Uterine prolapse is a typical situation, however it’s typically missed by ladies and their medical doctors.
Dr. Karyn Eilber, a urologist at Cedars-Sinai Medical Center and co-founder of Glissant Intimate Wellness, tells Yahoo Life that nearly each girl who has given beginning vaginally and about half of all ladies over age 50 have “some degree” of uterine prolapse, though ladies of any age can expertise the situation.
What is uterine prolapse?
“Uterine prolapse is often referred to as a ‘falling’ uterus,” Eilber says. “It’s when the uterus pushes into the vaginal canal because of loss of support.” The situation is typically known as a hernia, since “both terms imply an organ is sticking out where it’s not supposed to,” she explains.
Dr. Jill Purdie, ob-gyn and medical director at Pediatrix Medical Group, tells Yahoo Life that “this is caused by relaxation or damage to the muscles and ligaments of the pelvic floor.”
When ladies first discover a prolapsed uterus, Eilber says that they might be “alarmed,” as a result of they assume the protruding uterus “may be a tumor or something growing in the vagina.”
What are the signs of uterine prolapse?
According to Eilber, most girls experiencing uterine prolapse haven’t any signs. However, for many who do, the obvious signal is often “a bulge coming out of her vagina,” says Eilber. “The cervix or entrance to the uterus is usually what sticks out, and can feel firm and rounded.”
Other ladies might discover “pelvic pressure that increases as the day goes on … the more a woman is on her feet,” which “improves with lying down,” Eilber notes.
Lynn Julian, an actress and singer who has had uterine prolapse twice, tells Yahoo Life that the primary symptom she skilled on each events was easy. She “could physically feel” her cervix “while inserting tampons.”
Edwina Caito, a content material creator, knew one thing was flawed when she began having “incredibly heavy and uncomfortable periods, with a heaviness” in her pelvis and higher thighs. She tells Yahoo Life that she was “getting constant urinary tract infections” and needed to “urinate more, with urgency.” Caito additionally shares that her “vagina felt dry and irritated” continually: “Some days, it felt like I was carrying a bowling ball in my vagina.”
Unsure what was taking place to her physique, Caito determined to analyze herself. “I got out a mirror, hoisted my foot onto the toilet lid and stared in disbelief when I couldn’t see my vaginal opening,” she says. “It was completely obstructed by a dark pink object. I could push it back up and it would fall back down. This bulge is what was making me feel dry and irritated all the time.”
Caito went to her gynecologist, however was misdiagnosed. She says that her physician put her on drugs “without testing for prolapse.” After a 12 months of being on remedy with no enchancment, she went for a second opinion. Her new gynecologist examined her “for actual prolapse and was shocked that it was so bad,” Caito says.
What causes uterine prolapse?
Anything from pushing on account of power constipation to repeated heavy lifting may cause uterine prolapse, however Eilber says that the commonest trigger is vaginal childbirth. Sometimes prolapse happens shortly after childbirth, however different instances it doesn’t occur till ladies enter their 50s or 60s, notes Eilber.
Other threat components embody earlier “pelvic surgery, obesity and connective tissue disorders,” Eilber explains. Dr. Seth Cohen, a urologic surgeon and urogynecologist at City of Hope Orange County Lennar Foundation Cancer Center, tells Yahoo Life that different causes of uterine prolapse embody a “decrease in estrogen as menopause approaches” and pelvic tumors. Aging is one other threat issue, says Cohen, as a result of “pelvic muscles and ligaments weaken over time.”
Caito says that her physician informed her that her uterine prolapse “was likely due to a number of things, including a forceps delivery” of her first little one and “rapid delivery” of two of her different kids. After Caito skilled uterine prolapse, she was identified with a connective tissue dysfunction known as Ehlers-Danlos syndrome, which can even have contributed to her prolapse.
Julian attributes her first bout with uterine prolapse to “a lifetime of exercise,” together with “aerobics, trampolines and calisthenics.” She additionally has Ehlers-Danlos syndrome, however says her physician doesn’t assume the dysfunction was “solely responsible” for her prolapse. With her second uterine prolapse, Julian believes intense coaching for the Boston Marathon with out utilizing supportive clothes, comparable to compression pants, performed a job.
How does uterine prolapse affect ladies’s lives?
