Just as our skin is vulnerable to the effects of gravity and time, so are the pelvic organs and the structures that support them. 'Pelvic organ prolapse' is the all-encompassing term for the descent of one of the pelvic organs from their normal positions. This happens when the muscles and tissues that hold all these organs in their proper place become weak and the organs begin to sag. Your symptoms will depend on which organ decides to become rebellious.
“'Pelvic organ prolapse' is the all-encompassing term for the descent of one of the pelvic organs from their normal positions”
If the bladder in front of the vagina prolapses it's called a cystocele. This usually happens alongside a urethrocele, which means the ureter, or the tube that carries urine away from the bladder and into the toilet, prolapses. Cystoceles are the most common type of prolapse.
If the large intestine intrudes into the back wall of the vagina, this is called a rectocele. This is different from a rectal prolapse, in which the large intestine prolapses through the anus.
If the uterus slides down, along with the cervix, into the vagina, this is called a uterine prolapse. This is the second most common type of prolapse. For people who have had a hysterectomy, the top of the vagina might droop down into the vaginal canal. This is called a vaginal vault prolapse.
“People with a mild prolapse may not have any symptoms and only discover that they have had a prolapse during a routine gynecological examination.”
People with a mild prolapse may not have any symptoms and only discover that they have had a prolapse during a routine gynecological examination. But if you’re experiencing symptoms, and have risk factors associated with pelvic organ prolapse, here are some of the first signs that pop up (or out!):
1. A bulging sensation:
You may feel the sensation of 'sitting on a ball' or that something is protruding out of your vagina.
2. Heaviness or pressure:
The feeling of pelvic pressure that might get worse throughout the day. Coughing, constipation, or heavy lifting might also worsen the symptoms. Some people describe it as a 'feeling of fullness' in the vagina.
3. Low back pain or aches:
While back pain may be the result of many things, an achy pain that becomes less painful when you lie down may be a sign of a pelvic organ prolapse.
4. Abdominal pressure or pain:
This is also a vague symptom that can be the result of any number of issues, but please don't ignore it! Especially if you have other symptoms.
5. A visible lump:
You may see a little lump at the entrance of the vagina. This is a pretty clear sign of a prolapse and usually happens during the later stages of a prolapse, or when there’s a complete prolapse. At this point, the prolapse is quite severe, and conservative treatment may not be an option. Get this checked out as soon as possible to prevent complications.
6. Difficulty inserting a tampon:
If you're having a difficult time inserting a tampon, or if it's constantly sliding down, this could be a sign of a prolapse.
7. Difficulties during sex:
A prolapse may result in vaginal pain during sex, difficulty with penetration, or bladder leakage during sex. This may cause a decrease in your libido, or general sexual dissatisfaction and disinterest.
8. Bladder problems:
The need to urinate more frequently, an urgent need to empty your bladder, problems with urine flow, incomplete bladder emptying, and leaking of urine when you cough, sneeze, laugh, have sex, or exercise could be a sign of prolapse, specifically a cystocele. Some people find that their bladder flow changes when they change their body position or find that they can only empty their bladder when manually repositioning their vagina. Incomplete bladder emptying can be the cause of more frequent infections, so it would be wise to get this symptom checked out by a doctor.
9. Bowel problems:
Some symptoms that especially occur with a rectocele type of prolapse are difficulty emptying the bowel, feeling like you need to strain, constipation, and incontinence. Signs of incontinence are stains in your underwear, which especially occur with a rectal prolapse. Other symptoms are poor wind control, bowel urgency, and general discomfort during or after passing stools.
10. Abnormal bleeding from the vagina:
While this can occur for any number of reasons, one of them can be a prolapse. It's important to talk to a doctor about any irregular bleeding.
What to do once you realize you might have a prolapse
If you're experiencing any of these symptoms, get them checked out! There's no need to live with discomfort or pain as there are great treatment options available. Also, if left untreated, complications such as frequent infections or ulceration of the pelvic organs can occur.
For people with mild symptoms, a doctor may prescribe pelvic floor physiotherapy. Read about Kegel exercises, and learn the best way to strengthen your pelvic floor from the comfort of your own home.
If you aren't experiencing these symptoms, here are some tips about how to prevent a prolapse in the future!
Learn more about prolapse:
Discover the magic behind a healthy pelvic floor: