Definition

Vaginal prolapse is the inward and downward bulging of the vaginal walls.

Causes

Vaginal prolapse is caused by weakened support structures in the pelvis. This causes the walls of the vagina to weaken, sag, and collapse.

Pelvic Floor Muscles and Organs

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Risk Factors

This problem is more common in older women after menopause. Other things that may raise the risk are:

• Multiple vaginal deliveries
• Obesity
• Straining caused by chronic cough, constipation, or heavy lifting

Symptoms

Problems may be:

• Pelvic pressure, heaviness, or pain
• Pain during sex
• Tissue that slips or extends past the vagina
• Vaginal discharge
• Problems passing stool
• Problems passing urine, such as urgency and frequency
• Low backache that is relieved with lying down

Diagnosis

You will be asked about your symptoms and health history. A physical exam will be done. A pelvic exam will also be done. This is often enough to make the diagnosis.

Treatment

Some women may not need to be treated. The goal is to ease symptoms in those who do need to be treated. This can be done with:

• Kegel exercises to strengthen the pelvic floor muscles
• Estrogen therapy to prevent further weakness of the pelvic floor
• A device placed in the vagina to prop up the uterus and bladder

Women with severe symptoms may need surgery. It can help repair the pelvic floor structures.

Prevention

The risk of vaginal prolapse may be lowered by:

• Staying at a healthy weight
• Limiting heavy lifting
• Avoiding constipation
• Doing exercises to strengthen the pelvic floor