A prolapse is where part of the body has moved from its original position. In gynaecology, “prolapse” usually refers to the uterus (womb) starting to come down through the vagina (uterovaginal prolapse).

It can also mean the bladder (cystocele) or bowel (rectocele) has moved and is pressing on the vaginal walls.

Main causes:

• Overstretching of the vaginal tissues and supporting structures, usually at childbirth
• Straining to empty bowels
• Persistent coughing

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Signs & Symptoms

• A feeling of something coming down
• A dragging or heavy sensation either vaginally or deep within the pelvis, that worsens as the day progresses
• A bulging in the vagina (made worse by squatting)
• A protrusion from the vagina
• Difficulty or pain with intercourse

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How to Help

• Pelvic floor exercises: Strengthen the pelvic floor muscles which support the pelvic organs
• Avoid heavy lifting: This strains the pelvic floor further
• Weight reduction: Extra weight places greater strain on the already stretched pelvic floor
• Stop smoking: A smoker’s cough will continue to damage the pelvic floor
• Avoid constipation: This may mean a change in diet or learning the correct way to empty your bowels

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Managing Prolapse

Current research shows that most mild to moderate prolapse can be managed by assessment and input from a specialist physiotherapist.

• You will be given general advice and specific pelvic floor exercises
• Some women are fitted with a special pessary (a plastic device) to support the bulge
• In a few cases, surgery may be required
• In all cases, it is important to have good pelvic floor muscles