The pelvic floor is a topic that’s growing in awareness in women’s health, and rightfully so. As the support center for our reproductive organs, intestines, and bladder, muscles and ligaments of the pelvic floor hold everything in place. If the muscles and tendons of the pelvic floor become injured or weak, certain organs can drop down, causing a prolapse.
What is Prolapse?
Prolapse is when organs fall out of place, often into the vagina, rectum, or uterus. Prolapses are common today and vary in severity depending on the situation.
A pelvic organ prolapse (POP) is most common after a woman gives birth. It can also happen due to weakened muscles that come with aging or menopause. Women who have had a hysterectomy (surgical removal of the uterus) often experience a pelvic organ prolapse.
Pelvic Organ Prolapses in Women
One in three women experiences a pelvic organ prolapse in her lifetime. Clinically, a prolapse is categorized as a type of pelvic floor disorder (National Institute of Health).
Pelvic organ prolapse can be a result of single factors or a combination of the following:
Older age
Intense labor
Multiple childbirths
Hypermobility (stretchier muscles)
Chronic constipation
Cancer of female reproductive organs
Two types of prolapse affect women’s reproductive organs specifically: uterine prolapse and vaginal prolapse. (Note that there are other types of prolapses.)
Vaginal Prolapse
When the vaginal vault (the upper portion of the vagina) tears, weakens, or loses shape, it can droop down into the vaginal canal. A prolapsed vagina can cause a feeling of pressure or fullness in the vagina. In Stage 4 vaginal prolapse, the vagina can sometimes drop outside of the body.
Uterine Prolapse
An estimated 50% of women between 50 and 79-years-old experience prolapse of the uterus. This is when the uterus drops down into the vagina. Signs of uterine prolapse include a bulge in the vagina, feelings of fullness in the abdomen, and difficulty going to the bathroom normally.
Prolapse Treatment for Women
How are women’s pelvic organ prolapses treated? It depends on the type and severity, or POP stage.
Sometimes a prolapse is out of a woman’s control. Fortunately, many prolapses are not dangerous, and there are ways to improve symptoms and conditions.
Pelvic Floor Rehabilitation Therapy
Pelvic floor therapy is a type of physical therapy that helps people with pelvic floor dysfunction. It can include a combination of Kegel exercises, biofeedback, trigger points, and electrical stimulation.
Pelvic Floor Exercises for Prolapse
Kegels are well-known in women’s wellness (here’s your reminder to go do some!). Strengthening the pelvic floor with Kegels has been proven to relieve symptoms of pelvic organ prolapse. Critical to know is that doing the proper Kegels is important so you may consider speaking with an expert first.
To learn more about why the proper exercises and support are needed, listen to Corey Hazama of Beyond Basics in our episode Prolapse: A Crash Course.
Weight Management
Obesity and lack of muscle strength contribute to prolapse in women. Exercise, fitness training, and maintaining a healthy weight can be part of prolapse treatment. Always ask your doctor what exercise you can do, as you want to avoid strain.
Surgery
In Stage 4 (severe) prolapse cases, surgery might be necessary. There are three types of surgery for prolapse:
Obliterative surgery: a procedure that closes off or narrows the vagina.
Reconstructive surgery: a surgery that restores the anatomical structure of the pelvic floor or organs.
Laparoscopic surgery: a surgery that uses small incisions to repair the pelvic floor (although there is debate on how materials used in this procedure may affect pelvic organs).
How Can Women Prevent Prolapse?
With better education and awareness, women can be proactive in preventing prolapses later in life. If you’ve already had a prolapse, you can prevent it from getting worse or from experiencing one again.
Keep the Pelvic Floor Strong
Practice Kegels and pelvic floor exercises regularly. Although it’s normal for organs to move naturally with your body’s movements, maintaining a healthy posture also encourages optimal pelvic organ alignment.
Avoid Chronic Strain
Eating a healthy diet that contains plenty of fiber prevents constipation which strains pelvic floor muscles. Consider other lifestyle factors that cause strain such as vigorous exercise or frequent manual labor that may affect your pelvic floor.
Get Routine Pelvic Exams from Your Doctor
Like any other medical concern, scheduling annual pelvic exams with your doctor can help you catch warning signs when it’s early. Noticing a Stage 1 or 2 vaginal or uterine prolapse can be treated with more effectiveness than a Stage 4.
Perform Self-Checks
While doctor visits are necessary, you can also check for signs of vaginal or uterine prolapse at home. Here’s how to do a self-exam:
With clean hands, insert two fingers into your vagina.
Cough or bear down as if you’re taking a bowel movement. Normally, you won’t notice any bulge push onto your fingers.
If you do feel a bulge— such as a push-down, forward, or back against your fingers— it indicates a sign of prolapse.
When trying this self-exam, if you notice an interference in your vagina to the point where you can’t insert your fingers all the way, that could be a sign of prolapse.
You can do this type of self-examination every 1-3 months.
Visit a Pelvic Physical Therapist During Pregnancy
Did you know you can prevent prolapse that affects many women after labor? You can work with a pelvic physical therapist before having a baby. This can help you get your pelvic muscles strong and supple for supporting your body during (and after) vaginal birth.
Listen to Georgie Kovacs and Corey Hazama discuss prolapse and pelvic floor physical therapy in this episode of Fempower Health.
More on Pelvic Organ Prolapse
Since POP affects so many women worldwide, there’s a lot more to learn about both treatment and prevention of prolapse. Talk to your doctor, discuss personal experiences with other women, and stay up to date with pelvic floor health. You can listen to the pelvic floor playlist on Fempower Health for more.
Resources
Check out all of Fempower Health’s resources on Pelvic Health.
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