What is a prolapsed uterus?

Prolapsed uterus (also called uterine, or pelvic organ prolapse) is when the uterus falls down towards the vaginal opening.

A prolapse occurs when the ligaments that hold the pelvic organs in place are stretched or weakened. Without the support, the uterus can drop forward. If it drops forward all the way into the vaginal passage, it is called a prolapse.

Doctors use a grading system to describe how far the uterus has dropped — grade 1 is mild, grade 2 is moderate and grade 3 is severe.

In some women, the bladder and bowel can also prolapse. If the bladder bulges into the front wall of the vagina, it is called a cystocoele. If the bowel bulges through the back wall, it is called a rectocoele.

Prolapse usually worsens without any treatment, so it’s important to seek medical help.

What are the symptoms of a prolapsed uterus?

Women who have a prolapse may feel:

• an inability to completely empty the bladder or the bowel when going to the toilet
• straining to get urine flow started, or to empty the
• a sensation of heaviness or dragging in the pelvis or vagina
• a lump or bulge in, or out of, the vagina
• bowel or bladder problems
• pain during sex
• lower back pain

What causes a prolapsed uterus?

Childbirth is the main cause of prolapse, and is due to the baby stretching and tearing support tissues as it passes down the vagina. Other causes include:

• prolonged constipation
• repetitive heavy lifting
• chronic coughing

Women are more likely to have a prolapse after menopause than before it. Prolapse tends to run in families, and is also more common in women who are overweight.

How is a prolapsed uterus diagnosed?

If you think you might have a prolapse, your doctor will talk to you and examine you. You will need to have an internal examination. You may also be asked to have tests like ultrasounds and urine tests.

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How is a prolapsed uterus treated?

The treatment suggested will depend on the type and extent of the prolapse. Whatever the course of action, it is important that you do something about the issue or your symptoms are likely to get worse.

In some women, strengthening the pelvic floor muscles and changing their daily activities may be all that is needed.

Some women may be offered a ring pessary, which is a small disc put high in your vagina as a support.

In severe cases, women will be advised to have surgery to repair weakened tissues, insert synthetic meshes to replace damaged tissues, or remove the uterus entirely (hysterectomy).

Can a prolapsed uterus be prevented?

You can reduce your risk of prolapse through:

• regular pelvic floor exercises
• regular physical activity
• avoiding heavy lifting
• eating high fibre foods and drinking plenty of fluid (to prevent constipation)
• achieving and maintaining a healthy weight
• not smoking