Pelvic prolapse occurs when the muscles supporting the pelvic organs become too weak to hold them in place and they gradually work their way down, causing discomfort and many other problems. Doctors consider damage during childbirth to be one of the most common causes, but the damage done then does not show up until many years later, usually after menopause, although some younger women do suffer from it enough to need surgery.

Prolapse can still happen even if you have never had a baby or if you have had a hysterectomy. Other causes of prolapse can be chronic coughing and lifting heavy weights such as a full laundry basket or packed shopping bags. Straining from chronic constipation is another cause.

Many women have mild prolapse with no symptoms – or only very mild symptoms that don’t worry them. However, it is possible that the condition will slowly progress over time until surgery is required to fix it. For these women, doing pelvic floor exercises to strengthen the weakened muscles will delay the need for further intervention, sometimes for many years.

Different types of prolapse

Symptoms of pelvic prolapse vary and not all women suffering from it will experience the same symptoms. Much depends on how bad the prolapse is and what type it is. There are 3 types:

• Cystocele, where the organs bulge through the front wall of the vagina;
• Rectocele, or enterocele where they bulge through the back wall of the vagina and
• Uterine, where the uterus drops into the vagina. In some cases more than one organ can drop into the vagina.

Symptoms of prolapse

Usually, women with prolapse that is considered medium to severe will experience at least some of these symptoms.

1. Severe constipation with small, hard stool.
2. Vaginal bleeding or spotting
3. Painful intercourse
4. Slow passing of urine with weak stream or difficulty in emptying the bladder. Some women suffer from incontinence.
5. Painful, dragging pressure in the vagina, lower abdomen and/or lower backache
6. A feeling that internal organs are going to fall out through the vagina, or a lump in the vagina.
7. Recurring urinary tract infections
8. A lump that bulges right outside the body causing soreness and bleeding due to friction with underwear.

Often such symptoms become worse as the day progresses, but can be relieved if you lie down.

How to prevent prolapse

Preventing prolapse is better than enduring it. Sadly, many women never give much thought to the health and strength of their pelvic floor and unwittingly hasten the onset of prolapse. Simple lifestyle changes can prevent this condition, or minimise it if the muscles were damaged during childbirth. Here are some tips for prevention: –

• Coughing causes the muscles in the pelvic floor to contract and chronic coughs can weaken it further. So, avoid chronic coughs by seeing your doctor early and having it treated. Asthmatics should ensure their condition is properly cared for.
• Avoid chronic constipation as the straining can stretch and weaken the pelvic floor muscles.
• Have a diet high in fibre
• Drink plenty of liquids so that the fibre works properly.
• Avoid high impact exercise such as weightlifting or jogging that can strain the pelvic floor muscles.
• Keep your weight down as being overweight is a contributing factor.
• Do low impact exercise such as walking, swimming or cycling.