Prolapsed uterus

A prolapsed uterus happens when the uterus (womb) falls or drops into the vagina.

Uterine prolapse is very common. As many as half of women between the ages of 50 and 80 experience pelvic organ prolapse. It typically causes mild or no symptoms.

In some cases, uterine prolapse can be uncomfortable and embarrassing, as well as cause urination problems and interfere with sexual intercourse.

The gynecologists at Dignity Health are here to provide a diagnosis and help you determine the right treatment for prolapsed uterus. Find a Doctor near you today.

Symptoms

A prolapsed uterus sometimes has no signs at all, if the prolapse is incomplete. Depending on how far the uterus has fallen into the vaginal canal, you may notice some discomfort or other symptoms.

The most common signs and symptoms include:

• Pressure or a feeling of heaviness in the pelvic region or vagina
• Difficulty urinating, pain with urination, urine retention, repeated bladder infections, or urine leakage
• Difficulty passing a bowel movement
• Feeling like your internal organs are “falling out,” or like you’re sitting on a ball
• Visible tissue bulging from your vagina
• Increased discharge or bleeding from the vagina
• Pain or achy feeling in the lower back
• Problems with sexual intercourse

Causes

Typically, the uterus is held in place above the vagina by a group of muscles and ligaments called the pelvic floor. A prolapsed uterus occurs when the pelvic muscles and ligaments that support the uterus weaken to the point where they no longer support the uterus.

This condition is most common in women who have given birth vaginally, but women who have never given birth can also develop a prolapsed uterus in some cases.

The most common causes of prolapsed uterus include:

• Pregnancy
• An instrument-assisted delivery (such as a forceps- or vacuum-assisted birth)
• Delivery of a large baby
• Obesity: being overweight doubles the risk of developing prolapsed uterus
• Aging: the loss of estrogen after menopause has been associated with weakening of the pelvic muscles that support the uterus
• Long-term constipation: straining to have a bowel movement puts excess stress on the pelvic muscles over time

Types

Uterine prolapse can be partial or complete, depending on the degree of weakening in the pelvic floor and how far the uterus has descended into the vaginal canal:

• Incomplete uterine prolapse occurs when the uterus falls down but does not protrude from the vagina.
• Complete uterine prolapse occurs when the uterus descends far enough that some of the tissue protrudes from the vagina.

The degree of prolapse (measured by how far the uterus has fallen) is also commonly assigned a “grade,” from 1 to 4. A grade 1 prolapse means that the uterus has only descended into the upper vagina, while a grade 4 prolapse means that both the uterus and cervix are outside the entrance to the vagina.

The type and grade of prolapse will determine the type of treatment needed.

Risk factors

Risk factors for prolapsed uterus include:

• Being overweight
• Smoking
• Previous pregnancy or pregnancies
• Labor and delivery where instruments such as forceps or a vacuum were used
• Aging
• Issues with the pelvic muscles, such as from chronic constipation
• Previous pelvic surgery
• Genetics (family history of prolapsed uterus)
• Chronic or uncontrollable cough

Prevention

To help prevent uterine prolapse, you can take steps to protect and strengthen the pelvic floor:

• Avoid heavy lifting and other strenuous activities after giving birth
• Lift heavy objects with proper form and avoid overexerting yourself
• Maintain a healthy weight
• Treat or prevent constipation, for example by eating a diet higher in fiber and staying hydrated
• Perform Kegel exercises regularly to strengthen the pelvic floor

The information contained in this article is meant for educational purposes only and should not replace advice from your healthcare provider.