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Prolapse and Body Image

October 31, 2016 | Mary South, MD, MHA

As an intern in residency, I very clearly recall the first time I saw complete uterine prolapse in the emergency room. A woman came in and stated that she had noticed a bulge getting bigger and bigger and now it was out so far she could not push it back up inside. The woman was terrified. Although I had personally never seen Stage IV prolapse (complete uterine prolapse) other than in textbooks, I knew what it was and I quickly reassured her that this was not life-threatening and was easily fixable.

I will never forget how mortified this woman was and how she had no understanding of what was going on with her body. Pelvic organ prolapse may be a benign, curable condition, but it can have a significant impact on a woman’s sense of self and body image. A study published in the American Journal of Obstetrics and Gynecology by researchers at Magee-Women’s Hospital, stated “Women living with prolapse [are] more likely to feel self-conscious, isolated, “different,” less feminine, and less attractive. Women often changed sexual intimacy practices because of embarrassment or discomfort, and many avoided intimacy all together” (Lowder et al., 2014).

As a physician who cares for women with pelvic floor complaints, women express all kinds of different feelings about prolapse. Some say they know it’s there but it doesn’t bother them; others know it’s there and it feels uncomfortable, while others still are bothered just because they know it’s there, but don’t necessarily feel physical discomfort.

I hear women say:

“I’m afraid to have sex because I’m worried I’ll hurt it.”

“I don’t want to have sex because I’m embarrassed by it.”

“My husband won’t have sex with me because he’s afraid he will hurt me.”

“My husband won’t have sex with me because he’s grossed out by the prolapse.”

It’s no wonder a woman’s body image could be affected by having a prolapsed uterus or vaginal walls! Researchers at The Cleveland Clinic also found an association between body image and quality of life (Jelovsek & Barber, 2006). Women with advanced prolapse were more likely to feel self-conscious, less physically attractive, less feminine, and less sexually attractive. The goal of treatment for these women is to restore their quality of life and improve their body image.

There are different ways to treat prolapse. Regardless of the treatment option you choose, it’s important to feel confident that it’s the right decision for you. Read more about this common condition and others who have found solutions that have made a positive impact on their lives.

Jelovsek, J. E., & Barber, M. D. (2006). Women seeking treatment for advanced pelvic organ prolapse have decreased body image and quality of life. Am J Obstet Gynecol, 194(5), 1455-1461. doi: 10.1016/j.ajog.2006.01.060

Lowder, J. L., Ghetti, C., Oliphant, S. S., Skoczylas, L. C., Swift, S., & Switzer, G. E. (2014). Body image in the Pelvic Organ Prolapse Questionnaire: development and validation. Am J Obstet Gynecol, 211(2), 174 e171-179. doi: 10.1016/j.ajog.2014.03.019

Find more articles on Prolapse, Prolapsed Bladder, Uterine/Vaginal Prolapse