Feeling Pressured Lately? It May Be Pelvic Organ Prolapse


If getting through your day includes bouts with pressure on your lower regions, you may be experiencing pelvic organ prolapse, a type of pelvic floor disorder. And you’re not alone. Pelvic floor disorder or similar conditions affect about one-third of all women throughout their lifetime.

So what are the symptoms of pelvic organ prolapse and what can you do about them? Dr. Eileen Farwick[Office1] , board-certified urogynecologist with Winnie Palmer Hospital for Women & Babies, explains.

A Little Background, Please

The "pelvic floor" is a group of muscles and tissues that form a kind of hammock across your pelvic opening, keeping the pelvic organs in place. These organs include your bladder, uterus, vagina, small bowel and rectum. "Prolapse" refers to a descending or drooping of any of these pelvic floor organs.

For some women, prolapse affecting these muscles and tissue can start as a mild discomfort and grow into a more serious condition.

How Do I Know If I Have Pelvic Organ Prolapse?

Many women who have pelvic organ prolapse do not even have symptoms. For those who do, the most common symptom is the pressing of the uterus or other organs against the vaginal wall. This pressure on your vagina may cause minor discomfort or problems in how your pelvic organs function. Symptoms of pelvic organ prolapse include:

  • A feeling of pelvic pressure
  • A feeling as if something is actually falling out of the vagina
  • A pulling or stretching in the groin area or a low backache
  • Painful intercourse
  • Spotting or bleeding from the vagina
  • Urinary problems, such as involuntary release of urine (incontinence) or a frequent or urgent need to urinate, especially at night
  • Problems with bowel movements, such as constipation or needing to support the back (posterior) of the vaginal wall to have a bowel movement

Standing, jumping and lifting can make these symptoms worse, while discomfort is usually relieved by lying down.

What Causes Pelvic Organ Prolapse?

The pelvic organs are kept in place by a group of muscles and connective support tissue that lines the pelvic floor creating the pelvic diaphragm. The vagina, rectum and urethra pass through this group of muscles to exit the body. These organs lean against each other and are loosely connected to one another, adding additional support.

It has been shown that pelvic organ prolapse usually occurs due to several factors coming together at one time. Failure of muscle and tissue support can occur in single or multiple areas within the vagina. The name of the prolapse is associated with the tissue involved. For example; failure of the front wall of the vagina where the bladder rests is called a cystocele; failure of the back wall of the vagina that rests against the rectum is called a rectocele; and the falling of the top of the vagina where the uterus attaches is called a uterine prolapse.

The most common conditions that contribute to prolapse are listed below but are not in any particular order of frequency:

Hysterectomy before menopause. Studies have shown that removal of the uterus before menopause may have a negative effect on the support of the bladder, rectum, or vaginal connective tissue.

Pregnancy alone can stretch and damage support tissue and the nerves that go to the muscles of the pelvic floor, causing an increased risk of prolapse in the future. Delivery method, such as vaginal delivery versus caesarian section, as well as the size of babies delivered, can all contribute to increased risk of prolapse. That is not to say that women who have never been pregnant do not get prolapse. They can, due to other factors involved.

Lower estrogen levels that occur at menopause contribute to the increase in frequency of prolapse as we age. Estrogen helps with blood flow to all tissues and production of collagen. Collagen is the protein that enables the support tissue to stretch and return to normal position. As estrogen levels go down, pelvic tissue becomes less elastic and can tear.

Other factors that influence the risk of prolapse are obesity, chronic constipation, chronic cough due to lung disease, chronic heavy lifting and genetic predisposition.

Wait…That’s Happening to Me

If you are experiencing any of the symptoms of pelvic organ prolapse, it would be wise to talk with your doctor. Pelvic organ prolapse may be a progressive condition, gradually getting worse and causing more severe symptoms. According to Dr. Farwick,   “many cases of pelvic organ prolapse, do not progress and may actually improve with early intervention, such as pelvic floor therapy and other treatments.”

It’s worth checking out because, really, who needs all that added pressure?

To learn more about pelvic organ prolapse or to find a physician specializing in treatment of pelvic organ prolapse visit WinniePalmerHospital.com/pelvicfloor.