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A Guide to Female Uterine Prolapse

written by: BStone • edited by: Diana Cooper • updated: 2/28/2011

Usually caused by a combination of factors, female uterine prolapse can be a very uncomfortable condition. What is it, why does it occur and what options are available for treating a prolapsed uterus?

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    What Is Uterine Prolapse?

    The uterus is held in place by muscles and connective tissue. Over years of pressure and use and natural changes to a women's body after menopause, the tissue that was holding the uterus can become weak. As a result, a part of the uterus can slip down into the vagina, usually only part way, causing a lump or bulge in the birth canal. This is a female uterine prolapse. This condition causes many symptoms and requires lifestyle chances and possibly treatment, but for the most part it does not require surgery. If it drops even lower, possibly even protruding from the opening of the vagina, the condition is known as a complete prolapse. In this case the symptoms may be more problematic.

    A prolapsed uterus is caused usually be a series of factors. First, muscle tone decreases with age. Strengthening the pelvic floor with Kegel exercises throughout a woman's life can help maintain muscle tone. Diminished estrogen levels after menopause can also contribute to pelvic relaxation and prolapse; estrogen helps to keep pelvic muscles toned. Giving birth vaginally, especially multiple times or to larger babies, can result in injury, which can eventually lead to part of the uterus dropping. Pressure on the pelvic floor over the years can be a contributing factor as well. Constipation, chronic coughing and obesity can cause this pressure.

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    Symptoms

    Uterine prolapse is a relatively common condition, especially among older women. For many women it may be nothing more than a feeling of heaviness and the cause of symptoms that may be easy to overlook. For others a prolapsed uterus is hard to ignore. It either case, see your doctor and address your health as soon as you believe you may have a prolapsed uterus. This is a condition that can become increasingly worse and potentially require surgery.

    The following are possible symptoms of weakening pelvic muscles and prolapse of the uterus:

    • A heaviness, pressure, or weight in the pelvis, it may feel like you are sitting on a small ball
    • Pain anywhere around the pelvic area, including the abdomen and lower back
    • Pain during sex
    • Urinary tract infections
    • Increased discharge, including bleeding from the vagina
    • Incontinence problems
    • Tissue at the opening of the vagina
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    Seeing Your Doctor

    While it may be uncomfortable to see your doctor about a possible prolapsed uterus, it is important to seek medical care and advice and to rule out other possible causes of symptoms. Also, keep in mind the fact that many women deal with this condition to some degree, even if it isn't a popular topic of conversation.

    For diagnosis, your doctor will do a pelvic exam, checking to see if the uterus is out of place. It is also possible for the bladder to have fallen slightly out of place. Although very rare, your doctor will check to make sure a tumor is not the cause.

    Read on to learn about treatment choices for female uterine prolapse.

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    While lifestyle changes may be all that is necessary for female uterine prolapse, you may be interested in other treatment options as well. Find out what the possibilities are and talk to your doctor about how to take care of yourself if you have a prolapsed uterus and if surgery or other treatments are right for you.
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    Treatment Options

    How is female uterine prolapse treated? In most cases all that is necessary is more care to take your of your body. As being overweight, being constipated and excessive coughing can all put pressure on the pelvic floor, it is important to address these factors. Make a healthy, high-fiber diet a priority both to lose weight (if necessary) and to prevent constipation. Stop smoking, avoid second hand smoke and improveOatmeal  your respiratory health with deep breathing exercises and fresh air. Do Kegel exercises to improve the muscle tone of the pelvic floor. Avoid any intense lifting or straining.

    If the uterus continues to drop, if symptoms are too much to bear or if you want to have more children, you can talk to your doctor about treatment options. Surgery is a potential treatment for a prolapsed uterus, although it is only used when necessary, such as a severe case, other medical problems or to be able to have more children.

    A less risky option is to use a vaginal pessary. A pessary is inserted into the vagina and simply serves as a device to hold the uterus in place. It is made of plastic or rubber and is relatively small — your doctor will measure you to find the most comfortable size and shape for you. There are drawbacks however. Using a pessary can be uncomfortable, they can cause irritation and are not conducive to sexual intercourse. They also need to be cleaned regularly.

    Estrogen replacement therapy is a possible treatment option. Estrogen naturally acts to keep pelvic tissue strong, so hormone therapy can at least prevent uterine prolapse from worsening. On the other hand there are side effects of estrogen, such as an increased risk of blood clots, gallbladder disease, and breast cancer.

    Female uterine prolapse is not uncommon, and in fact many women will have some problems with pelvic relaxation after menopause, especially if they went through childbirth. See your doctor if you are experiencing symptoms, and both as prevention and to help treat the condition, take care of your health.

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    References

    Medicine Plus, http://www.nlm.nih.gov/medlineplus/ency/article/001508.htm

    Cleveland Clinic, http://my.clevelandclinic.org/disorders/uterine_prolapse/hic_uterine_prolapse.aspx

    Mayo Clinic, http://www.mayoclinic.com/health/uterine-prolapse/DS00700/DSECTION=treatments-and-drugs

    photo by The Culinary Geek