Overview

Uterine prolapse occurs when pelvic floor muscles and ligaments stretch and weaken and no longer provide enough support for the uterus. As a result, the uterus slips down into or protrudes out of the vagina.

Uterine prolapse can occur in women of any age. 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.

Uterine prolapse care at Mayo Clinic

Symptoms

Mild uterine prolapse generally doesn't cause signs or symptoms. Signs and symptoms of moderate to severe uterine prolapse include:

  • Sensation of heaviness or pulling in your pelvis
  • Tissue protruding from your vagina
  • Urinary problems, such as urine leakage (incontinence) or urine retention
  • Trouble having a bowel movement
  • Feeling as if you're sitting on a small ball or as if something is falling out of your vagina
  • Sexual concerns, such as a sensation of looseness in the tone of your vaginal tissue

Often, symptoms are less bothersome in the morning and worsen as the day goes on.

When to see a doctor

See your doctor to discuss your options if signs and symptoms of uterine prolapse become bothersome and disrupt your normal activities.

Causes

Uterine prolapse results from the weakening of pelvic muscles and supportive tissues. Causes of weakened pelvic muscles and tissues include:

  • Pregnancy
  • Difficult labor and delivery or trauma during childbirth
  • Delivery of a large baby
  • Being overweight or obese
  • Lower estrogen level after menopause
  • Chronic constipation or straining with bowel movements
  • Chronic cough or bronchitis
  • Repeated heavy lifting

Risk factors

Factors that can increase your risk of uterine prolapse include:

  • One or more pregnancies and vaginal births
  • Giving birth to a large baby
  • Increasing age
  • Obesity
  • Prior pelvic surgery
  • Chronic constipation or frequent straining during bowel movements
  • Family history of weakness in connective tissue
  • Being Hispanic or white

Complications

Uterine prolapse is often associated with prolapse of other pelvic organs. You might experience:

  • Anterior prolapse (cystocele). Weakness of connective tissue separating the bladder and vagina may cause the bladder to bulge into the vagina. Anterior prolapse is also called prolapsed bladder.
  • Posterior vaginal prolapse (rectocele). Weakness of connective tissue separating the rectum and vagina may cause the rectum to bulge into the vagina. You might have difficulty having bowel movements.

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.

Prevention

To reduce your risk of uterine prolapse, try to:

  • Perform Kegel exercises regularly. These exercises can strengthen your pelvic floor muscles — especially important after you have a baby.
  • Treat and prevent constipation. Drink plenty of fluids and eat high-fiber foods, such as fruits, vegetables, beans and whole-grain cereals.
  • Avoid heavy lifting and lift correctly. When lifting, use your legs instead of your waist or back.
  • Control coughing. Get treatment for a chronic cough or bronchitis, and don't smoke.
  • Avoid weight gain. Talk with your doctor to determine your ideal weight and get advice on weight-loss strategies, if you need them.

Uterine prolapse care at Mayo Clinic

Aug. 02, 2017
References
  1. Lobo RA, et al. Anatomic defects of the abdominal wall and pelvic floor: Abdominal hernias, inguinal hernias, and pelvic organ prolapse: Diagnosis and management. In: Comprehensive Gynecology. 7th ed. Philadelphia, Pa.: Elsevier; 2017. https://www.clinicalkey.com. Accessed April 12, 2017.
  2. Ferri FF. Pelvic organ prolapse (uterine prolapse). In: Ferri's Clinical Advisor 2017. Philadelphia, Pa.: Elsevier; 2017. https://www.clinicalkey.com. Accessed April 14, 2017.
  3. Rogers RG, et al. Pelvic organ prolapse in women: Epidemiology, risk factors, clinical manifestations, and management. https://www.uptodate.com/home. Accessed April 18, 2017.
  4. Handa VL. Urinary incontinence and pelvic organ prolapse associated with pregnancy and childbirth. https://www.uptodate.com/home. Accessed April 18, 2017.
  5. AskMayoExpert. Pelvic organ prolapse (adult). Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2016.
  6. Fashokun TB, et al. Pelvic organ prolapse in women: Diagnostic evaluation. https://www.uptodate.com/home. Accessed May 10, 2017.
  7. Ridgeway BM. Does prolapse equal hysterectomy? The role of uterine conservation in women with uterovaginal prolapse. American Journal of Obstetrics & Gynecology. 2015;213:802.
  8. Lobo RA, et al. Lower urinary tract function and disorders: Physiology and micturition, voiding dysfunction, urinary incontinence, urinary tract infections, and painful bladder syndrome. In: Comprehensive Gynecology. 7th ed. Philadelphia, Pa.: Elsevier; 2017. https://www.clinicalkey.com. Accessed April 13, 2017.
  9. Hokenstad ED, et al. Health-related quality of life and outcomes after surgical treatment of complications from vaginally placed mesh. Female Pelvic Medicine & Reproductive Surgery. 2015;21:176.
  10. Warner KJ. Allscripts EPSi. Mayo Clinic, Rochester, Minn. April 5, 2017.