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Spot the Symptoms of Pelvic Organ Prolapse

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Plus, learn how you can support your pelvic floor health to prevent prolapse

Posted by Carol Ann Glowacki, MD, FACOG

As a Temple Health urogynecologist, I see many patients with pelvic organ prolapse. The condition affects about 30% of women in the United States, and while it's not life-threatening, it can have a significant impact on their quality of life. My patients often tell me their symptoms, such as urine leakage when they cough or sneeze, can be embarrassing and affect their daily lives.

I reassure my patients that treatment can help them regain control — and confidence. At Temple’s Urogynecology Program, we offer a range of options to help patients at every stage of pelvic organ prolapse.

Because many people are uncomfortable discussing problems with their bladder and pelvic organs — or don't recognize the early symptoms of pelvic organ prolapse — they may delay seeking care for the condition. Pelvic organ prolapse may worsen over time, so spotting the signs of prolapse early may make it easier to manage the condition.

Here's what I wish everyone knew about pelvic organ prolapse, recognizing the early signs, and what they can do to prevent it.

Pelvic organ prolapse is a pelvic floor disorder

Understanding the symptoms of pelvic organ prolapse helps to understand how the pelvic floor works — and what goes wrong in the case of pelvic organ prolapse.

The pelvis is a bowl-shaped structure supporting and protecting the pelvic and abdominal organs. The pelvic floor is an intricate hammock-like structure located between the hip bones. When it's functioning normally, your pelvic floor:

  • Supports your bladder, bowel, rectum, and sexual and reproductive organs
  • Allows you to move with strength and flexibility
  • Controls the sphincter muscles of the bladder and anus
  • Maintains healthy sexual functioning

When a person develops pelvic organ prolapse, the muscles and ligaments of the pelvis become stretched and weakened.

Depending on where the weakness occurs, one or more organs in the lower abdomen, such as the uterus or bladder, move down or forward from the normal position and bulge — or herniate — into and, sometimes out of, the vagina.

Many factors can cause the pelvic muscles to stretch and weaken, increasing the risk of pelvic organ prolapse. Though anyone can be affected, you may be at increased risk if you’ve experienced any of the following:

  • Pregnancy and childbirth, particularly vaginal birth
  • Giving birth to multiple babies or a baby weighing more than 8 1/2 pounds
  • Aging
  • Hormonal changes during menopause
  • Carrying excess body weight
  • Excessive heavy lifting
  • Smoking
  • Long-term health conditions that cause straining during bowel movements
  • Long-term health conditions that cause coughing
  • Family history of pelvic organ prolapse
  • Connective tissue disorders, such as joint hypermobility, Marfan syndrome, or Ehlers-Danlos syndrome

Pelvic organ prolapse symptoms start early

Because pelvic organ prolapse often gets worse over time, it's important to recognize and treat it early — while it's still what's known as mild pelvic organ prolapse. At this stage, the abdominal organs are still fairly well supported by the pelvic floor. In some cases, organs have begun to descend, but they are still contained inside the vagina.

The early symptoms of pelvic organ prolapse may be mild, but you might notice:

  • A feeling of constant heaviness, aching, or fullness in the pelvis, which may be worse after exercise, coughing, or standing for long periods
  • Constipation
  • Difficulty inserting a tampon
  • Low-back pain
  • Needing to strain or "push" to urinate, even when the bladder is full
  • Urine leakage, particularly when coughing or sneezing
  • Difficulty emptying the bladder or bowels

Symptoms may intensify as the prolapse worsens. You may feel a small bulge in the vagina or at the vaginal opening. Many of my patients describe the sensation as feeling like they're sitting on a small ball. You may even be able to feel a bulge, or see it if you examine your vagina with a mirror.

If these symptoms sound familiar, know that you don't have to live with them. A urogynecologist like the experienced experts at Temple Health can assess your condition and help you find the treatment option that's right for you.

You can reduce your risk for pelvic organ prolapse

Pelvic organ prolapse can't always be avoided, but I tell my patients that, just like they might take steps to protect their heart health, they can adopt lifestyle habits to support the health of their pelvis and help strengthen their pelvic floor. Here's what I recommend:

  • Try not to strain during bowel movements. Pushing hard can stress the pelvic muscles and make them weaker.
  • Eat a fiber-rich diet. Straining is often caused by constipation. You can make bowel movements easier to pass by eating a high-fiber diet rich in fruit, vegetables, beans, and whole grains. Drink plenty of fluids, too.
  • Limit or avoid heavy lifting. Lifting is another form of straining. When you have to lift a heavy object, make it a point to lift from your legs rather than your waist or your back.
  • Maintain a healthy weight. Carrying excess body weight can strain the pelvic muscles and increase prolapse risk.
  • Get help if you have a cough. If you have a chronic cough or bronchitis, talk with your doctor about ways to manage your cough.
  • Quit smoking. Smoking can make you more prone to chronic cough. If you're having trouble quitting, ask your doctor for help.
  • Don't push during urination. Pushing while urinating (or while having a bowel movement) can also weaken the pelvic floor muscles. Try to let urine flow naturally.

Don't delay treatment

Lifestyle strategies help prevent pelvic organ prolapse. But if you’re already experiencing symptoms, it's time to seek treatment. There are many effective options, including pelvic floor physical therapy, devices such as pessaries that can be placed in the vagina to support the pelvic organs, and, in some cases, surgery. A urogynecologist can assess your condition and recommend the option that best meets your needs. The experienced specialists at Temple Health are trained to treat these issues and help you feel comfortable talking about them.

To schedule a consultation with a Temple urogynecologist, call 800-TEMPLE-MED (800-836-7536) or request an appointment online.

Helpful Resources

Looking for more information?

Carol Ann Glowacki, MD, FACOG

Dr. Glowacki is the Director of Urogynecology and Pelvic Reconstruction Surgery at Temple University Hospital. Her clinical interests include urinary incontinence, pelvic organ prolapse and pelvic and bladder pain.

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