What is prolapse

But it often affects postmenopausal women who've had one or more vaginal deliveries. Mild uterine prolapse usually doesn't require treatment. But if uterine prolapse makes you uncomfortable or disrupts your normal life, you might benefit from treatment. Mild uterine prolapse generally doesn't cause signs or symptoms.

Signs and symptoms of moderate to severe uterine prolapse include:. See your doctor to discuss your options if signs and symptoms of uterine prolapse become bothersome and disrupt your normal activities. Uterine prolapse results from the weakening of pelvic muscles and supportive tissues.

Causes of weakened pelvic muscles and tissues include:. Severe uterine prolapse can displace part of the vaginal lining, causing it to protrude outside the body. Vaginal tissue that rubs against clothing can lead to vaginal sores ulcers. Rarely, the sores can become infected. Uterine prolapse care at Mayo Clinic. Mayo Clinic does not endorse companies or products.

Advertising revenue supports our not-for-profit mission. This content does not have an English version. This content does not have an Arabic version. Overview Uterine prolapse Open pop-up dialog box Close. Uterine prolapse Normally, supporting ligaments and other connective tissues hold your uterus in place inside your pelvic cavity. Request an Appointment at Mayo Clinic. Treatment for vaginal prolapse varies, depending on the severity of the symptoms.

Many cases will not require treatment. In mild cases, your physician may recommend pelvic floor exercises to strengthen the muscles. In moderate cases, your doctor may insert a vaginal pessary to support your vaginal wall. In the most severe cases, you may benefit from surgery, such as colposuspension , a minimally invasive surgical procedure, where the vaginal wall is attached to a stable ligament in the pelvis.

Health Home Conditions and Diseases. What is vaginal prolapse? What causes vaginal prolapse? What are the signs and symptoms of vaginal prolapse? Vaginal Pressure Women with vaginal prolapse often report feeling pressure in the vaginal area, described as a throbbing pain in the vagina. Women also report: Vaginal fullness such as the feeling that something is stuck in the vagina The sensation that something is falling out of her vagina Additional Vaginal Prolapse Symptoms The pelvic organs are all supported by each other.

Thus, some women also experience: Changes in bowel function, such as difficulty having a bowel movement Changes in bladder function, such as inability to empty the bladder Secondary prolapses, specifically rectocele prolapse sagging of the connective tissue between the vagina and rectum or cystocele prolapse sagging of the connective tissue between the vagina and the bladder. Pain or discomfort during sexual intercourse Difficulty using tampons. Pelvic physiotherapists treat all 4 types of prolapse.

A prolapse occurs when the support structures for the pelvic organs and the pelvic floor muscles can no longer adequately support the pelvic organs [4]. Pregnancy and childbirth can weaken the pelvic floor and decrease pelvic organ support. This effect increases with more pregnancies, use of forceps, larger babies and prolonged labour. Increased abdominal pressure can be a contributing factor to prolapse. These can include chronic coughing, chronic constipation, obesity, and repeated heavy lifting [2].

Connective tissue disorders, such as Ehlers-Danlos syndrome, can predispose you to prolapse. In these disorders the connective tissues that support the pelvic organs are not as strong and are not able to provide adequate support over time. A prolapse is more common in women who have had one or more vaginal deliveries, but it can also occur in women who have had C-sections or have never been pregnant. Prolapse may occur in women postpartum, either soon after childbirth or when returning to exercise.

Another common time for women to notice a prolapse is around or after menopause. The pelvic floor muscles, pelvic organs and associated connective tissues are sensitive to estrogen. As estrogen levels decrease around menopause, support for pelvic organs decreases, increasing the likelihood of prolapse [5]. A minor prolapse most often occurs without symptoms. It may only be noticed by your doctor. A prolapse that is more progressed may have symptoms such as a vaginal bulge, or feelings of pressure or things will fall out of the vagina.

A prolapse generally does not cause pain. Prolapse symptoms generally vary with coughing, lifting and other activities. They will often vary based on time of day, and may also vary with bowel and bladder filling.

Women with prolapse may experience difficulty emptying the bladder due to kinking of the urethra, or difficulty passing bowel movements due to a prolapse. A prolapse will generally be diagnosed by your family doctor, gynecologist, urogynecologist or pelvic floor physiotherapist. Generally it is diagnosed by vaginal exam.

Your doctor or physiotherapist will generally ask you to bear down as they note how far different parts of the vagina descend. If you are being assessed for a suspected prolapse, whether you are seeing your family doctor, a physiotherapist or a specialist, you should expect to have a vaginal exam.

In addition, you will be asked about the extent of your symptoms. Questions you may be asked may include:. There are multiple treatment options for pelvic organ prolapse. They may be done individually, or you may use a combination of these options. The first is to wait and observe. This is generally done in women who do not notice their prolapse. They may progress to further treatment options if their prolapse progresses.

The second treatment option is pelvic floor muscle exercises with or without training and supervision by a pelvic floor physiotherapist. A pelvic floor physio will also often address constipation. She will also give you guidance and modifications to your regular non-pelvic floor exercise routine as needed to allow you to keep active without aggravating your prolapse.

She will also help you to address any other symptoms related to pelvic floor disfunction such as urinary or fecal incontinence, constipation, pelvic or sexual pain, and overactive bladder symptoms. Another treatment option is the use of a pessary. A pessary is a device that is inserted into the vagina to support a prolapse.