What is uterine prolapse?

Uterine Prolapse

Uterine prolapse happens when the pelvic floor muscles and tissues stretch and weaken. There’s not enough support for the uterus, which makes it drop down and protrude out of the vagina. In some cases, it may come out of the vaginal opening.


Uterine prolapse is caused by the weakening of pelvic muscles and supportive tissues.

Here are some factors that can affect the strength of pelvic muscles and tissues:

  • Being overweight or obese
  • Chronic constipation or straining with bowel movements
  • Chronic cough or bronchitis
  • Repeated heavy lifting
  • Pregnancy
  • Having a difficult labor and delivery
  • Trauma during childbirth
  • Delivery of a large baby
  • Lower estrogen level after menopause

Any woman can experience uterine prolapse regardless of age. However, it’s more common among postmenopausal women who’ve had one or more vaginal deliveries.


Mild uterine prolapse often doesn’t show signs and symptoms. For moderate to severe cases, symptoms may include:

  • A pulling sensation or heaviness in your pelvis
  • Aching or pressure in your lower abdomen or pelvis
  • Feeling as if you’re sitting on a small ball or as if something is falling out of your vagina
  • Muscle tissue protruding from your vagina
  • Urinary problems, such as urine leakage (incontinence) or urine retention
  • Constipation and other bowel movement issues
  • Lower-back pain
  • Sexual concerns, such as a sensation of looseness in the tone of your vaginal tissue

Risk factors and complications

Risk factors for uterine prolapse are:

  • Giving birth (this poses the highest risk, especially if you’ve given birth to a large baby)
  • Normal vaginal delivery (compared to cesarean section)
  • One or more pregnancies and normal vaginal births
  • Aging
  • Menopause
  • Obesity
  • Prior pelvic surgery
  • Chronic constipation or frequent straining during bowel movements
  • Family history of weakness in connective tissue

Uterine prolapse may lead to prolapse of other pelvic organs. These are:

  • Anterior prolapse (cystocele), where the bladder bulges into the vagina
  • Posterior vaginal prolapse (rectocele), where the rectum bulges into the vagina

Severe uterine prolapse may also displace parts of the vaginal lining and cause it to protrude out of the body. If the vaginal tissue rubs against clothing, it may lead to vaginal sores.


To reduce your risk for uterine prolapse, you should:

  • Do Kegel exercises regularly
  • Treat and prevent constipation
  • Control and treat coughing, and avoid smoking
  • Maintain a healthy weight


Most cases of mild uterine prolapse don’t need treatment. But when symptoms bother you and cause discomfort, it’s best to see your doctor to discuss treatment options.

You can use a pessary, which is a device inserted in the vagina to support pelvic organs, to help alleviate symptoms.

A more permanent solution is getting a hysterectomy, an operation where the uterus is completely removed. This can be done through the vagina, and can have a shorter recovery time compared to operations that need abdominal incision.




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