Pelvic organ prolapse and physical activity: directions for future research

The global prevalence of pelvic organ prolapse (PoP) varies widely, but it is estimated that up to 40% of women will experience some degree of PoP in their lifetime. The likelihood of developing PoP increases with age, multiparity, obesity, chronic cough and certain occupational or lifestyle factors.1 Women with PoP often report a fear of engaging in physical activity (PA), driven by concerns that it may exacerbate symptoms or accelerate prolapse progression.2 Surveys indicate that nearly one in three women with PoP cite their symptoms as a barrier to exercise, leading to reduced participation in both structured and recreational PA.2 3 Despite these concerns, the impact of PA on PoP remains unclear due to inconsistencies in research findings. Some studies suggest that high-impact activities may worsen symptoms, while others report no association or potential benefits of moderate exercise.4 5 The lack of definitive guidance leads many women to limit their PA unnecessarily, increasing the risk of sedentary behaviour and associated comorbidities such as cardiovascular disease and osteoporosis.4 5 Furthermore, surgical interventions such as mesh implants have introduced additional complications, with many women experiencing chronic pain that further reduces PA participation.6 The aim of this discussion is to highlight the key gaps that remain from previous research that limit understanding of the relationship between PA and PoP, and to recommend future research directions that are required to enable women to make informed decisions on …