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.

Causes

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.

Symptoms

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.

Prevention

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

Treatment

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.

Sources:

https://www.hopkinsmedicine.org/health/conditions-and-diseases/uterine-prolapse

https://www.mayoclinic.org/diseases-conditions/uterine-prolapse/symptoms-causes/syc-20353458

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