Uterine Prolapse: Finding a Treatment that Works for You
Uterine prolapse affects nearly half of all post-menopausal women. This is a serious health concern that often requires medical or even surgical intervention. However, there are ways to strengthen the pelvic floor muscles to help you avoid uterine prolapse later in life.
Uterine prolapse happens when the pelvic muscles and ligaments weaken and can no longer support the weight of the abdominal organs. This usually happens after the age of 50, especially in women who have given birth vaginally and gone through menopause. In this article, you’ll learn more about uterine prolapse, how to treat it, and what to avoid when doing so.
What causes uterine prolapse?
Prolapse of the uterus (or other pelvic organs) happens when weakened or damaged pelvic muscles allow the uterus to drop into the vagina. Pregnancy and childbirth make the pelvic muscles work harder than usual, but they usually recover well. However, a difficult birth or carrying a large baby can strain these muscles to excess.
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Other potential causes include:
- Drop in oestrogen after menopause
- Heavy lifting
- Constipation, forced bowel movements
- Obesity
- Chronic coughing
Additional risk factors include multiple vaginal deliveries, smoking, eating an unhealthy diet, drinking alcohol, not exercising, or doing exercises incorrectly. Caucasian and Hispanic women have the highest risk of developing uterine prolapse.
What are the symptoms of uterine prolapse?
Symptoms that may indicate uterine prolapse include discomfort sitting and walking, the feeling of ball-like tissue in the vaginal canal, difficulty urinating and defecating, discomfort during vaginal intercourse, the feeling of looseness in the vagina, pain in the lower back and/or pelvic area.
Uterine prolapse has four stages:
- Stage one—the uterus begins to drop into the vagina
- Stage two—the uterus has descended to the opening of the vagina
- Stage three—the uterus protrudes from the vagina
- Stage four or procidentia—the uterus falls out of the vagina
Treatments
To treat most cases of mild to moderate prolapse, doctors will recommend a few simple lifestyle changes. The most effective way of keeping the uterus in place is to strengthen the pelvic muscles by doing Kegel exercises. Other recommendations include avoiding lifting heavy objects, improving your diet to reduce constipation, and using stool softener rather than forcing bowel movements. More severe cases may require the help of a removable pessary device to support the pelvic floor and hold the uterus in place. In the most severe cases, a hysterectomy can be performed to remove the uterus entirely.
The leading cause of uterine prolapse is the natural weakening of the muscles as we age and the reduced production of oestrogen that comes with menopause. Oestrogen replacement therapy in the form of vaginal creams or suppositories that release moderate amounts of oestrogen into the bloodstream helps restore elasticity and makes it easier to build strength in the pelvic floor.
All women, regardless of age and childbearing experience, can strengthen their pelvic muscles to prevent uterine prolapse and incontinence later in life.
The pelvic floor
The pelvic floor is a layered sheet of muscles, connective tissue, and ligaments with openings for the anus, urethra, and vagina. The pelvic floor is suspended within the base of the pelvic cavity and is one of four muscle groups that make up your core, together with the abdominal muscles, the back muscles, and the diaphragm.
The pelvic floor has five important functions: to support the abdominal organs (bladder, uterus, rectum); to help stabilise the pelvis and lower back; to control the urethra and anal sphincter preventing leakage of urine, faeces, and gas; to facilitate blood flow and vaginal contractions during sex and orgasm; and to help pump blood back to the heart.
Most people don’t think about their pelvic floor until there is a problem, but like any other muscles, these can be trained and strengthened.
Kegel exercises
Kegel exercises are done as short sets of squeezing and releasing the pelvic muscles to build strength and elasticity. Once you know what you’re doing, you can do them anytime, anywhere (and no one will even notice). The stronger these muscles are, the less likely you are to experience uterine prolapse and you will benefit from greater core strength, more powerful orgasms, more satisfying sex, an easier time giving birth, and speedier postpartum recovery. For men, strengthening the pelvic muscles can help prolong sex and improve control of ejaculation.
