Can Pelvic Prolapse be Prevented?

Pelvic prolapse is a common condition that affects about 30% of women, causing problems like urinary incontinence and difficulty having sex. Prolapse occurs due to loss of muscle strength and low levels of estrogen — two problems that can be corrected to help prevent pelvic prolapse.

Dr. Swainston offers some information to get you started on prolapse awareness and prevention, but you can call if you have any concerns or questions.

What is pelvic prolapse?

The organs in your pelvic area, including your uterus and bladder, are supported by a group of muscles called pelvic floor muscles. These muscles form a sling that holds organs in place. They also wrap around your urethra and rectum, where they control urination and bowel movements.

When pelvic floor muscles weaken or become damaged, they can’t continue to support the weight of your organs. As a result, one or more organs begin to prolapse or drop down from their normal position.

Although the bladder and rectum can prolapse, a uterine prolapse is more common. As the uterus begins to drop from its normal position, it pushes down against your cervix and vagina, causing a bulge in the vaginal wall. In severe cases, the uterus comes down through the vagina, potentially ending up outside the vagina.

Can pelvic prolapse be prevented?

There aren’t any guarantees you can prevent pelvic prolapse, but you can significantly lower your risk by taking steps to change the things that cause the problem.

Here are some of the top ways to avoid pelvic prolapse:

Strengthen your pelvic floor muscles

Like other muscles in your body, your pelvic floor muscles gain tone and strength with regular exercise. You can strengthen these muscles with Kegel exercises, which help prevent prolapse and also may relieve symptoms if you already have a mild prolapse.

Follow these steps to perform Kegel exercises:

Tighten two groups of muscles – those that you’d tighten to prevent passing gas and the ones that hold in urine.

Hold the contraction for five seconds, then relax for five seconds. If you can’t hold it that long when you first start, aim for two seconds and gradually increase the length of time as muscles strengthen.

Work up to holding the contraction for 10 seconds, relax, then repeat the contraction. Repeat the contraction 10 times at least three times daily.

If you’re not sure you’re doing the exercises properly or not making progress, talk with Dr. Swainston. He may recommend meeting with a physical therapist or using biofeedback, which shows whether you’re tightening the right muscles for the optimal length of time.

Consider hormone replacement therapy

Women naturally lose muscle strength and mass as they get older, but the problem accelerates after menopause when estrogen levels drop. In fact, lack of estrogen may be one of the top causes of pelvic prolapse.

When you replace estrogen and restore its levels back to normal, you can help maintain the strength of pelvic floor muscles. Hormone replacement therapy also restores the health of tissues in your vagina and urethra, which alleviates postmenopausal problems such as vaginal atrophy, painful intercourse, and incontinence.

Lose weight if needed

Overweight and obesity are strongly associated with pelvic prolapse. Carrying extra weight contributes to the problem because it increases the pressure inside your abdomen. Over time, the constant pressure weakens pelvic floor muscles and tissues. As your weight increases, your chance of pelvic prolapse also rises.

If you’re overweight, you may prevent a prolapse by losing the excess pounds. You’re more likely to be successful and keep the weight off if you follow a plan to consistently lose weight gradually, in the range of about two pounds a week.

Make these lifestyle changes

You can further lower your risk of pelvic prolapse by making these lifestyle changes.

Take steps to prevent constipation

Any time you strain or push to have a bowel movement, you increase pressure on pelvic floor muscles. If you’re constipated, it’s important to avoid straining, but the best solution is to prevent constipation with a high-fiber diet and plenty of fluids.

If you resort to over-the-counter laxatives, follow the instructions and don’t take them longer than the recommended time. When constipation becomes frequent or chronic, talk with Dr. Swainston about treatment.

Stop smoking

A chronic smoker’s cough places tremendous pressure on your pelvic floor muscles, so taking steps to eliminate an ongoing, constant cough is an important way to prevent pelvic prolapse.

Lift items properly

Repeatedly lifting heavy objects weakens pelvic floor muscles. If your pelvic muscles are already weak, suddenly lifting one heavy item may contribute to prolapse. When you lift heavy objects, pull in your lower abdominal muscles and tighten your pelvic floor muscles.

Women who already have symptoms of pelvic prolapse can still follow these steps to relieve symptoms, but it’s important to schedule an appointment with Dr. Swainston to learn about other treatment options.