Rectal Prolapse Symptoms Women Over 50 Should Never Ignore, Plus How To Treat It

As women age, we often hear references about our memories (or even bustlines) slipping. But no one talks about another health issue: our pelvic floor slipping out of place. About 50 percent of women will suffer some level of pelvic organ prolapse (POP) in their lifetime, mostly occurring in our post-menopausal years, finds the University of Chicago-Medicine. And rectal prolapse is one of the most common. 

While these conditions are often not dangerous in the long term, they definitely disrupt our quality of life, causing discomfort, frustration and stress. So let’s talk about this once-taboo topic. Keep reading for comforting advice to help with rectal prolapse.

What is rectal prolapse?

You’ve likely heard of a uterine prolapse, where the uterine falls from its optimal position. But women can suffer different types of pelvic organ prolapse. A common type is called rectal prolapse.

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A rectal prolapse is when the lowest part of the intestine loses its normal support and starts to bulge, descend or even protrude through the anus. “Rectal prolapse is much more common than most people think,” says Alexandra Dubinskaya, MD, a urogynecologist and intimate health expert.

Rectal prolapse symptoms 

In cases of a rectal prolapse, Dr. Dubinskaya says, “many women describe a feeling of ‘something falling out’ or a heaviness sensation in the rectal area.” They can also have lower back pain, due to pinched nerves. And when the connective tissues and muscles get stretched and damaged, it can lead to mucus leakage or even bathroom accidents.

Kim Vopni, a personal trainer who specializes in helping women retrain their pelvic floor, says other symptoms can arise when things shift out of place down there. For example, a related, but different condition called a rectocele is when the rectum bulges into the vaginal wall. This can lead to difficulty emptying the bowels completely. “If the rectum starts to shift out of its position and bulge into the back wall of the vagina, it can create a little bit of a pocket where stool gets trapped.” So it’s always good to notice if pelvic changes have occurred. 

“Don’t suffer in silence. These conversations are not embarrassing—they’re empowering.” —Alexandra Dubinskaya, MD

What causes rectal prolapse? 

Age, genetics and childbirth—especially vaginal deliveries—play a role. Vopni confirms, “If anybody has given birth before, they have an increased risk of pelvic organ prolapse.” But there are other risk factors, including: 

Chronic constipation

A history of straining on the toilet can contribute to the weakening of the pelvic floor. Vopni, known on Instagram as The Vagina Coach, suffered her own rectal prolapse that required surgery. She says, “In working with women, chronic constipation is often one of the reasons why they develop pelvic floor problems in the first place.”

Too many kegels

Another thing Vopni sees: “Overdoing kegel exercises.” She explains that pelvic floor muscles can become overactive and hold tension in daily life when we need them to be able to relax so we can have a proper elimination on the toilet.

Poor posture

Many of us sit slouched or hunched during the day. But when we’re not sitting tall, our lungs can’t fully expand to breathe. And the diagram and pelvic floor work in concert with one another to stay toned.

Hormone changes at midlife

Shifts during menopause can also contribute to constipation and pelvic floor weakening. Ask your doctor about the healthy ratio between estrogen and progesterone.

How rectal prolapse is diagnosed

If you suspect you have rectal prolapse, consult a doctor for an exam. “Some doctors will use dynamic MRI, a specialized imaging test that allows us to see how all the pelvic organs move during straining,” says Dr. Dubinskaya. She explains, “This is important because many women with rectal prolapse also have other types of pelvic organ prolapse, such as bladder or vaginal wall descent.” She adds, “It’s quite common for these conditions to coexist, since the pelvic floor works as one connected system.”

How to manage rectal prolapse at home 

If symptoms are mild, try the following expert-approved tips to feel more comfortable while living with rectal prolapse.

Eat a diet that promotes soft bowel movements

Stay hydrated and choose fiber-rich foods like fruits, veggies and whole grains, says Dr. Dubinskaya. Aim for 25 to 30 grams of fiber daily.

Use a footstool in the bathroom

The doctor explains, “This simple but very effective tool positions the pelvis in a way that makes elimination easier and reduces downward pressure on the pelvic floor.” Look for something that elevates the feer 7 to 9 inches off the ground. One brand to try: Squatty Potty.

Try pelvic floor physical therapy

One of the standard treatments for pelvic organ prolapse of almost any kind is targeted physical therapy. “I recommend any vagina owner see a pelvic floor physical therapist once a year,” says Vopni.

Practice ‘reverse’ kegels

“Sometimes women pursue a pelvic floor exercise program and focus on the contraction. But they should really be focusing on the relaxation,” says Vopni. So throughout the day, tune in to your pelvic floor muscles and relax them whenever you notice they are holding tension.

Consider the ‘splinting’ strategy at bathroom time

Some women have success fully emptying their bowels by using this method during bowel movements. To do: Use a finger to externally apply pressure to the perineum (the skin between the vaginal opening and the anus), says Vopni. This can keep things on track and prevent tissue from bulging.

Try the ‘moo to poo’ breathing method

To avoid straining on the toilet, experts recommend relaxing the jaw (so as not to tense the body) and exhaling while making the sound “moo.” Research suggests that this type of relaxed humming can calm the nervous system and the pelvic floor muscles. It’s part of a practice called “bowel retraining.”

What to do if your prolapse is more serious

If your organ is protruding outside your body, “surgery may be needed to restore normal anatomy,” says Dr. Dubinskaya. About 12 percent of women in the US will have surgery to repair a pelvic floor problem.

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Some repairs can be done with minimally-invasive approaches such as laparoscopic surgery to reposition and help support the rectum. “What’s crucial is that treatment is individualized,” says Dr. Dubinskaya.

For more involved cases, the doctor says, “I often collaborate closely with colorectal surgeons so that we can address all aspects of pelvic floor prolapse—bladder, vagina/uterus and rectum—in one comprehensive surgery.”

The bottom line on rectal prolapse

“Don’t suffer in silence. These conversations are not embarrassing. They’re empowering. Talking about pelvic health is the first step toward healing,” says Dr. Dubinskaya. And remember: “The right evaluation and care can restore both comfort and confidence. Even making small daily adjustments to your routine can make a big difference over time.”