Prolapse Explained

The Good News About Prolapse

Prolapse is a common problem for females of all ages, worldwide. Yet prolapse is one of those conditions that many women are way too embarrassed to talk about, even with their closest friends.

Some can’t even discuss prolapse with their doctor, choosing instead to put up with light bladder leakage, discomfort, a poor sex life and low self esteem rather than get help, advice and treatment.

In mild cases, prolapse can easily be fixed through a number of non-surgical treatments such as pelvic floor exercises as well as simple lifestyle changes such as improved diet and nutrition.

In more serious cases prolapse surgery is usually very successful, as is the use of a pessary – a small silicone device fitted into the upper vagina by a doctor to provide support to the organs and their support structures.

What is prolapse and why does it happen to so many women?

The word prolapse means ‘to fall out of place’. In women, this refers to the uterus, bladder or rectum slipping out of place, and either protruding into the vagina or pressing up against the vaginal wall. Your pelvic organs are held in place by ligaments and muscles, connective tissue and fascia, which are collectively known as the pelvic floor. Weakening of or damage to the pelvic floor means the pelvic organs are no longer snugly held in their usual position.

Given the number of organs and supporting structures tucked into your pelvis, and the stresses and strains they’re subjected to during pregnancy and birth, and sometimes just life in general, it’s hardly surprising that sometimes things loosen and fall out of place.

Having a prolapse certainly doesn’t mean you’re falling apart or you’re past your prime. Prolapse can occur in young women who’ve never had a baby, while there are plenty of elderly women who’ve had swags of children yet never a prolapse problem in their lives.


The most common causes of prolapse

By far the most common cause of prolapse is having children, especially if the delivery is rapid, the baby has a big head when the mother has a small pelvis and when the mother has had to push strongly for a long time.

Pregnancy hormones cause ligaments to soften and stretch to accommodate the growing baby, while the extra weight can strain the pelvic floor, causing it to weaken. The pelvic floor can then be further weakened by long labour, instrument delivery (forceps or vacuum), and stretching or tearing during the birth.

A prolapse might not happen immediately following birth but years later post-menopause. Falling estrogen levels during and after menopause can cause the pelvic floor to lose some of its strength and elasticity, often exacerbating existing damage from childbirth. Aging also causes ligaments and other support structures to relax and sag, resulting in a leaking bladder and other symptoms.


What increases the risk of prolapse?

The chances of having a prolapse are heightened if you:

  •  Smoke or have a respiratory condition such as asthma or bronchitis that causes chronic coughing which places pressure on the abdomen

  • Are obese as the extra weight puts pressure and strain on your internal organs

  •  Have a connective tissue disorder

  • Suffer repetitive strain injuries or incorrectly lift heavy objects

  • Suffer from constipation – the strain of trying to have a bowel movement can damage your pelvic floor

  • Genetically predisposed to prolapse due to an inherited weakness in the pelvic floor

  • Have had previous rectal surgery 

The symptoms of prolapse

These will, of course, vary according to which organs are pressing into or up against the vagina, and how bad the prolapse is. A minor prolapse may be barely noticeable, while a severe prolapse may cause a range of symptoms, some of which can be very uncomfortable and depressing. However, the symptoms most commonly noticed by women are:

  • Lump or bulge in the vagina or entrance to the vagina

  • A dragging sensation or feeling that something is falling down in the lower abdomen

  • Aching discomfort in the pelvic region

  • Dull pain in the lower back

  • Decrease in pain or pressure when lying down

  • Urinary stress incontinence or light bladder leakage where urine leaks during sneezing, coughing or laughing

  • Constipation or frequent visits to the toilet and incomplete emptying of bladder

  •  Sexual problems, such as pain during sex or difficult penetration. The loss of pelvic tone can also cause a decrease in sensation

  • Obviously, prolapse – even a minor one – can play havoc with your health, self worth, personal relationships and enjoyment of life.

Different types of prolapse

Uterine prolapse – the uterus and cervix slip down into the vagina

Cystocele (bladder prolapse) – where the tissues supporting the wall between the bladder and vagina weaken, allowing a part of the bladder to drop and press into the vaginal wall

Urethrocele (urethral prolapse) – the urethra (tube from the bladder to the outside of the body) drops and presses into the vaginal wall. This is usually accompanied by a prolapse of the bladder

Rectocele (rectal prolapse) – where the tissues supporting the wall between the vagina and rectum weaken and so allow the rectum to drop and press against the wall of the vagina

Enterocele – the name of the hernia of the small intentine that descends and presses into the space between the rectum and vagina

Vaginal prolapse – the top of the vagina drops in women who’ve had a hysterectomy

Ways to lessen the impact of prolapse

Prolapse and the accompanying pain, female incontinence and other symptoms may not be something you can avoid all together but you can reduce your risk of having a prolapse and decrease the severity of symptoms by doing pelvic floor exercises, maintaining a healthy weight, and control coughing.

If you’re in menopause, or post-menopausal, taking oestrogen supplements may help with maintaining strong pelvic floor muscles and ligaments.

However, there is no conclusive proof that hormone replacement therapy prevents or treats prolapse. Please discuss this option with your doctor.

Managing light bladder leakage

Poise offers you a number of discreet and super absorbent products to discreetly deal with female incontinence. Stash a pack in your handbag or backpack and you can confidently go about your daily business, sports and social life without worrying about light bladder leakage.

Being able to get out and about, exercising and enjoying yourself, will not only make you feel good, but help keep your weight down and your muscles and ligaments in good working order.

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