Uterine prolapse is the descent of your uterus from its normal place in the abdomen into the vagina. In fact, the uterus is held in place by muscles and ligaments at the base of the abdomen. As a result of the loosening of the muscles and ligaments here, the support of the uterus decreases and it sags downwards by gravity. It is more common in menopausal women who have given birth vaginally. During pregnancy and childbirth, gravity damages the support tissues. In addition, as a result of the decrease in estrogen and years of stretching, these muscles weaken over time and cause uterine prolapse. If there is only mild uterine prolapse, treatment is usually not necessary. However, if the prolapse is very uncomfortable and excessive, it may need to be surgically corrected. Or you can relax using a supportive device inserted through the vagina.
What are the Symptoms
Symptoms will vary according to your condition. If there is a mild sagging, there may be no symptoms. In moderate and severe sagging, the following may occur;
- Feeling of heaviness or pulling down in the lower abdomen
- Pain during sexual intercourse
- Something coming out of the vagina
- Low back pain
Some women with uterine prolapse say that they feel as if they are sitting on a small ball or as if something is hanging out of their vagina. Complaints are usually less in the morning (after a long lie-in) and more later in the day.
Why It Happens
During pregnancy and especially in those who have a difficult delivery due to a large baby, there is muscle weakening that causes uterine prolapse. After menopause, the muscles also weaken due to aging and decreasing estrogen levels. These also contribute to uterine prolapse. Genetic causes also play a role.
What are the Risk Factors
Some factors can facilitate uterine prolapse;
- Multiple pregnancies and normal childbirth
- Giving birth to a big baby
- Advanced age
- Lifting too heavy
- Persistent coughing
- Straining too much in the toilet
- Obesity, chronic constipation and certain lung diseases can overstretch the muscles and connective tissue at the base of the abdomen and contribute to the development of uterine prolapse.
When to consult a doctor
You should see your doctor if you have symptoms such as a feeling of fullness in the vagina or pain during sexual intercourse, or if you have trouble urinating or defecating.
How to Diagnose
Uterine prolapse is diagnosed with a gynecological examination. Your doctor will ask you about your previous pregnancies and births. Ultrasound, computed tomography and magnetic resonance imaging techniques may also be ordered for a more detailed view.
What It Can Lead To
Severe uterine prolapse can cause sores in the vagina. This is because the prolapsed uterus will cause the vaginal wall and the outer skin to rub against each other and cause sores. Rarely, it can also lead to infection. In addition to uterine prolapse, prolapse of other intra-abdominal organs such as the bladder and intestines can also occur together. Prolapse of the bladder occurs through the front part of the vagina and causes difficulty urinating. It also predisposes to urinary tract infections. In prolapse of the intestine, it causes difficulty in defecation and hemorrhoids.
How to Treat
If you do not have any complaints and have a mild uterine prolapse, there is no need for treatment. Weight loss, smoking cessation, treatment of aggravating causes such as lung disease will slow the progression of uterine prolapse. However, if you do not pay attention to these, treatment may be necessary in the future.
– You need to make changes in your lifestyle. If you are overweight, you need to pay attention to eating a balanced diet and correcting your weight. Doing exercises that will work the abdominal floor muscles will strengthen the muscles here. You will also need to avoid heavy lifting.
– Vaginal rings. Vaginal rings are designed to lift the uterus. There are temporary or permanent rings. They come in different shapes and sizes. Your doctor will choose the right one for you.
– Surgical repair of the uterus. If lifestyle changes and vaginal rings have not solved your problem, surgery is another option. The problem can be solved by supporting the muscles that cause the prolapse with your own tissues or synthetic materials. Or removal of the uterus may also be recommended. However, not all women are suitable for surgery, especially women who want children and very old women for whom surgery is risky.
What You Should Do to Prevent
It is not possible to prevent uterine prolapse. But you can reduce the risks. Be careful not to gain excess weight by eating healthy. Do exercises to strengthen your abdominal floor muscles. Tighten your muscles as if you are stopping while urinating, count to five, relax and repeat. Do this many times a day. Do not smoke. If you have a disease that causes excessive coughing or chronic constipation, get treatment. Taking estrogen at menopause will help you prevent your muscles from relaxing. However, remember that hormone therapy has risks and you and your doctor should decide on treatment based on the benefit/loss ratio.