One in three women has pelvic prolapse. Many consider it a hidden problem that’s taboo to talk about.

Pelvic prolapse is a pelvic floor disorder that can cause discomfort. There are nearly 300,000 surgeries performed annually in the United States to treat this condition.

In 2016, nearly 10 million women around the country participated in road races, with 30% to 70% experiencing urinary leakage while running, jogging, or performing other exercises. This is an indication of a weakened pelvic floor, which can cause pelvic prolapse.

What is Pelvic Prolapse?

Pelvic prolapse is best described as a hernia of the vagina. It is a descent of organs including the uterus, bladder, and large or small bowel. The muscles and tissues that normally support these organs become loose or weak, leading to a protrusion of the uterus, vagina, or both.

If you suspect that you have pelvic prolapse, then your doctor may perform several tests. One is a bladder function test that determines if you experience leakage when the bladder is put back into place. How well your bladder empties may also be tested.

You may undergo pelvic floor strength tests. This will gauge the strength of muscles and ligaments in the rectum, uterus, vaginal wall, bladder, and urethra.

Your doctor may recommend magnetic resonance imaging or MRI. MRI uses radio waves and a magnetic field to create images of the pelvis. These provide greater detail and are typically only used in complex cases.

Ultrasound offers another imaging option. This method utilizes high-frequency sound waves to build an image of the bladder, kidneys, and muscles.

Four Main Types of Pelvic Prolapse

There are four main types of pelvic prolapse, each based on the location of the condition.

• Cystocele – Cystocele occurs when the protrusion is positioned at the anterior wall or front of the vagina and bladder. It is also referred to as a “dropped bladder.”
• Rectocele – Rectocele happens when the protrusion is positioned at the back or posterior wall, involving the rectum and vagina.
• Enterocele – Enterocele describes pelvic prolapse that involves the upper region of the vaginal wall and small bowel.
• Uterine – Uterine prolapse occurs when the uterus descends. This type is also called a dropped uterus.

The Causes of Pelvic Prolapse

Conditions that weaken the pelvic floor and supportive tissues can cause a pelvic prolapse. Common causes include:

• Vaginal Birth – Vaginal childbirth can strain the pelvic floor. Women who have given birth multiple times have an increased risk of pelvic prolapse when they get older. You can still experience prolapse, even if you have never given birth or if you did so with a cesarean or C-section.
• Obesity – Excess weight puts pressure on the abdomen, which can lead to a pelvic prolapse. Obesity can damage or weaken the pelvic floor, increasing your risk.
• Straining or Coughing – Chronic coughing or straining during bowel movements can cause a pelvic prolapse. Both actions put pressure on the abdominal area. If you experience chronic coughing or frequent difficulties with bowel movements, you should talk to a medical professional about possible underlying conditions.
• Aging – The natural course of aging can cause the pelvic floor to weaken. Approximately 37% of women with pelvic floor disorders are between the ages of 60 and 79 and around half are over age 80. It is best to minimize other risk factors to reduce the chances of experiencing this condition when you get older.
• Hormonal Changes – Hormone changes, like those caused by menopause, can also increase risk. Researchers are still trying to determine why, but there appears to be a link between loss of estrogen and pelvic prolapse.
• Family History – Genetics play a role in your risk factor. Those with a family history of pelvic prolapse are more likely to experience it themselves.

What Are the Signs of Pelvic Prolapse?

Many women who have pelvic prolapse are embarrassed to discuss it. You should know the symptoms so that you know when you should seek medical advice. Most women with pelvic prolapse report:

• Pressure or pain in the pelvic region and/or lower back
• Increased pelvic pressure when coughing
• Unexplained constipation
• Urinary leakage or excessive urge to urinate
• Pain during intercourse
• Difficulty inserting tampons
• Feeling or seeing a bulge coming out of the vagina

You should speak to your doctor right away if you notice one or more of these symptoms.

What Can I Do About Pelvic Prolapse?

The recommended treatment will depend on the severity of the problem. Your doctor may advise you to strengthen the pelvic floor using Kegel exercises. This is done by squeezing and releasing the muscles that you would usually use to hold gas in. It builds muscles to support the pelvic organs.

You must ensure that you are performing Kegels the correct way to get the desired effect. A physical therapist can guide you through the process. In some cases, this is all that is needed to relieve the symptoms of pelvic prolapse.

Some patients may be prescribed a pessary. This device is made of silicone and comes in different shapes. It is inserted into the vagina to provide support to organs. It is custom fitted for the patient and removable.

Women who do not want to use a pessary or did not get relief that way may consider surgery. Uterine prolapse can be corrected with a hysterectomy or removal of the uterus. Those with a high risk of repeat prolapse may undergo a sacrocolpopexy. During this procedure, a surgeon makes small incisions along the abdomen to reposition pelvic organs.

Preventing Pelvic Prolapse

If you haven’t experienced a pelvic prolapse, now is the time to take steps to avoid it. Maintain a healthy body weight to lower pressure on the abdomen. Smoking cessation is also recommended to reduce coughing. You should also strengthen pelvic floor muscles and use caution when lifting heavy objects.

If you have questions about pelvic prolapse or other health conditions, let us know. Complete Women’s Care is here to provide guidance and help you stay healthy and pain-free.