Uterine prolapse

Overview

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

Uterine prolapse most often affects people after menopause who've had one or more vaginal deliveries.

Mild uterine prolapse usually doesn't require treatment. But uterine prolapse that causes discomfort or disrupts daily life might benefit from treatment.

Symptoms

Mild uterine prolapse is common after childbirth. It generally doesn't cause symptoms. Symptoms of moderate to severe uterine prolapse include:

• Seeing or feeling tissue bulge out of the vagina
• Feeling heaviness or pulling in the pelvis
• Feeling like the bladder doesn't empty all the way when you use the bathroom
• Problems with leaking urine, also called incontinence
• Trouble having a bowel movement and needing to press the vagina with your fingers to help have a bowel movement
• Feeling as if you're sitting on a small ball
• Feeling as if you have vaginal tissue rubbing on clothing
• Pressure or discomfort in the pelvis or low back
• Sexual concerns, such as feeling as though the vaginal tissue is loose

When to see a doctor

See a health care provider to talk about treatment options if symptoms of uterine prolapse bother you and keep you from doing daily activities.

Causes

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

• Vaginal delivery
• Age at first delivery (older women are at higher risk of pelvic floor injuries compared with younger women)
• Difficult labor and delivery or trauma during childbirth
• Delivery of a large baby
• Being overweight
• 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 the risk of uterine prolapse include:

• Having one or more vaginal births
• Being older when you have your first baby
• Giving birth to a large baby
• Aging
• Obesity
• Prior pelvic surgery
• Chronic constipation or often straining during bowel movements
• Family history of weak connective tissue
• Being Hispanic or white
• Chronic coughing, such as from smoking

Complications

Uterine prolapse often happens with prolapse of other pelvic organs. These types of prolapse can also happen:

• Anterior prolapse. Anterior prolapse results from weak connective tissue between the bladder and roof of the vagina. It can cause the bladder to bulge into the vagina. This is called a cystocele or prolapsed bladder.
• Posterior vaginal prolapse. Weak connective tissue between the rectum and the floor of the vagina can cause the rectum to bulge into the vagina. This might cause difficulty with bowel movements. Posterior vaginal prolapse is also called a rectocele.

Prevention

To reduce the risk of uterine prolapse, try to:

• Prevent constipation. Drink plenty of fluids and eat high-fiber foods, such as fruits, vegetables, beans and whole-grains.
• Avoid heavy lifting. If you have to lift something heavy, do it correctly. Correct lifting uses the legs instead of the waist or back.
• Control coughing. Get treatment for a chronic cough or bronchitis. Don't smoke.
• Avoid weight gain. Talk with your doctor about your ideal weight and get advice on how to lose weight, if you need to.