While uterine prolapse could be uncomfortable, Eilber says that, usually, “prolapse doesn’t cause pain.” In phrases of intimacy, she explains that the uterus would get “pushed back into the vagina with sex,” so it mustn’t affect a lady’s intercourse life bodily. However, Eilber notes that many ladies with prolapse keep away from intercourse on account of embarrassment.
When Caito skilled uterine prolapse, she says that intercourse did not harm and “didn’t feel much different.” But she explains that she “was easily irritated.” Caito says that whereas she was experiencing uterine prolapse, her now ex-husband “said it felt tight and cozy,” which she says is smart, as a result of her “organs” have been in her vaginal canal.
Julian’s expertise, nevertheless, is completely different. She remains to be struggling the situation and says that “life with uterine prolapse makes literally everything involving that area of my body more difficult. Pelvic exams are harder to perform and more uncomfortable for me,” including that “even everyday things, like inserting a tampon, are more difficult and uncomfortable.” As for intercourse, Julian says it’s “awkward,” as a result of she has to elucidate why her “uterus and cervix are visible.”
How is uterine prolapse handled?
For delicate instances of uterine prolapse, remedy isn’t all the time vital. Purdie says that “only around half” of girls identified with prolapse will endure remedy. Among Eilber’s sufferers, some “just want to know that the bulge isn’t cancer, … while other women want it treated right away.”
Treatments for delicate uterine prolapse embody “observation, pelvic floor physical therapy” or utilizing a pessary, a versatile gadget that goes into the vagina to push up the uterus, explains Eilber.
Purdie says that “a woman has to see her physician to be fitted for the correct type of pessary that will help the most with her prolapse.” Some ladies with delicate instances of uterine prolapse elect to have surgical procedure, as a result of they don’t like having a bulge or discover it uncomfortable.
For extra extreme instances, surgical procedure may be wanted to deal with the situation. “Sometimes the uterus can be lifted, but other times it may need to be removed,” Eilber explains.
On uncommon events, uterine prolapse can turn into an emergency. “If you are experiencing severe symptoms, such as difficulty urinating or having a bowel movement, or complete uterine prolapse, in which your uterus is outside of your vagina, seek urgent medical attention,” Cohen advises.
Julian says when she skilled her first uterine prolapse, she “had years of unsuccessful pelvic floor physical therapy to try to fix the prolapse.” When that didn’t work, she underwent surgical procedure. However, even surgical procedure didn’t stop a recurrence of the issue.
She tried pelvic flooring remedy once more after her second prolapse however says it “was too severe to be repaired” by remedy alone. For now, she resides with the situation, though Julian says she “has not ruled out surgery in the future, to either lift up or remove my uterus completely.”
If Caito’s uterine prolapse had been identified earlier, she says she would have been capable of attempt pelvic flooring bodily remedy or use a pessary to deal with the situation. “There is a possibility that the year I went being misdiagnosed could have worsened things, causing my only recourse to be prolapse surgery,” she explains.
To deal with her uterine prolapse, Caito says she wanted “radical surgery” — specifically, a hysterectomy, in addition to anterior and posterior lifting. She additionally says her pelvic flooring required “rebuilding,” particularly, “building a vaginal cuff with suspension, giving me a bladder and urethral sling, and tightening my outer vulva.”
Caito says, “It was a six-hour surgery that took 12 weeks of recovery. It was grueling and awful.” Still, she considers the surgical procedure successful. “It changed my life dramatically,” she says. “The pain relief was the immediate change, the UTIs stopped, that heavy feeling and pain in my low back and upper thighs disappeared and my sex life? It was far better post-op.”
Having skilled uterine prolapse twice, Julian says she would “love to create awareness about this common problem for women, to break the stigma.” Caito feels the identical manner, saying that she needs she had identified extra about pelvic organ prolapse earlier than it occurred to her, including that some gynecologists aren’t “educating people with vaginas as they should be.”
Although some ladies are too embarrassed to hunt assist in the event that they expertise uterine prolapse, Eilber says “Prolapse is very common and nothing to be ashamed about — if a woman has prolapse and is bothered, there are doctors who can help.”
Cohen concurs. “It is always essential to voice symptoms or concerns you may have with your health care team, to ensure you receive the right diagnosis and treatment,” he says. “We want to empower patients with education to make informed decisions, from diagnosis to treatment.”
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