If you aren’t sure which muscles to contract or how they feel, think of squeezing any of the openings between your legs—stopping the flow of urine in the middle of a wee, squeezing your anus to keep from farting, or you may want to try squeezing a finger inside your vagina to feel the pressure that way. The pelvic floor muscles are intertwined and work together; as you contract the muscles you should feel them pulling upward and inward.
Once you have located the muscles, try doing a set of Kegels:
- Squeeze the pelvic floor muscles slowly and deliberately for a count of eight.
- Relax completely for a count of eight—this is just as important as the squeezing.
Remember, when you are squeezing the pelvic floor, breathe normally and keep your butt and thighs relaxed. Repeat steps 1 and 2 eight times.
If your muscles don’t feel strong enough for eight seconds, start with three repetitions of 3-second Kegels and slowly build strength over time. To allow the rest of your body to relax, you can start by lying on your back with your feet on the ground and your knees bent. When you get used to the exercise, you should be able to do it whenever and wherever you like.
If eight seconds seems easy, build up to twelve. You can do multiple sets of Kegels every day.
If you feel pain in the vagina or pelvis while doing Kegels, it may be the sign of a urological problem, a gynaecological disorder, or an STD, and you should definitely see a doctor for a diagnosis.
Kegel balls and other devices
There is a variety of devices on the market to help you tone the pelvic muscles, although you can maintain sufficient muscle tone with the simple squeeze and release exercise.
Do a little internet research and you will find that vaginal weights come in many different shapes and materials and go by many different names including geisha balls, ben-wa balls, rin-no-tama, jade eggs, yoni eggs, and orgasm balls. Many new age gurus swear by the benefits of the yoni egg or similar devices for pelvic health and feminine energy, but there is little evidence for spiritual benefits beyond the confidence one feels having well-toned muscles.
You can use the pelvic floor weights lying down to start if that seems easiest, but they provide a greater challenge in an upright position. In a sitting position you can try to move the balls back and forth or simply squeeze and release. In a standing position (feet shoulder width apart), the balls will fall out unless you are contracting your muscles. A squatting position (which can also be done with your back against the wall) combines the challenges of sitting and standing, but because your leg muscles will be working it also takes more concentration not to assist with your glutes and thighs.
If you are interested in working with Kegel balls or some other type of vaginal weights, there are two important things to keep in mind:
- The device should be made of a material that is safe to insert into your body and not abrasive or breakable. Many of these devices are coated with a smooth, non-porous, body-safe silicone that is easy to clean.
- The device should be easy to remove, for example with a protruding bar or cord that is also non-porous and easy to keep clean.
Yoni eggs are usually made of jadeite, nephrite, and similar minerals. Although they may look and feel smooth, the surface of such stones is porous enough for bacteria to grow and cause infections, and they are difficult to sterilise properly before each use. Using a yoni egg that has not been cleaned properly can cause bacterial vaginosis or a vaginal yeast infection. If the egg gets stuck, you might also damage your vaginal walls by trying to take it out.
Gamify your coochie
There’s an app for that! Actually, there are many apps on the market these days to help you gain and maintain muscle tone in your pelvic floor. Some are simple and provide just a little instruction and send you daily reminders, while others come with internal sensors, audio visual guides, and customizable exercise plans. Now we even have apps that can be paired with devices to give you biofeedback readings in real time as you play games on your phone or tablet by squeezing your pelvic floor muscles. Now that’s a great workout!
Final thoughts
Uterine prolapse is an uncomfortable condition that affects nearly half of all women over the age of 50. Fortunately, there are simple steps that can be taken to reduce the problem or avoid it altogether. Once you understand how they work, Kegel exercises are easy to do and can be done anytime and anywhere. The biggest hurdle for many of us is to remember to do them. To help yourself establish a regular Kegel routine, try associating something else that you do regularly every day with doing a set of Kegels such as brushing your teeth, feeding the cat, or answering your phone. You will be happy you did.
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