Being a woman is full of awesome moments and wonderful experiences. Vaginal prolapse, however, is not one of them. If you are unfamiliar with vaginal prolapse, it’s worth a few minutes of your time to learn what it is and, more importantly, natural ways to prevent it. After all, prevention is always the best cure!
What is vaginal prolapse?
The term “vaginal prolapse” is something of a misnomer because it isn’t always used to refer to the vagina only but to other pelvic organs and tissues as well. In a pure sense, vaginal prolapse is when the vagina itself falls out of its normal position. Also known as a vaginal vault prolapse, it can occur after a woman has undergone removal of her uterus (a hysterectomy), but there are other causes as well (see “Causes of Vaginal Prolapse”).
This surgical procedure can weaken the ligaments that help support the top of the vagina, causing the organ to drop toward the vaginal opening. Over time, the top of the vagina can protrude through the vaginal opening.
The term vaginal prolapse is also used to describe the dropping or shifting of structures in the vicinity of the vagina, including the uterus, rectum, bladder, small bowel, and urethra. Sometimes doctors use the terms “dropped uterus,” “dropped bladder,” or cystocele, enterocele, or rectocele to describe these situations.
Getting a little confused? Here’s a quick breakdown of the types of vaginal prolapse:
• Cystocele (aka, dropped bladder): when the front wall of the vagina prolapses and the bladder than drops into the vagina. If this occurs, the urethra can prolapse as well, resulting in a condition known as an urethrocele
• Enterocele (prolapsed small bowel): when the upper vaginal supports weaken and the front and back walls of the vagina separate, which allows the small bowel to press against the vagina. This usually occurs after a hysterectomy
• Rectocele (prolapsed rectum): when the back wall of the vagina weakens allowing the rectum to push against the vaginal wall.
• Prolapsed uterus: when the ligaments at the top of the vagina weaken, it can cause the uterus to drop, which in turn usually causes the front and back walls of the vagina to weaken as well
Basically, because the prolapse of these structures involves the vagina, “vaginal prolapse” is often used to describe them.
Causes of vaginal prolapse
In addition to undergoing a hysterectomy, two other main causes of vaginal prolapse can include:
• Menopause. The drastic decline in estrogen levels results in a significant weakening of the muscles and tissues that support pelvic structures
• Childbirth. This is the main risk factor for cystocele. Childbirth damages the muscles, ligaments, and tissues around and in the vagina. Women who have large infants and/or difficult labor are especially susceptible to vaginal prolapse
Factors that contribute to vaginal prolapse include obesity, advanced age, damaged and/or abnormal connective tissue, history of pelvic surgery, dysfunctional nerves and tissues, and strenuous physical activity, including lifting. All of these factors can weaken your pelvic floor muscles.
What does vaginal prolapse feel like?
Although the symptoms can vary depending on the type of vaginal prolapse a woman has, many women describe it as a dragging, dropping, or pressure sensation, as if something were out of place. Women can experience pressure or pain in the pelvic area or the vagina, and these feelings may decrease when lying down. Other symptoms can include:
• Painful intercourse
• Recurring urinary tract infections
• A lump or mass at the vaginal opening
• Problems emptying the bladder or bowel
• Enlarged vaginal opening
• Pain that worsens when standing for prolonged periods of time
Not all women with vaginal prolapse experience symptoms.
Preventing vaginal prolapse naturally
Since vaginal prolapse is associated with damaged or weakened pelvic floor muscles and ligaments that support the vagina and surrounding pelvic organs and tissues, the best prevention and treatment strategies involve stabilizing and strengthening those supportive structures. Here’s what you can do.
Kegel exercises. These simple exercises can be done anytime, anywhere, and no one will even know it! Kegels can strengthen the pelvic floor muscles, which support the bladder, uterus, small intestine, and rectum. To identify your pelvic floor muscles, stop your urine flow the next time you go to the bathroom. If the flow stops, you have found the right muscles (aka the pubococcygeus [PC] muscles of the pelvic floor). To practice Kegels, tighten your PC muscles, hold for five seconds, then relax for five seconds. Repeat four to five times, eventually over time increasing to 10 second contractions and 10 second relaxation, three sets of 10 per day.
Vaginal tightening balls. For hundreds of years, women have had access to a simple yet effective technique to tighten the vagina and strengthen the pelvic floor muscles. Also known as Ben Wa balls, love balls, and orgasm balls, these are typically highly polished weighted orbs made of metal, silicone, glass, or polished stone with a string attached for easy removal. Women insert the balls into their vagina and use their muscles to hold them in, similar to performing Kegel exercises.
Prevent and treat constipation. Maintain a high-fiber diet (lots of fresh fruits and vegetables, whole grains, seeds) to help prevent and treat constipation. Straining can exacerbate already weakened pelvic floor muscles.
Avoid heavy lifting. This type of physical activity stresses the pelvic muscles. Even if you lift correctly (with your legs), you can still stress your pelvic floor.
Pilates. Some Pilates exercises are especially helpful for strengthening the pelvic floor muscles. One popular Pilates exercise is the supine hip lift.
Yoga. A number of yoga poses can help strengthen your pelvic floor muscles. Several reclining poses, such as the child’s pose, lotus pose, and spinal twists, among others, as well as some standing poses and inversions, are suggested.
Rebounding. Rebounding means exercising on a mini trampoline, which allows you to get a great cardio workout without the jarring and pounding associated with a hard surface. According to Dr. Brianne Grogan, DPT, rebounding can be helpful for strengthening pelvic floor muscles if you do a gentle Kegel (i.e., hold a gentle contraction of your pelvic floor muscles) while you are on the trampoline. She warns, however, that “If you have moderate to severe pelvic organ prolapse, or significant bladder leakage, rebounding might not be the best option for you at this time.”
Know which exercises to avoid. Many of the exercises women are doing at the gym or at home are contributing to weakened pelvic floor muscles! According to Pelvic Floor Physiotherapist Michelle Kenway, some of those exercises include traditional sit-ups, exercise ball sit-ups, bicycle legs, double leg raise, and others. Fortunately, you can modify these exercises as well as choose safe pelvic floor exercises that will still work your abdominal muscles.
FemFusionFitness. Ask us: Rebounding and the pelvic floor
eMedicine. Vaginal prolapse
Kenway, Michelle. 12 unsafe abdominal exercises for prolapse and after prolapse surgery
Livestrong. Pilates exercises with a prolapsed uterus
Livestrong. Yoga poses for pelvic floor strengthening
Voices for PFD. Pelvic organ prolapse