Millions of women suffer with pelvic organ prolapse, and millions more are at risk — but few women understand what prolapse really is.
What is cystocele? What is rectocele? What does it mean that my uterus is prolapsed? What does pelvic organ prolapse mean for my health? What does prolapse mean for my sex life?
What’s happening in your body when you have prolapse? When you feel that “something’s not right down there,” what are you feeling? If your doctor has told you that you have prolapse, but you feel normal, what’s going on?
The word “prolapse” means that something in the body has moved out of its proper position. Pelvic organ prolapse means that one (or more) of your pelvic organs — your bladder, uterus, or rectum — has literally fallen out of its proper place in your body. Sometimes people describe prolapse as a “fallen” or “dropped” bladder, uterus, or rectum.
Prolapse happens when your pelvic organs lose support. Your pelvic organs are supported in two ways.
They’re held up from the sides and the top by ligaments. The ligaments are like ropes and sheets attached to your pelvic organs, connecting them to each other and to other parts of your body to hold them in place.
Your pelvic organs are also supported, from behind and below, by the bowl of muscle called the pelvic floor. If the ligaments, or pelvic floor, or both, are not doing their job of supporting the pelvic organs, pelvic organ prolapse is the result.
Three Types of Pelvic Organ Prolapse
There are three types of pelvic organ prolapse, because there are three pelvic organs that can be involved. Bladder prolapse is called cystocele. A prolapsed rectum is called rectocele. A prolapsed uterus is simply called a prolapsed uterus, or uterine prolapse.
A woman may have just one type of pelvic organ prolapse, or more than one. With each type of prolapse, whether it’s the bladder, rectum, or uterus that has prolapsed, the organ falls out of place and takes up space inside the vagina. With uterine prolapse, the cervix (the “neck” of the uterus) is lower in the vagina than normal, or the uterus itself can descend into the vagina. With bladder prolapse or rectal prolapse, the bladder or rectum creates a bulge in the vagina, but the organ itself is covered by the vaginal wall.
What Does Pelvic Organ Prolapse Feel Like?
With all types of pelvic organ prolapse, women often describe a heavy, aching, sagging, or “dragging” feeling in the pelvis. Some women with more severe prolapse have the sensation of something coming out of the vagina, or feel “like I’m sitting on something.”
If you have a cystocele (prolapsed bladder), you might have trouble emptying your bladder completely. Try shifting your position on the toilet after you urinate to empty the bladder more. You can also try “double voiding”: After you pee, wait a few minutes, and try to pee again. You’ll often be able to empty your bladder more completely that way.
With a rectocele, you may have trouble moving your bowels. “Splinting” can help. While you’re moving your bowels, use two fingers to push on your perineum (the skin between your vagina and your anus), or place two fingers inside your vagina to hold the rectum in place. I know, you’d rather not have to do that, but it can help you avoid constipation. And besides the obvious discomfort, constipation can be a real problem for prolapse. Pushing hard on the toilet can actually cause prolapse, or worsen the prolapse you already have.
Problems with sex are common too. A lot of women, or their partners, are afraid to have sex. Sometimes prolapse can make sex physically or psychologically uncomfortable, but as long as partners keep communication open and follow a few basic safety and comfort guidelines, you can still have safe, satisfying sex even when you suffer with prolapse. For most couples, the fear of having prolapse-related problems with sex is worse than any actual physical problems the prolapse may cause.
How Bad Is My Prolapse?
Prolapse can be mild or severe. With mild prolapse, you might not even realize you have prolapse at all. When prolapse is mild, the cervix, or the bulge of cystocele or rectocele, is smaller and farther up inside the vagina. When prolapse is more severe, the bulge or cervix goes all the way to the opening of the vagina. In the most severe cases, the cervix or bulge protrudes out from the vaginal opening — not only taking up space in your vagina, but taking up space in your underwear.
Will your prolapse get worse? If you have prolapse, this can be a terrifying question. The good news is that there’s a lot you can do to stabilize your prolapse. You may even be able to reverse your prolapse and relieve your symptoms — all without the dangers and pain of surgery.
What Do I Do Now? Do I Have to Have Surgery for My Prolapse?
Your doctor may tell you that surgery is your only option. In reality, surgery is by far the most dangerous, and the most expensive, option for treating prolapse — and for up to half of women who have the surgery, the surgery fails. If your doctor says you need surgery, this quick article is a must-read.
Prolapse can be a terrifying problem. You may wonder if it’s possible to ever feel normal again. But many women can relieve prolapse symptoms, or even reverse prolapse partially or entirely. Even if you’re afraid now that you can never again be physically active, or enjoy sex, or just feel comfortable and normal, there is hope. Join this webinar to find out more about non-surgical prolapse care that can work for you.