What is a prolapsed uterus?
The uterus is usually held in place by a group of muscles and ligaments. Sometimes this support structure fails, releasing the hold it has on the uterus. When this happens, the floor of the uterus bulges out and sags downward, causing the condition called uterine prolapse. Sometimes the uterus can sag all the way out of your vaginal opening, which is called a complete uterine prolapse.
Women who have given birth many times through vaginal delivery are at high risk of having a prolapsed uterus. Some doctors say up to half of all women develop uterine prolapse during the years after childbirth. However, very few of them seek medical treatment for the symptoms of this condition.
Since mild cases of a prolapsed uterus don’t show any symptoms, it is easy for someone not to notice anything wrong. Even so, there are times when the condition presents in a more advanced way, showing a number of signs and symptoms. You may first notice symptoms after standing or sitting for a long time.
Signs and symptoms of a prolapsed uterus
You will not always notice symptoms if you have a prolapsed uterus. For those with a uterus that has collapsed farther into the vaginal canal, noticeable symptoms are more likely. Typical signs of a uterine prolapse are:
- Pressure or heaviness in the vaginal area: You may feel as if something is about to fall from the vagina.
- Discomfort in the vagina, lower abdomen, groin, or lower back: You may experience a pulling or aching sensation that gets worse during sexual intercourse or periods.
- Problems with sexual intercourse: These include pain, urine leakage during sex, or an inability to have an orgasm.
- Leakage of urine: If some urine leaks out when you cough, sneeze, or lift a heavy object, it could be a sign of uterine prolapse.
Causes of a prolapsed uterus
A prolapsed uterus is caused by weakened pelvic floor muscles and tissues that are unable to support the weight of the uterus. These muscles can be weakened by a number of factors including:
Being overweight doubles your risk of developing a prolapsed uterus.
Disorders of the pelvic floor, including uterine prolapse, are more common among women who have had at least one baby through vaginal birth.
Coughing causes the pelvic floor to move downwards and may worsen prolapse symptoms. Some doctors say that smoking can cause a chronic cough, which may apply pressure on the organs that rely on the pelvic floor for support.
When to see the doctor for a prolapsed uterus
Call your doctor right away if you need to push your fingers into your vagina, into your rectum, or to push against the skin near your vagina in order to empty your bladder or have a bowel movement. If a prolapsed uterus has progressed that far, it likely needs medical treatment.
Diagnosing a prolapsed uterus
When you visit the doctor about the condition, they will most likely conduct a pelvic exam. You may be asked to squat to the bowel movement position in order for the doctor to check how far down your uterus has dropped. Your doctor may do a cystoscopy, a procedure that examines your bladder and urethra especially if you feel like you cannot empty your bladder.
Treatments for a prolapsed uterus
One study found that smoking causes chronic respiratory diseases and higher abdominal pressure, a factor that increases the risk of a prolapsed uterus. If you smoke, trying to quit or reduce smoking will help the severity of coughing, which can worsen uterine prolapse.
This is a flexible device that the doctor places in the vagina to hold the uterus in place. If your doctor recommends this treatment, ask them about the side effects before proceeding.
Pelvic floor exercises
Pelvic floor exercises, also called Kegel exercises, can help strengthen the muscles supporting the uterus. This approach tends to be most effective in more mild cases of uterine prolapse.
Doing pelvic floor exercises involves squeezing the muscles you use to prevent yourself from passing urine. Hold the contraction for 5 to 10 seconds, breathing normally, then release. Relax your pelvic floor muscles completely after the contraction. Repeat this routine with 10 contractions, 5 times a day.
Only in advanced cases would your doctor suggest this treatment option. Be prepared to talk about your future plans to retain vaginal function or get pregnant.
Women's Conditions Resources
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Dignity Health: "Prolapsed uterus."
Harvard Health Publishing: "Uterine And Bladder Prolapse."
International Urogynecology Journal: "Risk factors for pelvic organ prolapse and its recurrence: a systematic review."
Johns Hopkins Medicine: "Uterine Prolapse."
Obstetrics and Gynecology: "Effect of Weight Change on Natural History of Pelvic Organ Prolapse."
Obstetrics and Gynecology: "Pelvic Floor Disorders 5-10 Years After Vaginal or Cesarean Childbirth."
Victoria State Government Better Health Channel: "Prolapsed uterus."