Let’s Talk About Vaginal Prolapse

Prolapse can be a bit of a scary word. Women have often heard horror stories from their mothers, aunties or friends. However, having a prolapse isn’t actually that scary. It’s also very common – 1 in 2 women who have had a baby have one.  Want to know the good news? Prolapse is very treatable, and pelvic floor exercises are the number one treatment recommended for prolapse worldwide.

 

There are different types of pelvic organ prolapse, essentially, it’s when any of the pelvic organs – the bladder, uterus or rectum – moves down out of its normal position and bulges into the vagina. It is sometimes called “POP” for short (pelvic organ prolapse). 

 

It’s sort of like a hernia and there are different degrees or stages of prolapse, from mild to moderate or more severe.  

 

The most common symptoms are the feeling of a bulge in your vagina, a heavy or dragging sensation in your vaginal and pelvic area, or low back ache. If you haven’t gone through menopause, these symptoms can be worse when you have your period.  Difficulty emptying or controlling your bladder or bowels can also be a related symptom. 

 

The pelvic floor muscles, pelvic ligaments and pelvic tissues hold up the pelvic organs.  Stretch, weakness or damage to any of these supporting structures can lead to prolapse of one or more of the pelvic organ(s).  

 

The most common time women develop a POP is after pregnancy and childbirth.  It can also occur in women who have been through menopause, who strain when opening their bowels, have a chronic cough, do lots of heavy lifting or high impact exercise, work in physically demanding occupations, or are overweight. Genetics also play a role, if other women in your family have had a prolapse, you are more likely to have one yourself. 

 

If you think you might have a prolapse, your best first port of call is your GP or Gynaecologist.  They will do a thorough pelvic examination to diagnose if you have a prolapse.  If the prolapse is at a mild or moderate stage, they will recommend that you see a pelvic floor physiotherapist, for a 3-6 month personalised pelvic health program including pelvic floor exercises.

 

Pelvic floor exercises under the guidance of a specifically trained pelvic floor physiotherapist is the number one recommended treatment for POP, backed by very strong research.  As we can’t see the pelvic floor muscles, they need to be specifically assessed, and the exercises individually prescribed. Some women can’t actually contract their muscles correctly so it’s not a one size fits all situation.  

 

Pelvic floor physios also provide lifestyle advice such as reducing straining when having a bowel motion to help take pressure off the pelvic organs. Physio’s can also fit a support device called a pessary. We help women modify the way they do some things at home or work, and provide advice for keeping fit without making their prolapse symptoms more bothersome, enabling women to live full lives.

 

Heightened levels of stress, worry and thinking a lot about the prolapse may also exacerbate a woman’s prolapse symptom experience, so it is important to find out what women are experiencing in this respect, and provide education and emotional support. 

 

Improving how well the pelvic floor muscles work increases the support of the pelvic organs and reduces the sensations women experience.  If women improve their pelvic floor muscle strength, they can improve the position of a mild to moderate POP, and completely reduce the sensations of heaviness or bulge.  If they stick to their program, it will also prevent the prolapse from coming back in the future.

 

This is SO IMPORTANT. The earlier prolapse is treated the better the long-term results.  The longer women delay seeking treatment, the more stretch happens in the supporting structures that hold up the bladder, bowel and uterus, which cannot be reversed.  Seeking help early is the key! 

 

At Women’s & Men’s Health Physiotherapy, we have helped thousands of women get rid of prolapse symptoms, and get back into doing the things they love.  Prolapse is very treatable, so don’t put up with it.  We really encourage you to do something about it, it doesn’t have to be a drag anymore.