What is the best nonsurgical therapy for pelvic organ prolapse?

One flaw of this study was that the women received hormone replacement therapy, which the investigators didn’t evaluate independently. However, a 2010 Cochrane review (2 small trials, one meta-analysis) found insufficient data to determine whether hormone replacement therapy alters POP.⁵

RECOMMENDATIONS

The American College of Obstetricians and Gynecologists Practice Bulletin on POP recommends the following:⁶

• Pessaries can be fitted in most women with prolapse, regardless of prolapse stage (equivalent to grade) or site of predominant prolapse.
• Pessary use should be considered before surgical intervention in women with symptomatic prolapse.
• Women with prolapse who are asymptomatic or mildly symptomatic can be observed at regular intervals, unless new bothersome symptoms develop.