What is a vaginal prolapse?
A vaginal prolapse is a dropping of your vagina from its normal location in the body. The vagina, also called the birth canal, is the tunnel that connects the uterus to the outside of a woman’s body. Your vagina is one of several organs that rests in the pelvic area of your body. These organs are held in place by muscles and other tissue. These muscles come together to create a support structure. Throughout your life, this support structure can start to weaken. This can happen for a variety of reasons, but the result is a sagging of your organs. When your organs sag or droop out of their normal position, this is called a prolapse.
Prolapses can be small—with just a little movement—or large. A small prolapse is called an incomplete prolapse. A bigger prolapse (called a complete prolapse) is one where the organ has shifted significantly out of its normal place. A complete prolapse can result in part of the organ sticking out of the body. This is a very severe prolapse.
Are there different types of prolapse?
There are several different types of prolapse. Several of the organs in your pelvic area can shift out of place, developing into a prolapse. The different types of pelvic organ prolapse can include:
- Vaginal vault prolapse: The top of the vagina (known as the “vaginal vault”) droops down into the vaginal canal. This usually occurs in women who have had a hysterectomy (removal of the uterus).
- Uterine prolapse: The uterus bulges or slips into the vagina, sometimes so far that it comes out of the vaginal opening.
- Cystocele: The bladder drops into the vagina.
- Urethrocele: The urethra (the tube that carries urine away from the bladder) bulges into the vagina. A cystocele and urethrocele are often found together.
- Rectocele: The rectum bulges into or out of the vagina.
- Enterocele: The small intestine bulges against the back wall of the vagina. An enterocele and vaginal vault prolapse often occur together.
How common is vaginal prolapse?
Vaginal prolapse is fairly common. More than one-third of women in the U.S. have some type of pelvic area prolapse during their lifetime. You’re more likely to experience a vaginal prolapse later in life, especially if you have had multiple pregnancies with a vaginal birth.
What causes vaginal prolapse?
Your vagina is held in place within your pelvis by a group of muscles and other tissue—creating a support structure of sorts. This structure keeps the organs in your pelvis in place. Over time, this structure can weaken. When that happens, the vagina might slip down out of place, causing a prolapse. Several common causes of a vaginal prolapse can include:
- Childbirth: Vaginal delivery raises the risk of prolapse more than a cesarean section (when the baby is delivered through a surgical opening in the wall of the abdomen). It’s also thought that the more children a woman delivers, as well as the delivery of a large baby (more than 9 pounds), will raise the risk of prolapse.
- Surgery: A procedure like a hysterectomy, or radiation treatment in the pelvic area, could cause a prolapse.
- Menopause: During menopause, your ovaries stop producing hormones that regulate your monthly menstrual cycle (period). The hormone estrogen is particularly important because it helps keep your pelvic muscles strong. When your body doesn’t make as much estrogen as before, those pelvic muscles can become weak and a prolapse can develop.
- Aging: As you grow older, you are at a higher risk of forming a prolapse.
- Extreme physical activity or lifting of heavy objects: Strain from activity can also weaken your pelvic muscles and allow your organs to sag out of position.
- Genetic or hereditary factors: Your pelvic support system could naturally be weaker than typical. This can be passed down throughout your family.
Activities or conditions that place extra pressure on your abdominal area can also cause a prolapse. These can include:
- Being overweight.
- Straining to have a bowel movement.
- Having a chronic cough (such as in smokers or people with asthma).
What are the symptoms of vaginal prolapse?
In many cases, you may not feel any symptoms from a prolapse. You may find out about a vaginal prolapse during an exam in your healthcare provider’s office. If you do experience symptoms, they can include:
- A feeling of fullness, heaviness or pain in the pelvic area. This feeling often gets worse as the day goes on or after standing, lifting or coughing.
- Lower back pain.
- Bulging in the vagina.
- Organs slipping out of the vagina.
- Leakage of urine (urinary incontinence).
- Bladder infections.
- Difficulty having a bowel movement.
- Problems with sexual intercourse.
- Problems inserting tampons.