Right now, you may be trying to piece together advice from Google, social media and forums often finding completely conflicting information. This handbook brings the evidence together in one place, in clear, calm language, so you can understand your options and know where to start.
Feel informed, not frightened. The Prolapse Handbook is a 55-page, evidence-based guide to understanding pelvic organ prolapse and what you can do about it. Written by specialist pelvic health physiotherapist Ali Cansell, it covers symptoms, pelvic floor exercises, exercise and lifting, pessaries, bladder and bowel habits, surgery and more, all in clear, calm language. Instant PDF download, with access to future updates.
It's 11pm. You've just been told you have a prolapse, or you suspect you might and you're doing what almost every woman in this position does: scrolling, searching, trying to work out how serious this is. The problem isn't a shortage of information, it's quitethe opposite. Everyone seems to say something different, and none of it agrees. One site tells you to stop exercising altogether. Another says kegels don't work. A forum thread convinces you your life has to shrink from here.
So many women arrive at my clinic already believing:
- Their days of running, Pilates, or exercise are over
- They shouldn't lift their children or grandchildren
- Sex will never feel normal again
- They've somehow caused the prolapse by not doing enough pelvic floor exercises after birth
- Surgery is inevitable, whatever they do
- Their body has somehow "let them down"
None of these are things you should simply accept as your new normal. So much of this simply isn't true and much of it is based on fear rather than what we actually know about prolapse. Many have already seen a GP and been told it's "just normal after having children," with no real plan beyond that which is exactly why it all feels so frightening and unknown.
This handbook is what I'd want you to read instead. It's the same evidence base I use every day in clinic, written in plain, calm language so that by the time you finish it, you understand exactly what's happening in your body, you know what actually helps.
Hi, I'm Ali Cansell, founder of The Pelvic Physio Farnham. I've been a physiotherapist for almost 20 years, and pelvic health is the whole of my clinical practice, not one interest among several.
A lot of people know me for pregnancy and postnatal care, and that's genuinely a big part of what I do but it's far from all of it. I see women with prolapse, bladder and bowel symptoms, pelvic pain, and menopause-related changes just as often, at every age and stage, not only in the years around having children.
I wrote this because I've sat with so many women who walked into the clinic, scared women who'd stopped doing the things they loved because they thought they had to, often after reading so much conflicting, frightening information online that they no longer knew what to believe.
Some had already bought a prolapse guide or exercise programme from an overseas seller with no specialist pelvic health training; some of it was fine, some was outdated, and none of it reflected UK guidance. I wanted to put something out there that's evidence-based and accurate, without any scaremongering, something that helps women see that life hasn't stopped, and that there's real help available long before surgery even needs to be on the table.
Surgery can absolutely be the right choice for some women, and this handbook doesn't shy away from that either but it's very rarely the only option, and it's almost never the first one.
Prolapse is one of the most researched areas of pelvic health, and the guidance on how to manage it well is genuinely clear. This handbook doesn't offer opinion, trends, or anecdote, it's built directly on the same evidence I'm required to work from as a clinician, including:
NICE guidance (NG210: Pelvic floor dysfunction - prevention and non-surgical management; NG123: Urinary incontinence and pelvic organ prolapse in women)
The POPPY trial (Hagen et al., 2014, The Lancet) - the UK randomised controlled trial establishing pelvic floor muscle training as an effective, evidence-based treatment
Cochrane systematic reviews of conservative management for prolapse
POGP (Pelvic, Obstetric and Gynaecological Physiotherapy) clinical guidance, including current best-practice guidance on vaginal pessaries
any UK clinician- ICS/IUGA terminology and grading standards, so the language matches exactly what you'll hear from
Every claim in this handbook is sourced, current at the time of writing, and reviewed as guidance updates. Where the evidence is strong, it says so plainly. Where evidence is more limited, for example, around certain adjuncts or products, it says that too, rather than overstating what's actually known. A full reference list is included at the back of the book.
This isn't based on opinion, trends or anecdote. It's based on the same evidence and clinical guidance that informs my work with patients every day.
Good pelvic health care shouldn't only be available to people who can book, and afford, a full 1:1 assessment straight away. This handbook exists to make that starting point accessible, priced well below a 1:1 session, so you can begin in the right direction immediately, with real, specialist-level guidance, rather than waiting or guessing. The aim is to give you a clear starting point, rather than leaving you with months of Googling, guessing and worrying.
55 pages, covering everything I'd normally talk you through in a full assessment except the internal exam itself:
What pelvic organ prolapse actually is, the different types, and how common it really is so you understand what you're dealing with, not just what you're afraid of
Why it happens and why it's very rarely down to one single thing you did
What your "grade" or "stage" actually means, and why it matters far less than you've probably been told
A whole-person approach to feeling better: breathing, your nervous system, your core, not just pelvic floor exercises in isolation
A full, NICE-guided conservative care pathway, pelvic floor exercises, bladder and bowel habits, vaginal oestrogen and moisturisers, biofeedback, support garments, pessaries, and a calm, honest look at surgery
Everyday guidance on lifting, weights, exercise, and picking up your children or grandchildren, with confidence instead of fear
What actually happens at a pelvic health assessment, step by step, so it never has to feel like an unknown again
A symptom and exercise tracker, a glossary, and a full list of the evidence behind every page
Format & Delivery:
Instant PDF download, 55 pages
Designed to read comfortably on your phone
Yours to keep and refer back to including free access to future updated editions
This handbook won't replace an individual assessment as nothing can fully replace the internal examination, or a programme built specifically around your own findings, and it never claims to.
What it will do is take away the fear of not knowing, and give you a genuine, evidence-based head start before you ever sit down with a physiotherapist.
It's written for any woman who has been told she has a prolapse, thinks she might have one, or simply wants to understand her pelvic floor properly, whatever your age or stage of life, whether you're newly postnatal, well past it, or navigating perimenopause or menopause, and whether or not you're already one of my patients.
