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Pelvic Organ Prolapse in Perimenopausal and Menopausal Women



Pelvic organ prolapse (pop) is a chronic disorder, often asymptomatic. There are several factors involved in the aetio-pathogenesis of POP. Perimenopausal women bear most of the burden of pop. Vaginal delivery is an established risk factor and clinical presentation may take years when women are symptomatic in menopausal age.


A cross-sectional study was done for one year in a rural teaching hospital, where 150 pop women were included. Variables associated with both asymptomatic & symptomatic pop were analyzed. The mean, proportion, & simple logistic regression were used to analyze the data and p value < 0.05 was considered significant.


The prevalence of pop was 4.8%. Associated socio-economic & obstetrical variables were age group of 41–50 years (82.7%), housewives (84%), multiparty (93.33%), lower economic conditions (86.7%), home deliveries (74.71%), and early resumption of work after delivery (61.3%). Bulging in the vagina (p < 0.001), & difficulties in micturition (p = 0.001) were significant symptoms. Among asymptomatic & symptomatic pop, difference in BMI (p = 0.042), education level (p = 0.001), menstrual history (p = 0.001) & place of delivery (p = 0.037) were significant. Different stages of pop were significantly associated with differences in age groups (p < 0.001), menstrual history (p < 0.001) & place of delivery (p = 0.039). Differences in the proportion of constipation were significant with anterior compartment defects (p < 0.001), whereas the association of chronic lung diseases was found significant (p = 0.028) in the case of apical compartment prolapse. Simple logistic regression of co-variants shows age can predict the severity of pop stages (OR 7.25; 95% CI 1.95–26.99).


All stages of pop were present mostly in the age group of 41–50 years rather than in the over 50 years age group. Menopause is associated with the severity of prolapse and is mostly symptomatic. Age can predict the severity of pop.

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  1. Sumathi N, Nandhini CC. Uterovaginal prolapse-a study in South Indian Women. Sch J Appl Med Sci. 2017;5(4F):1698–704.

    Google Scholar 

  2. Miedel A, Tegerstedt G, Maehle-Schmidt M, et al. Non obstetric risk factors for symptomatic pelvic organ prolapse. Obstet Gynecol. 2009;113(5):1089–97.

    Article  Google Scholar 

  3. Quiroz LH, Munoz A, Shippey SH, et al. Vaginal parity and pelvic organ prolapse. J Reprod Med. 2010;55(3–4):93–8.

    PubMed  PubMed Central  Google Scholar 

  4. Shaikh Z, Pathak R. Revised Kuppuswamy and B. G. Prasad socio-economic scales for 2016. Int J Community Med Public Health. 2017;4:997–9.

    Article  Google Scholar 

  5. WHO Expert Consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet. 2004;363(9403):157–63.

    Article  Google Scholar 

  6. Raiser J, Kumari S, Walia I, et al. Self-reported uterine prolapse in a resettlement colony of north India. J Midwifery Women’s Health. 2011;45(4):343–50.

    Article  Google Scholar 

  7. Wu JM, Vaughan CP, Goode PS, et al. Prevalence and trends of symptomatic pelvic floor disorders in U.S. women. Obstet Gynecol. 2014;123(1):141–8.

    Article  Google Scholar 

  8. Barber MD, Maher C. Epidemiology and outcome assessment of pelvic organ prolapse. Int Urogynecol J. 2013;24:1783–90.

    Article  Google Scholar 

  9. Gumanga SK, Munkaila A, Malechi H. Social demographic characteristics of women with pelvic organ prolapse at the Tamale Teaching Hospital. Ghana Ghana Med J. 2014;48(4):208–13.

    CAS  Article  Google Scholar 

  10. Dhama V, Chaudhary R, Singh S, et al. Evaluation of pelvic organ prolapse by standardized pop q system for vaginal hysterectomy. Int J Reprod Contracept Obstet Gynecol. 2017;6:2584–8.

    Article  Google Scholar 

  11. Asresie A, Adamassu E, Setegn T. Determinants of pelvic organ prolapse among gynecologic patients in Bahir Dar, North West Ethiopia: a case-control study. Int J Womens Health. 2016;8:713–9.

    Article  Google Scholar 

  12. Mesenga GG, Shayo BC, Rasch V. Prevalence and risk factors for pelvic organ prolapse in Kilimanjaro, Tanzania: a population based study in Tanzanian rural community. PLoS ONE. 2018;13(4):1–13.

    Google Scholar 

  13. Giri A, Hartmann KE, Hellwege JN, et al. Obesity and pelvic organ prolapse: a systematic review and meta-analysis of observational studies. Am J Obstet Gynecol. 2017;217(1):11–26.

