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Inside the Exam Room: Commonly Asked Questions About Prolapse

December 22, 2016 | Dr. Ray Bologna

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Oftentimes, women visit my office because they feel something new when showering and are unsure of what, exactly, they’re feeling. Prolapse simply means the presence of a bulge between your legs. This experience is so foreign that some women feel the need to rush to the emergency room. I can assure you that prolapse is common, non-harmful, treatable, and fortunately not an emergency!

Here are the most frequently asked questions women ask me and what I most often tell them.

Is my bladder or uterus at risk of falling out?

No, not at all. The prolapse can potentially worsen over time, but nothing is going to fall out! There are surgical and non-surgical options that can lessen or completely resolve the prolapse.

Do I need to consider surgery?

Surgery truly isn’t necessary, but if you’re unable to empty your bladder or if the prolapse making it difficult for your kidneys to drain, we should discuss all of your surgical options. You might consider transvaginal mesh, a completely safe procedure designed to support the prolapsed organ, or more conservative therapies like kegel exercises or a pessary. It’s important to me that you understand all your options before having surgery.

Do kegels help with prolapse?

Kegels strengthen pelvic floor muscles. The pelvic floor supports the bladder, uterus, and vagina (where prolapse occurs), so these strengthening exercises can actually help decrease the prolapse in some cases or, at the very least, decrease the symptoms of prolapse.

When you say “decrease the prolapse,” how far can prolapse slip down?

Throughout the day, you might be on your feet, which can cause the prolapse to slip further. This doesn’t hurt anything, but if it’s making you feel self-conscious or uncomfortable, you simply can push the prolapse back in. There are no consequences to pushing it in either. And when you lie down, it will usually go back up automatically.

Speaking of lying down, is it okay for me to have sex with prolapse?

Yes, absolutely! The most important thing for you to remember is that sex will not hurt the prolapse or make the prolapse worse. Prolapse also has no effect on the quality of your sex life (or your partner’s). If irritation occurs, it’s likely due to another problem like vaginal atrophy.

What’s vaginal atrophy and how can a woman with prolapse remedy that pelvic floor complaint?

Vaginal atrophy occurs after menopause when the vaginal tissue changes. These changes can cause dryness or itching. When you have prolapse, you might think the prolapse is the cause of your pain, but prolapse itself doesn’t hurt. If the area gets dry or irritated due to vaginal atrophy, there are medications that can help such as estrogen cream.

Can I still exercise, even with prolapse?

Moderate exercise will not hurt the prolapse. If you think that you can’t go swimming or work out, that’s not the case at all! That being said, it’s best to avoid straining exercises such as squats.

You’re not alone! Read Anna’s Story about overcoming prolapse. Women with prolapse live healthy and productive lives. It’s important to note that prolapse can occur, even if you have had a hysterectomy, so if you feel a bulge between your legs, visit your health care provider and discuss your options.

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