As we age, our bodies have a way of reminding us that gravity is not on our side. This is especially true for the many women who experience pelvic prolapse, which occurs when muscles and tissues from organs inside the pelvis (uterus, rectum, bladder, etc.) weaken and protrude through the vaginal opening. Essentially, a prolapse is a hernia that extends into the vagina.
Although this sounds alarming, it is also a common, highly treatable condition that affects about 50% of women.
“Pelvic prolapse is a very normal condition, and it's nothing to be embarrassed or ashamed about,” says Jolyn Hill, MD, a urogynecologist and associate professor in the Department of Obstetrics and Gynecology at University of Utah Health. “Urogynecologists are trained to take care of this problem specifically, so I want to encourage anyone who's feeling discomfort to get help.”
Is My Leaky Bladder a Sign of Pelvic Prolapse?
If you feel a constant need to urinate or have difficulty holding it, there's a good chance your symptoms could be caused by a UTI or a pelvic floor disorder that isn't a prolapse. Hill notes that women with a prolapse often experience one obvious symptom: the feeling of a bulge between their legs. In many cases, the signs are subtle, and women aren’t even aware they have a prolapse.
“When women notice a bulge, it can be very alarming and scary. I’ve seen many of them rush to the ER fearing they have cancer. It’s always a relief when they’re assured that this is a common condition that can be fixed with treatment.”
Who’s Most at Risk?
Pelvic prolapse is most common among women who have given birth as well as older women (ages 60 and up). Other risk factors include genetics and chronic conditions that strain the body, such as constipation and chronic coughing. Yet, despite these factors, little is known about the exact cause of prolapse because it can occur randomly.
“We know how to deal with pelvic prolapse, but we need more research to explain why it happens,” Hill says. “This could happen to a woman who's never given birth, and it could completely skip another woman who has given birth to 10 babies. The same goes for older women. I've had patients in their 90s who have never experienced prolapse.”
What Are My Treatment Options?
If you’re dealing with daily bother and discomfort, book an appointment with your doctor to explore treatment options, which may include:
- Structural Devices (Pessary): A pessary is a medical device inserted into the vagina to support the uterus, vagina, bladder, or rectum.
- Pelvic Floor Physical Therapy: Patients are given various exercises, such as Kegels, to strengthen their pelvic floor.
- Surgery: Surgery can treat bothersome or persistent and/or worsening prolapse symptoms.
Get it Out in the Open
If this information surprises you, you're not alone. That's why it's important to share your experiences with friends and loved ones so they won't panic if this happens to them. The good news is, this is not a life-threatening condition, and many women can live their lives unbothered by a prolapse.
“Depending on the severity of the prolapse, sometimes people don't need treatment at all,” Hill says. “But if it's affecting your quality of life, I encourage you to seek treatment because there's no reason to suffer through it alone.”
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