Prolapsed uterus
The uterus, or womb, is said to be prolapsed when it is downwardly displaced from its normal position. That is, it has descended down the vagina closer to the vaginal opening, occasionally even protruding through it.
This condition is very common, and while it may not necessarily cause symptoms, a prolapsed uterus (also called uterine prolapse) can have a negative impact on a woman's physical and sexual activity as well as her quality of life.
Causes of prolapsed uterus
These include:
- Childbirth, which is probably the single biggest risk factor for developing a uterine prolapse. This risk is increased if the baby delivered was large, if there was a prolonged pushing stage during childbirth and if the delivery involved the use of forceps or resulted in a third-degree tear.
- Low levels of oestrogen following menopause, which can result in the deterioration of the muscles, ligaments and connective tissue that hold the uterus in place. The weakening and deterioration of these tissues can be prevented, and possibly reversed, with oestrogen therapy.
- Increased pressure within the abdomen, which often occurs with constipation, chronic cough, obesity and frequent heavy lifting.
Symptoms of prolapsed uterus
The most common symptom of uterine prolapse is the awareness of a ‘heaviness’ in the vagina and a sensation of ‘something coming down’. Sometimes a woman can feel a distinct lump or bulge in her vagina or even have tissue protruding through the vaginal opening. There is often associated backache.
These symptoms usually improve when lying down and are less noticeable in the morning, getting worse during the course of the day or after exertion.
Uterine prolapse may also cause urinary problems such as difficulty passing urine, problems holding urine or frequent urinary tract infections. It might also cause pain on sexual intercourse. Occasionally, it can also interfere with bowel movements.
Treatment
If there are no symptoms from the uterine prolapse, then treatment is generally not required.
Women with mild symptoms should avoid anything that makes the condition worse, such as heavy lifting or constipation. Oestrogen therapy, usually in the form of a cream or pessary, may also be beneficial. Pelvic floor exercises are often useful in alleviating symptoms and preventing the prolapse from becoming worse.
Uterine prolapse can also be treated with a vaginal ring pessary. The device, shaped like a doughnut, is individually fitted and positioned to prop up the cervix and the uterus. The pessary needs to be removed and cleaned or changed every 4 to 6 months.
Women with a prolapsed uterus often require surgery, especially when other treatment options have failed. Prolapse can recur after surgery, with either the same or a different type of prolapse, but in more than 80 per cent of cases surgery is curative.
Last Reviewed: 17 June 2005
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