Up to 50% of women will develop a pelvic organ prolapse, which occurs when either the bladder, uterus, gastrointestinal tract, or bowel loses its muscle and connective tissue support and falls into the vaginal wall. It is popularly believed to happen only to those women who have been pregnant and had a vaginal delivery but in reality, any woman can have a prolapse. Prolapses vary in size and are graded on a scale of 1 to 4, with four being the most severe. A woman may have one or more prolapses at the same time and the position of the prolapse can vary throughout the day, depending on whether she is standing, lying down or sitting.
Activities that may worsen symptoms include:
- Heavy lifting
- Coughing
- Straining with a bowel movement
- Being on one’s feet for long periods of time
Pelvic organ prolapses have different names, depending on the organ involved:
- bladder: cystocele or anterior vaginal prolapse
- uterus: uterine prolapse
- rectum: rectocele or posterior vaginal prolapse
How would I know if I have a prolapse?
Symptoms of a prolapse include:
- feelings of heaviness or bulging from the vagina
- heaviness in the lower abdomen
- leaking from the bladder or bowel (incontinence)
- urgency or frequent trips to the bathroom for bladder or bowel
- frequent urinary tract (bladder) infections
- painful sex
Is it safe to have sex with a prolapse?
Many women (and their partners) are concerned that further damage will be done if they have insertional sex, but this is not true. Although some women with a prolapse may find sex uncomfortable, altering positions can often improve sensation and experience. Discomfort during sex can also be due to other factors such as vaginal dryness related to menopause. Try changing positions and/or adding a lubricant to your intimacy and see how you feel!