What Is Uterine Prolapse & How Can You Prevent It?

Uterine prolapse, along with vaginal vault prolapse or other forms of pelvic organ prolapse, affects almost half of women ages 50 to 79. This can result in physical, psychological and social stress. Fortunately, there are ways to reduce your risk.

What is uterine prolapse?

Uterine prolapse occurs when the pelvic floor muscles and ligaments holding the uterus in place weaken, causing the uterus to sag. The degree of uterine prolapse can vary. An incomplete prolapse happens when the uterus drops into the vagina, resulting in a lump or a bulge. In a complete prolapse, the uterus descends ever lower, protruding outside the vagina.

Symptoms of uterine prolapse

Mild uterine prolapse may go unnoticed as some people don't experience any symptoms. As the degree of prolapse worsens, you may notice one or more of the following issues:

• Constipation
• Frequent bladder infections
• Heaviness or pressure in the pelvis
• Pain during sex
• Pain in the pelvis, abdomen or lower back
• Unusual or excessive vaginal discharge
• Urinary problems, such as involuntary loss of urine (incontinence), needing to go often, needing to go urgently
• Uterine tissue at the opening of the vagina

Symptoms may worsen when you stand or walk for prolonged periods because gravity can place added pressure on the uterus.

Who is at risk for uterine prolapse?

These conditions that weaken the pelvic floor muscles increase your risk of uterine prolapse:

• Chronic constipation and straining
• Chronic coughing
• Obesity
• Older age
• One or more vaginal births
• Postmenopausal

During menopause, the ovaries stop producing the hormones responsible for regulating menstrual cycles. One such hormone is estrogen, which helps keep the pelvic muscles strong. Women with family members (a mother or sister) who have had uterine prolapse are at an increased risk of developing the condition.

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Uterine prolapse treatment options

Uterine prolapse may be treated with nonsurgical or surgical methods, depending on the degree of symptoms.

Nonsurgical options include performing Kegels (special exercises designed to strengthen your pelvic floor muscles) or the use of a vaginal pessary. A pessary is a ring-shaped device inserted into the vagina by your healthcare professional. It is placed under the lower part of the uterus and helps hold the uterus in place.

In some cases, surgery may be necessary. A hysterectomy to remove the uterus is one option. After a hysterectomy, though, pregnancy is no longer possible. Another option is a prolapse repair without a hysterectomy. During this procedure, pelvic ligaments are reattached to the uterus.

How to prevent uterine prolapse

Not all uterine prolapse cases are preventable, but there are steps you can take to lower your risk:

• Don't smoke. Smoking can cause a chronic condition that can weaken your pelvic floor muscles
• Eat a healthy, fiber-rich diet to prevent constipation and straining
• Exercise regularly
• Maintain a healthy weight
• Perform Kegel exercises (see below)
• Use safe lifting techniques and avoid lifting heavy objects

It is essential to see your healthcare professional as soon as you start experiencing any symptoms—don't wait. Early detection and treatment of uterine prolapse can help keep your condition from worsening.

Practicing Kegel exercises

Regular Kegel exercises can maintain strong pelvic muscles and lower your risk of uterine, bladder and bowel prolapse. Strengthening these muscles stops involuntary leakage of urine, gas and stool, and it can even improve orgasms.

To learn which muscles to contract, try stopping your urine flow midstream. The squeezing or lifting sensation is what you should mimic when performing a Kegel.

Contract your pelvic floor muscles for three seconds and then relax for three seconds. Repeat this a total of 10 times (or fewer if you cannot complete 10 comfortably). Do another set of 10 later in the day. As you become stronger, you can increase the duration (up to four or five seconds) and the number of sets (up to three per day).

You can do Kegels lying down, sitting or standing. It may initially be easier to perform these exercises while lying down, but you can do them anywhere as you get stronger. Try using an app to keep track of your progress.