

2

Practice Kegel exercises.

Kegel exercises are performed by contracting the muscles of your pelvic floor (as if you were attempting to stop the flow of urine), holding them for a brief period, and then releasing them, explains Dr. Ackerman. Dr. Anika Ackerman Board Certified Urologist and Women’s Health Expert Expert Interview Regular performance of these exercises, which require no special equipment and can be performed anywhere (including while waiting in line, at a desk, or relaxing on the couch), can strengthen your muscles. In mild cases, they can keep your prolapsed bladder from descending further. To perform Kegel exercises:

Kegel exercises are performed by contracting the muscles of your pelvic floor (as if you were attempting to stop the flow of urine), holding them for a brief period, and then releasing them, explains Dr.
Anika Ackerman Board Certified Urologist and Women’s Health Expert Expert Interview Regular performance of these exercises, which require no special equipment and can be performed anywhere (including while waiting in line, at a desk, or relaxing on the couch), can strengthen your muscles.
In mild cases, they can keep your prolapsed bladder from descending further.
To perform Kegel exercises:
Kegel exercises are performed by contracting the muscles of your pelvic floor (as if you were attempting to stop the flow of urine), holding them for a brief period, and then releasing them, explains Dr.

3

Use a pessary.

A pessary is a small, silicone device that, when inserted into the vagina, holds the bladder (and other pelvic organs) in place. Some are made for you to insert yourself; others need to be inserted by a doctor. Pessaries come in a variety of shapes and sizes and a healthcare professional can help a woman choose the most comfortable fit, adds Dr. Ackerman. Dr. Anika Ackerman Board Certified Urologist and Women’s Health Expert Expert Interview

A pessary is a small, silicone device that, when inserted into the vagina, holds the bladder (and other pelvic organs) in place.
Some are made for you to insert yourself; others need to be inserted by a doctor.
Pessaries come in a variety of shapes and sizes and a healthcare professional can help a woman choose the most comfortable fit, adds Dr.
Anika Ackerman Board Certified Urologist and Women’s Health Expert Expert Interview
A pessary is a small, silicone device that, when inserted into the vagina, holds the bladder (and other pelvic organs) in place.

4

Try estrogen replacement therapy.

Because a reduced level of estrogen is so frequently responsible for weakened vaginal muscles, your doctor may suggest estrogen therapy. Estrogen can be prescribed as a pill, vaginal cream, or ring inserted into the vagina in an effort to strengthen weak pelvic floor muscles. The cream doesn't absorb very well and thus is strongest on the area where it is applied.

Because a reduced level of estrogen is so frequently responsible for weakened vaginal muscles, your doctor may suggest estrogen therapy.
Estrogen can be prescribed as a pill, vaginal cream, or ring inserted into the vagina in an effort to strengthen weak pelvic floor muscles.
The cream doesn't absorb very well and thus is strongest on the area where it is applied.
Because a reduced level of estrogen is so frequently responsible for weakened vaginal muscles, your doctor may suggest estrogen therapy.
Estrogen can be prescribed as a pill, vaginal cream, or ring inserted into the vagina in an effort to strengthen weak pelvic floor muscles.

5

Undergo surgery.

If other treatments do not work, or if your cystocele is very severe (Grade 3 or 4), your doctor may recommend surgery, advises Dr. Ackerman. Dr. Anika Ackerman Board Certified Urologist and Women’s Health Expert Expert Interview Surgery works better for some women than others. For example, if you have plans for future children, you may wish to postpone the surgery until after your family is complete to avoid prolapse happening again after childbirth. Older women may also have higher risks associated with surgery.

If other treatments do not work, or if your cystocele is very severe (Grade 3 or 4), your doctor may recommend surgery, advises Dr.
Anika Ackerman Board Certified Urologist and Women’s Health Expert Expert Interview Surgery works better for some women than others.
For example, if you have plans for future children, you may wish to postpone the surgery until after your family is complete to avoid prolapse happening again after childbirth.
Older women may also have higher risks associated with surgery.
If other treatments do not work, or if your cystocele is very severe (Grade 3 or 4), your doctor may recommend surgery, advises Dr.

Pro Tips

Keep a bladder diary for one week to identify triggers like caffeine or artificial sweeteners.
Practice 'timed voiding' by going to the bathroom every 3-4 hours even if you don't feel a strong urge.

Community Q&A

Q Can bladder control be fully restored after a prolapse?

A Yes, in many cases, a combination of pelvic floor therapy and lifestyle changes can significantly improve control. For severe cases, surgical intervention is highly effective.

Q How long does it take to see results from Kegels?

A Most people notice an improvement in bladder control within 4 to 12 weeks of consistent daily practice.

How to Master Bladder Control and Manage Pelvic Health

Recognizing the Symptoms of a Prolapsed Bladder