Pelvic organ prolapse is treatable and shouldn't stop you doing the things you love.
Pelvic organ prolapse, also known as pelvic floor prolapse, is much more common than you might think. In fact, you probably know someone who has or has had a prolapse. If you think you might be experiencing a prolapse, you’ve got company!
According to the Continence Foundation of Australia, over half of all people who have been pregnant have some level of prolapse. Even if you haven’t had a baby can also have a prolapse, caused by things like having an ongoing cough, lifting heavy loads or straining on the toilet.
Prolapse can really effect quality of life and up to one in five people who have a prolapse will need to seek medical help. So, what should you do if you think you have a prolapse? Read on to find out.
What is a pelvic organ prolapse?
To understand what a prolapse is, first you need to understand your pelvic floor and the way it functions in your body.
In the female body, the pelvic organs—bladder, uterus, large intestine and rectum—are held in place in the pelvis by fascia and ligaments. The pelvic floor muscles are a ‘sling’ of muscles that support these organs from beneath.
If you have weak, torn or damaged fascia, ligaments or muscles, your pelvic floor might not be able to support your organs properly. The pelvic organs can then bulge down into the vagina, or rectum, which is called a prolapse.
A prolapse can occur at the front wall of the vagina, which can cause bladder symptoms, the back wall of the vagina, which can have bowel symptoms, or you can have a uterine prolapse, where the uterus prolapses downwards into the vagina.
Who has prolapses?
A lot of people experience prolapse at some point in their lives. While more common in those who have gone through menopause, it is possible to have a prolapse at any time, including soon after giving birth.
Signs and symptoms of pelvic organ prolapse
Prolapses will affect different people in different ways, depending on the cause of their prolapse and their body. Signs and symptoms of prolapse depend on where it is occurring and how much support has been lost.
Symptoms of prolapse can include:
- a heavy sensation or dragging in your vagina
- the feeling of something ‘coming down' or a lump in your vagina
- a lump bulging out of your vagina, which you see or feel when you are in the shower or having a bath
- sexual problems, including pain during or after sex or less sensation
- a bladder that doesn’t empty as it should, or a weak urine stream
- reoccurring urinary tract infections
- difficulty emptying your bowel.
Risk factors for having a prolapse
There are a lot of risk factors for prolapse. You might be at higher risk of having a prolapse if you have:
- given birth vaginally
- given birth aided by forceps
- given birth to an infant with a high birth weight
- had a hysterectomy (womb/uterus removal surgery)
- a family history of prolapse
- a connective tissue disorder
- gone through menopause.
Your age and weight can also play a role in your prolapse risk, as can conditions like chronic constipation or cough.
How do I know if I have a prolapse?
If you think you might be experiencing a pelvic organ prolapse, book in to see your GP. If you’ve recently given birth, you can talk to your midwife or obstetrician. They can refer you to a doctor who specialises in female reproductive health called a gynaecologist.
Gynaecologists use a grading system to measure prolapse degree called the POP-Q system.
- Stage 1: The wall/organ protrudes a little way into the vagina
- Stage 2: The wall/organ protrudes close to the vaginal opening
- Stage 3: The wall/organ protrudes out of the vagina
To find out if you have a prolapse and how it is affecting your body, your gynaecologist might order some tests. Tests that may be conducted include pelvic ultrasound, tests of bladder function, bladder ultrasound, and urine tests.
How is pelvic floor prolapse managed and treated?
The good news is that once diagnosed, a pelvic organ prolapse and its symptoms can be managed.
Management and treatment can include:
- physiotherapy and pelvic floor muscle training (for more information on pelvic floor exercises, read our article: How to find and exercise your pelvic floor muscles)
- lifestyle changes, such as weight loss, improved diet, fluid intake and exercise, and learning good bowel and bladder habits
- pessaries (a plastic or rubber device that fits into the vagina) can be fitted to provide internal support
- surgery to repair stretched or torn tissue and ligaments.
What should I do if I think I have a prolapse?
If you think you have a prolapse, don’t be afraid to talk about it to your healthcare provider. Even if you feel a bit embarrassed by issues affecting your vagina or pelvic area, it can help to remember that this is something your doctor sees regularly. You can request a female doctor if that makes you feel more comfortable.
You don’t have to put up with symptoms of prolapse. Help is available, and the sooner you make an appointment, the sooner you can access information and treatment.