When the uterus slips or drops from its usual position and protrudes into the vaginal canal, it is known as uterine prolapse. It is primarily brought on by weaker ligaments and muscles in the pelvic floor that support the uterus.
The muscles and ligaments of the pelvic floor keep the uterus, bladder, and rectum in their proper positions within the pelvis. When these supporting structures deteriorate or are injured, the uterus can no longer be appropriately supported, which causes prolapse.
A complete prolapse, in which the uterus protrudes outside the vaginal opening, can range in severity from a modest sinking of the uterus into the vaginal canal to uterine prolapse. Depending on how far it has descended, it can be divided into various degrees:
- First-degree prolapse is when the cervix protrudes into the vagina.
- Second-degree prolapse occurs when the cervix lowers to the vaginal opening.
- Cervical prolapse in the third degree occurs when it extends past the vaginal opening.
Women who have given birth vaginally had many pregnancies, or have achieved menopause are more likely to get uterine prolapse. Aside from obesity, other risk factors for uterine prolapse include pelvic trauma, chronic cough, chronic constipation, hormonal imbalances, and genetic susceptibility.
Causes of Utreine Prolapse
- Pregnancy and childbirth: The muscles and ligaments in the pelvic floor can experience severe tension during pregnancy and childbirth. Large birth weights, vaginal deliveries, and many pregnancies can all raise your risk of uterine prolapse. Later in adulthood, prolapse may result from the supporting tissues being stretched and weakened during childbirth.
- Age and hormonal changes: As women age, their levels of estrogen and other hormones drop, affecting the tissues in the pelvis. The pelvic floor may become weaker and more prone to prolapse due to the loss of flexibility and strength in the connective tissues.
- Weak pelvic floor muscles: A sedentary lifestyle, obesity, chronic coughing, chronic constipation, and heavy lifting are just a few of the factors that can lead to weak or damaged pelvic floor muscles. It is more likely that the uterus will prolapse when these muscles are weak because they cannot maintain it adequately.
- Factors of genetic origin: Some women may be genetically predisposed to the weakening of the ligaments and muscles of the pelvic floor, increasing their risk of uterine prolapse.
- Chronic diseases: Obesity and chronic obstructive pulmonary disease (COPD), which increases pressure on the pelvic organs, are two chronic diseases that can aggravate the status of the uterus and lead to prolapse.
- Hysterectomy (removal of the uterus), for example, can impair the pelvic floor’s supporting systems, increasing the risk of prolapse. Previous pelvic procedures can also damage these structures.
Effects of Uterine Prolapse
- Physical discomfort: Women who have uterine prolapse may feel pain or discomfort in the pelvic area. These symptoms may include a feeling of weight or pressure in the pelvis, a bulge or protrusion in the vaginal region, back pain, or discomfort during sexual activity. The daily grind and overall quality of life may be affected by these symptoms.
- Urinary difficulties: Uterine prolapse can result in urinary issues such as urinary incontinence (leakage of urine), frequent urination, urgency, or trouble entirely emptying the bladder. These signs and symptoms may be brought on by the pressure the uterus exerts on the bladder as it descends.
- gastrointestinal issues: Uterine prolapse may occasionally result in gastrointestinal difficulties. Constipation, bowel movement challenges, or a sense of incomplete emptying are all common among women. The rectum may be compressed by the prolapsed uterus, which may also obstruct regular bowel movements.
- Uterine prolapse may have an impact on sexual performance and intimacy. Some women may feel pain or discomfort during sexual engagement, which might reduce their desire for sexual activity. This may have an emotional and interpersonal impact.
- A woman’s self-esteem may suffer due to dealing with uterine prolapse, which can also have emotional and psychological effects. Feelings of humiliation, frustration, or a loss of femininity may result from the condition’s physical restrictions and changes to one’s appearance. For help coping with these emotional difficulties, turn to counseling, support groups, or healthcare specialists.
- Impact on daily activities: A woman with severe uterine prolapse may be unable to move heavy objects, strain herself, or conduct duties that put pressure on her pelvic floor. Overall independence and movement may be impacted by this.
- Impact on fertility and pregnancy: Uterine prolapse may occasionally have an impact on fertility or pregnancy. It could be more difficult for sperm to reach the egg if the illness affects how the uterus is positioned. Additionally, having a prolapsed uterus during pregnancy might provide difficulties for the mother and the baby.
Symptoms of Uterine Prolapse
- The sentiment of pressure or heaviness in the pelvis: Many uterine prolapse sufferers report experiencing pressure or heaviness in the pelvic area. After prolonged standing or physical exertion, this sensation could get worse.
- A bulge or protrusion in the vaginal area may be felt or seen as the uterus enters the vaginal canal. This bulge might fluctuate in size and might become more apparent when you cough, sneeze, or strain, which all raise intra-abdominal pressure.
- Pain or discomfort: Some women may feel pain or discomfort in the lower back, pelvic area, or vaginal area. This can cause anything from modest discomfort to more severe pain, especially when engaging in physical or sexual activity.
- Urinary symptoms: Uterine prolapse can impair urination, resulting in a range of signs and symptoms. Urinary incontinence (urine leakage), increased frequency of urination, urgency (a sudden, intense urge to urinate), hesitation (difficulty commencing urination), or the impression that the bladder isn’t empty enough are some examples of these.
- Uterine prolapse may occasionally affect bowel function, according to symptoms. Constipation, bowel movement difficulty, or a sense of incomplete evacuation are all common among women. To pass feces, one may need to strain during bowel motions.
