Uterine prolapse describes the condition where the uterus has dropped from its position within the pelvis into the vagina. Normally, the uterus is held in place by the muscles and ligaments that make up the pelvic floor. Uterine prolapse results when pelvic floor muscles and ligaments weaken, providing inadequate support for the uterus. The uterus then descends into the vaginal canal.
Uterine prolapse often affects postmenopausal women who've had one or more vaginal deliveries. Damage to supportive tissues incurred during pregnancy and childbirth, plus the effects of gravity, loss of estrogen, and repeated straining over the years can weaken pelvic floor muscles and lead to prolapse.
Symptoms of uterine prolapse vary in severity, depending on the extent of the prolapse. Symptoms tend to be less bothersome in the morning — after a long period of lying down — and worsen as the day goes on. Those symptoms may include:
- A sensation of heaviness or pulling in your pelvis
- Pain during intercourse
- Tissue protruding from your vagina
- Low back pain
- Difficulty with urination or bowel movements
If the uterine prolapse is mild, treatment may not be necessary. However, if you experience discomfort or interruption of your lifestyle as a result of the prolapse, your provider may recommend a supportive device called a pessary. This device is inserted into the vagina to hold the uterus in place.
Lifestyle changes may also be recommended. If you're overweight or obese, your provider may suggest ways to achieve a healthy weight and maintain that weight. Exercises to strengthen your pelvic floor muscles may help. Your provider may also advise you to avoid heavy lifting or straining.
In other cases, surgery may be the appropriate treatment. The surgery involves repairing your pelvic floor muscles by grafting your own tissue, donor tissue or some synthetic material in such a way that it provides support to your pelvic organs. Another alternative is the surgical removal of the uterus, called hysterectomy.