Prolapsed Uterus Overview
Your uterus (or womb) is normally held in place inside your pelvis with various muscles, tissue, and ligaments. Because of childbirth or difficult labor and delivery, in some women these muscles weaken. Also, as a woman ages and with a natural loss of the hormone estrogen, her uterus can drop into the vaginal canal, causing the condition known as a prolapsed uterus.
- Muscle weakness or relaxation may allow your uterus to sag or come completely out of your body in various stages:
- First degree: The cervix droops into the vagina.
- Second degree: The cervix drops to the level just inside the opening of the vagina.
- Third degree: The cervix is outside the vagina.
- Fourth degree: The entire uterus is outside the vagina. This condition is also called procidentia. This is caused by weakness in all of the supporting muscles.
- Other conditions are usually associated with prolapsed uterus. They weaken the muscles that hold the uterus in place:
- Cystocele: A herniation (or bulging) of the upper front vaginal wall where a part of the bladder bulges into the vagina. This may lead to urinary frequency, urgency, retention, and incontinence (loss of urine).
- Enterocele: The herniation of the upper rear vaginal wall where a small bowel portion bulges into the vagina. Standing leads to a pulling sensation and backache that is relieved when you lie down.
- Rectocele: The herniation of the lower rear vaginal wall where the rectum bulges into the vagina. This makes bowel movements difficult, to the point that you may need to push on the inside of your vagina to empty your bowel.
Prolapsed Uterus Causes
The following conditions can cause a prolapsed uterus:
- Pregnancy/multiple childbirths with normal or complicated delivery through the vagina
- Weakness in the pelvic muscles with advancing age
- Weakening and loss of tissue tone after menopause and loss of natural estrogen
- Conditions leading to increased pressure in the abdomen such as chronic cough (with bronchitis and asthma), straining (with constipation), pelvic tumors (rare), or an accumulation of fluid in the abdomen
- Being overweight or obese with its additional strain on pelvic muscles
- Major surgery in the pelvic area leading to loss of external support
Other risk factors include:
- Excess weight lifting
- Being Caucasian
Prolapsed Uterus Symptoms
Symptoms of a prolapsed uterus include:
- A feeling of fullness or pressure in your pelvis (you may describe it as a feeling of sitting on a small ball)
- Low back pain
- Feeling that something is coming out of your vagina
- Painful sexual intercourse
- Difficulty with urination or moving your bowels
- Difficulty walking
When to Seek Medical Care
Notify your health care provider if you experience any of the following symptoms:
- You feel the cervix near the opening of the vaginal canal or you feel pressure in your vaginal canal and the feeling of something coming out of your vagina.
- You suffer persistent discomfort from urinary dribbling or the urge to have a bowel movement (rectal urgency).
- You have continuing low back pain with difficulty in walking, urinating, and moving your bowels.
Seek medical care immediately if you experience any of the following:
- Obstruction or difficulty in urination and/or bowel movement
- Complete uterine prolapse (your uterus comes out of your vagina)