Normally, supporting ligaments and other connective tissues hold your uterus in place inside your pelvic cavity. Weakening of these supportive structures allows the uterus to slip down into the vagina. As a result, the vagina also is pulled down and may turn inside out. Doctors refer to this downward movement of the uterus as uterine prolapse.
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.
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.
Uterine prolapse results from the weakening of pelvic muscles and supportive tissues. Causes of weakened pelvic muscles and tissues include:
- 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
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
- Prior pelvic surgery
- Chronic constipation or frequent straining during bowel movements
- Family history of weakness in connective tissue
- Being Hispanic or white
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.
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
Sept. 19, 2020
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