    Article  Google Scholar 

  14. Patil P, Patil A. Evaluation of Pelvic Organ Prolapse in Indian Females. J Evol Med Dent Sci. 2013;2(40):7612–20.

    Article  Google Scholar 

  15. Urbankova I, Grohregin K, Hanacek J, et al. The effect of the first vaginal birth on pelvic floor anatomy and dysfunction. Int Urogynecol J. 2019;30(10):1689–96.

    Article  Google Scholar 

  16. Peker N, Erdem B, Kaban A. Does home birth reduce the risk of pelvic organ prolapse? Ginekol Pol. 2018;89(8):432–6.

    Article  Google Scholar 

  17. Miedel A, Tegerstedt G, Maehle-Schmidt M, et al. Symptoms and pelvic support defects in specific compartments. Obstet Gynecol. 2008;112(4):851–8.

    Article  Google Scholar 

  18. Myers DL, Sung VW, Richter HE, et al. Prolapse symptoms in overweight and obese women before and after weight loss. Female Pelvic Med Reconstr Surg. 2012;18(1):55–9.

    Article  Google Scholar 

  19. Glazener C, Elders A, Macarthur C, et al. Childbirth and prolapse: long-term associations with the symptoms and objective measurement of pelvic organ prolapse. BJOG. 2013;120(2):161–8.

    CAS  Article  Google Scholar 

  20. Burrows LJ, Meyn LA, Walters MD, et al. Pelvic symptoms in women with pelvic organ prolapse. Obstet Gynecol. 2004;104(5):982–8.

    Article  Google Scholar 

  21. Gyhagen M, Bullarbo M, Nielsen TF, et al. Prevalence and risk factors for pelvic organ prolapse 20 years after childbirth: a national cohort study in singleton primiparae after vaginal or caesarean delivery. BJOG. 2013;120(2):152–60.

    CAS  Article  Google Scholar 

  22. Hoffman BL, Schorge JO, Schaffer JI, et al. Williams Gynecology. New York: McGraw-Hill; 2012. p. 633–58.

    Google Scholar 

  23. Swift S, Woodman P, O’Boyle A, et al. Pelvic Organ Support Study (POSST): the distribution, clinical definition, and epidemiologic condition of pelvic organ support defects. Am J Obstet Gynecol. 2005;192(3):795–806.

    Article  Google Scholar 

  24. Akter F, Gartoulla P, Oldroyd J, et al. Prevalence of, and risk factors for, symptomatic pelvic organ prolapse in Rural Bangladesh: a cross-sectional survey study. Int Urogynecol J. 2016;27(11):1753–9.

    Article  Google Scholar 

  25. Ellerkmann RM, Cundiff GW, Melick CF, et al. Correlation of symptoms with location and severity of pelvic organ prolapse. Am J Obstet Gynecol. 2001;185(6):1332–7 (discussion 1337–8).

    CAS  Article  Google Scholar 

  26. Weintraub AY, Glinter H, Marcus-Braun N. Narrative review of the epidemiology, diagnosis and pathophysiology of pelvic organ prolapse. Int Braz J Urol. 2020;46(1):5–14.

    Article  Google Scholar 

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Authors and Affiliations



MD KA &SK-design, data collection, analysis, interpretation of data and drafting of the article. PPS: conception, design, acquisition of data, analysis and revise critically for intellectual content of the article and final approval of the version.

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Correspondence to Partha Pratim Sharma.

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None declared regarding financial, personal, political, intellectual, or religious interests.

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This study on human participants was approved by the institutional ethics committee and has been performed in accordance with the ethical standard as laid down in the Helsinki Declaration. This article does not contain any studies with animals performed by any of the authors.

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Patients written, informed consent for the study was taken before enrollment.

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Md. Kamaluddin Ansari, M.B.B.S, M.S, RMO is an Department of Obstetrics and Gynecology, North Bengal Medical College and Hospital, Sushrutanagar, Darjeeling, West Bengal, India; Partha Pratim Sharma, M.B.B.S, M.D, Associate Professor is an Department of Obstetrics and Gynecology, Midnapore Medical College and Hospital, Paschim Midnapore, West Bengal, 721101, India; Sharmin Khan, M.B.B.S, M.D, Senior Resident, Department of Pharmacology, MidnaporeMedical College and Hospital, Paschim Midnapore, West Bengal, India.

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Ansari, M.K., Sharma, P.P. & Khan, S. Pelvic Organ Prolapse in Perimenopausal and Menopausal Women. J Obstet Gynecol India 72, 250–257 (2022).

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  • Perimenopause
  • Menopause
  • Pelvic organ prolapse
  • Symptomatic and asymptomatic pop