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.
Uterine prolapse is the one of the most common types of prolapse. It’s sometimes called women’s number one health secret, because it’s one of those conditions that many have but few admit to. Yet it’s been around for a very long time, with uterine prolapse and its treatment first described by physicians in an ancient Egyptian text dated about 2000 BC.
Up until recently, hysterectomy (surgical removal of the uterus) was often the prescribed ‘cure’, which is maybe why so many women keep quiet about it! Nowadays, hysterectomy is a last resort, and usually only for severe cases of uterine prolapse.
Laparoscopic surgery to repair the damage (without removing anything) may be done if the prolapse is serious. But usually other, non-surgical solutions are the first line of treatment. While in mild cases where the symptoms aren’t a problem, no treatment is required at all.
What is a uterine prolapse?
A uterine prolapse is when your uterus gives in to gravity and heads south into your vagina. This happens because the pelvic floor muscles – a tight hammock of muscles slung between the tailbone (coccyx) and the pubic bone – and ligaments that support the uterus have weakened or stretched and so can no longer firmly hold the uterus in its rightful place.
Uterine prolapse often affects postmenopausal women who’ve had at least one vaginal delivery of a baby. Damage to supportive tissues during pregnancy and childbirth, loss of oestrogen, and repeated straining and lifting of heavy objects over the years all can weaken your pelvic floor and lead to uterine prolapse.
The symptoms of uterine collapse
- The uterus and cervix protrude through the vaginal opening
- Low backache
- Frequent urination or a sudden, urgent need to empty the bladder (stress incontinence)
- Sensation of heaviness or pulling in the pelvis
- Difficult or painful sexual intercourse
- Repeated bladder infections
- Vaginal bleeding or an increase in vaginal discharge
- You feel like you’re sitting on a small ball. But you’re not
- Many of the symptoms are worse when standing or sitting for long periods of time
Causes of uterine prolapse
Pregnancy and childbirth are the main causes of prolapse. The prolapse can happen immediately after pregnancy or up to 30 years later. Contributing factors include a large baby, a long and intense labor, and assisted labour.
Even though female bodies are good at recovering from pregnancy and birth, damaged muscles and ligaments sometimes never fully regain their strength and elasticity.
Large fibroids or pelvic tumors put women at an increased risk of prolapse.
Ageing and menopause further weaken the pelvic muscles, as the natural reduction of oestrogen at menopause causes muscles to lose some of their strength and elasticity.
Obesity puts you at increased risk of prolapse as the extra weight stresses internal support structures.
Chronic coughing from smoking or asthma can lead to prolapse due to the constant straining of muscles and ligaments.
Constipation and the associated straining to have a bowel movement can stretch ligaments and weaken your pelvic floor.
Heavy lifting can damage pelvic muscles. Women in careers that involve regular manual labor or lifting, such as farming, landscaping and nursing, have an increased risk of prolapse.
Certain genetic conditions such as collagen deficiency increase the risk of prolapse even if there are no other risk factors.
Previous pelvic surgery, for example bladder repair procedures, may damage nerves and tissues in the pelvic region.
Spinal cord injury and other muscular atrophy conditions such as muscular dystrophy and multiple sclerosis increase the risk because pelvic muscles are paralysed or movement is restricted.