What is a prolapsed uterus?

A prolapse occurs when the ligaments that hold the pelvic organs in place are stretched. 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.

What causes 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.

Prolapsed uterus symptoms

Women who have a prolapse may feel:

• 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.

Diagnosis and treatment of prolapsed uterus

If 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.

The treatment suggested will depend on the type and extent of the prolapse.

Some women will be asked to do exercises to strengthen the pelvic floor muscles, and be advised how to take care not to make the prolapse worse.

Some women will be advised to take oestrogen treatment. Some will be offered a ring pessary, which is a small disc put high in your vagina as a support.

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

Prolapsed uterus prevention

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