The reasons are multifactorial and likely include: childbirth, hormonal status, body mass index and anything that increases intra-abdominal pressure (e.g. straining with chronic constipation, chronic cough or bronchitis, COPD, frequent vomiting, heavy lifting) and high impact activities (running, bump skiing, trampoline). The continuation of any of these factors after an attempted surgical repair may contribute surgical failure. There is also some evidence that there may be genetic component to pelvic prolapse, and it stands to reason that strength of supportive tissues, like ligaments, may be inheritable.