- Discomfort or pain experienced during sexual activity (dyspareunia) might be brought on by the uterus’ displacement and the pressure it puts on nearby structures.
- Lower back pain or generalized pelvic pain may be experienced by women with uterine prolapse. This may be connected to the stress put on the ligaments and muscles of the pelvic floor.
Natural Remedies for Uterine Prolapse
- Exercises for the pelvic floor (Kegels): Performing Kegels on a regular basis can assist tone the pelvic floor and strengthen the muscles that support the uterus. The pelvic floor muscles are contracted and then relaxed during kegel exercises. A pelvic floor therapist or medical expert can offer advice on appropriate workout routines and adequate techniques.
- Pilates and yoga: Performing mild Pilates or yoga poses can assist to build core strength and enhance pelvic floor stability in general. These practices’ specific poses and motions might target the pelvic area and support the uterus.
- Maintaining a healthy weight: By eating a balanced diet and doing regular exercise, one can lessen the pressure on the pelvic floor and reduce the likelihood that uterine prolapse symptoms will worsen.
- A fiber-rich diet can help prevent constipation, which can aggravate the signs and symptoms of uterine prolapse. Keep in mind that keeping regular bowel motions also requires adequate drinking. Additionally, reducing the intake of too much coffee and alcohol may lessen urinary symptoms and bladder discomfort.
- Herbal remedies: Some herbs and herbal treatments are thought to support the health of the pelvic floor. Dong quai, red raspberry leaf, and wild yam are a few examples. However, there isn’t enough research to prove that they work for uterine prolapse specifically, so you should always talk to a doctor before using any herbal therapies to make sure they’re safe and suitable for you.
- Maintaining excellent posture and employing the right body mechanics when lifting heavy objects or engaging in physical activity can assist to lessen the pressure on the ligaments and muscles of the pelvic floor.
- Supportive devices: A pessary, a device put into the vagina to support the uterus, may be advised in specific circumstances. A healthcare practitioner should be consulted to ensure that the pessary is fitted, inserted, and managed correctly.
Treatment Options for Uterine Prolapse
- Lifestyle changes: As a first line of treatment, lifestyle changes may be suggested in moderate cases of uterine prolapse without noticeable symptoms. In order to strengthen the pelvic floor muscles, these include pelvic floor exercises (Kegels), controlling chronic diseases like constipation or coughing, losing weight if necessary, refraining from hard lifting or straining, and losing weight if necessary.
- Pessaries are detachable medical devices that are put into the vagina to support the uterus and treat the signs and symptoms of uterine prolapse. The right kind of pessary is selected depending on a person’s specific demands because they come in a variety of sizes and shapes. The pessary will be fitted by a medical practitioner, who will also offer instructions on how to use, care for, and maintain it.
- Estrogen therapy: Topical estrogen therapy may be suggested for postmenopausal women. The effects of uterine prolapse symptoms may be somewhat alleviated by estrogen’s ability to increase the tone and elasticity of vaginal tissues. Usually, this therapy is applied in addition to other strategies.
- Physical therapy: For women with uterine prolapse, pelvic floor physical therapy may be helpful. Strengthening the pelvic floor muscles, enhancing overall pelvic stability, and treating symptoms can all be accomplished with the help of a physical therapist with experience in pelvic floor rehabilitation.
- Surgery may be necessary in severe cases of uterine prolapse or when
Prevention of Uterine Prolapse
- Exercises for the pelvic floor: Building up the muscles in the pelvic floor can support the uterus and avoid prolapse. The pelvic floor muscles can be toned effectively, especially with kegel exercises. To find out the right procedure, speak with a medical professional or a physical therapist.
- A healthy weight should be maintained because being overweight or obese might place more strain on the pelvic organs and raise the risk of uterine prolapse. This risk can be decreased by maintaining a healthy weight through consistent exercise and a well-balanced diet.
- Avoid excessive lifting: Frequent or vigorous lifting might tax the muscles in the pelvic floor and possibly cause uterine prolapse. To reduce pressure on your pelvic region when carrying large goods, remember to adopt the right lifting techniques, such as bending at the knees rather than the waist.
- Maintain healthy bowel habits: The pelvic floor muscles might become strained when you strain during bowel motions. To avoid constipation, be sure to eat a diet rich in fiber, drink enough water, and have regular bowel habits. Consult a healthcare professional if necessary to learn about the best constipation treatments.
- Be careful when pregnant and giving birth because the tension on the pelvic floor during these processes can occasionally lead to uterine prolapse. Although you cannot stop these variables, you can take measures to lessen their effects. Attend routine prenatal checkups, adhere to your doctor’s instructions, and think about pelvic floor exercises before, throughout, and after pregnancy.
- Avoid having a persistent cough since it can put pressure on your pelvic organs. Consult a healthcare professional if you have a chronic cough to determine the underlying cause and get the right care.
- Quit smoking since it can cause a persistent cough, which can cause uterine prolapse. In addition to improving your general health, quitting smoking lowers your risk of developing a persistent cough.
- Hormone replacement therapy (HRT): A drop in estrogen levels during menopause can cause the pelvic floor muscles and supporting tissues to deteriorate. If you’re thinking about HRT, talk to your doctor about the potential advantages and disadvantages so you can choose the best course of action.
*Disclaimer: This article is for informational purposes only and should not substitute professional medical advice. Please consult a healthcare professional for a thorough evaluation of your symptoms and appropriate treatment.
Author Information
Author Contribution: Reviewed by Dr. Ram Reddy, MD – General Physician