Which statement about pelvic organ prolapse risk factors is true?

Which statement about pelvic organ prolapse risk factors is true?

• A. Vaginal childbirth.
• B. Cesarean delivery with labor is equally risky.
• C. Early menopause with estrogen therapy.
• D. Regular strenuous exercise without childbirth.

Answer: (A)

Vaginal childbirth is the strongest risk factor for pelvic organ prolapse because the act of delivery can stretch and injure the pelvic floor muscles and the connective tissue that support the bladder, uterus, and rectum. When these support structures are weakened, pelvic organs are more likely to descend into the vaginal canal or beyond. Deliveries by cesarean section before labor generally spare the pelvic floor from that trauma, so the overall risk is lower than with vaginal birth. Even if labor occurs, cesarean delivery does not carry the same level of risk as vaginal birth without surgical delivery, so it isn’t equally risky. Estrogen therapy does not increase prolapse risk; in fact, estrogen helps maintain vaginal tissues, and prolapse risk tends to rise with age and loss of tissue support rather than with estrogen use. Regular strenuous exercise without childbirth is not a proven major risk factor for prolapse; the strongest, most consistent association is with vaginal childbirth. So the statement that vaginal childbirth increases prolapse risk is the true one.

Vaginal childbirth is the strongest risk factor for pelvic organ prolapse because the act of delivery can stretch and injure the pelvic floor muscles and the connective tissue that support the bladder, uterus, and rectum. When these support structures are weakened, pelvic organs are more likely to descend into the vaginal canal or beyond.

Deliveries by cesarean section before labor generally spare the pelvic floor from that trauma, so the overall risk is lower than with vaginal birth. Even if labor occurs, cesarean delivery does not carry the same level of risk as vaginal birth without surgical delivery, so it isn’t equally risky.

Estrogen therapy does not increase prolapse risk; in fact, estrogen helps maintain vaginal tissues, and prolapse risk tends to rise with age and loss of tissue support rather than with estrogen use.

Regular strenuous exercise without childbirth is not a proven major risk factor for prolapse; the strongest, most consistent association is with vaginal childbirth.

So the statement that vaginal childbirth increases prolapse risk is the true one.