POP has serious and extensive impact on the daily life of women in Nepal.17,23 Women with POP often report atypical symptoms, like lower abdominal pain and lower back pain and more specific signs, like bulging something in/out the vagina and feelings of heaviness or dullness in the pelvic area.4,25 Affected women report difficulties in walking, sitting, doing manual work and also problems with urination and bowel problems. Sexual discomfort is frequently mentioned which may lead to separation from spouse.5

The impact of POP on the quality of life of women has been captured by questions in nine different domains:

  1. general health perception due to POP in daily life (physical symptoms and back pain);
  2. impact of POP in quality of life due to physical discomfort (vaginal, urinary, bowel, and sexual symptoms);
  3. effect on daily household roles (outdoor and physical work);
  4. impact on physical activities (walking, sitting, sleeping, and standing);
  5. impact on emotional status (feeling of loneliness, sadness, and self-blame);
  6. impact on sleep energy (bad dreams and tiredness);
  7. impact on social activities (social work, meeting friends, and family life);
  8. impact on personal life (spousal relationship and effects in sexual relationship);
  9. severe measures due to POP (need to use pad or other protective material, pulling up uterus manually).5

In addition the impact is higher for more severely affected women. Women with severe POP had lowest quality of life and their health problems affect marital relationship, occupation, monthly income and healthcare-seeking practices.22

Given the early onset of POP and POP related problems in women in rural areas, ageing of women, discrimination of women and insufficient health care system, the prevalence and burden due to POP will remain high, unless long term interventions addressing all key elements have been initiated.