"It feels like something is falling out my vagina" - Pelvic Organ Prolapse

With many people taking up more exercise than before in lockdowns 1, 2 and 3, talks about prolapses and bladder weakness have also become more prevalent. Today we want to debunk myths and explain to you everything you need to know about a prolapse - in the hope it will help you make informed decisions and take some action to ensure your body is looked after.  Read on to find answers for the most important questions surrounding a pelvic organ prolapse. 

What causes a pelvic organ prolapse?

According to the NHS, “a pelvic organ prolapse is when 1 or more of the organs in the pelvis slip down from their normal positions and bulge into the vagina” Pelvic organ prolapse - NHS (www.nhs.uk).  The organs that slide down can be the uterus, the bowel, the bladder or the top of the vagina.  Whilst a pelvic organ prolapse is not a threat to your life, it is a threat to your wellbeing and can be painful and debilitating.  

A prolapse usually happens when too much pressure is put on the muscles of the abdomen, therefore pelvic organ prolapse can be caused by the following:

• Pregnancy, labour and vaginal childbirth - Pregnancy and childbirth place a lot of stress on the pelvic floor and if your baby was large, you had an assisted birth (forceps/ventouse) or your labour was prolonged you are at increased risk of developing a prolapse.
• Surgical removal of the uterus (hysterectomy) - If you’ve had a previous hysterectomy you can suffer because the top of the vagina is supported by ligaments and muscles. If these supports weaken, as can be the case when you’ve had a hysterectomy, a vault prolapse may occur.
• Respiratory problems, i.e. a chronic cough - Chronic coughing and heavy lifting can cause an increase in pressure on your abdomen resulting in pressure on your pelvic floor muscles as everything is interconnected.
• Pelvic organ cancers
• Constipation (straining when having a bowel movement)
• Obesity
• Excessive weight lifting (bodybuilders are especially at risk)

What are the signs of pelvic organ prolapse? 

Notice changes with your bladder

With the bladder, signs to look out for are feeling like your bladder is not emptying fully. If you’ve had children like me, you’ll remember needing to go to the toilet more often - if this is becoming a regular issue for you, you may need to investigate further. Failing to get to the bathroom in time or needing to go to the toilet at night is not just about drinking too much before bedtime! We know we need to keep our bodies hydrated so it’s really important to continue to do that and not reduce our water intake. And finally if you suffer with stress incontinence, ie. leaking when you cough, sneeze or exercise or a feeling of heaviness around your lower tummy and genitals, you could be seeing the early signs of a prolapse. 

Changes in the vagina

The second area to look out for signs is the vagina, where you could feel a dragging discomfort inside like there is something coming down into your vagina – it may feel like sitting on a small ball. You might feel or see a bulge or lump coming out of your vagina - if you haven’t seen a nurse or doctor by this time, you need to take action now. You may suffer with discomfort or numbness during sex or notice dislodged or dropped tampons.

Bowel Issues

Which leaves us with the third area, the bowel, where signs may include experiencing constipation, lower back pain or incomplete bowel emptying. Sufferers have described uncontrollable leakage from the anus along with difficulties getting clean after a bowel motion and uncontrollable flatulence. If you have noticed you have an anal prolapse, you may need to push back the prolapse to allow stools to pass.

Occasionally,  pelvic organ prolapse has no symptoms at all and is found during an internal examination carried out for a smear test, but make sure you do your research before you agree to any procedures that a doctor may suggest and perhaps get a second opinion if you’re feeling frightened about the situation.

 Symptoms and Types of Pelvic Organ Prolapse

If your bladder is affected, you may find you have problems urinating and like you can’t fully empty your bladder.  This will be an anterior prolapse. Here your bladder is bulging into the front wall of the vagina. You may also feel that you have to go to the toilet more often or that you can’t make it to the toilet in time and leak urine.  Maybe you have to get up to pee during the night and you experience a sensation of heaviness in your lower belly and around your genitals.  It may be the case that you suffer from stress incontinence, which means that you leak urine when you sneeze, cough or laugh, or when you do some high impact exercise such as running or jumping. It may also be the case that your bladder can be seen bulging out of the vagina.

If you are suffering from a uterine prolapse, it means that your uterus has dropped and now presses onto the vaginal area.  The muscles usually holding the uterus in place have become weak or have been torn or stretched. Symptoms can include increased vaginal discharge or bleeding, incontinence, a feeling as if something is inside your vagina and making its way down, like a displaced tampon, a dragging discomfort or, when you are sitting down, as if you are sitting on a little ball. 

A vault prolapse happens when the vagina collapses inwards. The top of the vagina (vault) sagging down. This happens to some women after they have had surgery to remove their womb (hysterectomy). It occurs in 1-5 women out of a 100 after a hysterectomy.

If your bowels are affected, this is a posterior prolapse. This means that the tissues or structures behind the rectum may bulge into the vagina. This may be noticeable if you have constipation or find it difficult to empty your bowels, it takes a while to clean yourself after a bowel movement, or you have anal leakage and can’t control flatulence.  In order to have a bowel movement, you may also have to push the prolapse back inside and you may be experiencing aches and pains in your lower back.

Note: It is possible to have more than one of these at the same time.

What does a prolapse feel like inside?

 As mentioned above, some women don’t notice they have a prolapse, but generally women notice one or more of the following feelings:

• Feeling full or pressure in the vagina/ pelvic area
• Pain during sex
• A feeling that something is dislodged or falling out of the vagina
• Lower back pain

Can you feel a prolapsed uterus with your finger?

The simple answer is yes. This may feel very daunting, but some women actually have to insert a finger into their vagina and push their bowels back inside so they can go to the toilet. The feeling of something “falling out” suddenly becomes very real.

How is a Prolapse Diagnosed?

During a vaginal examination the doctor or physiotherapist will insert a speculum (this is a plastic or metal medical instrument that is used to separate the walls of the vagina in order to show or reach the cervix) into the vagina to ascertain exactly which organ(s) are prolapsing. You may be examined lying down, standing up or on your side with your knees drawn up in order for this examination to be performed.

What Pelvic Organ Prolapse Grade?

Classified on a scale of 1 to 4 to show how severe it is, with 4 being a severe prolapse.

How do you fix a prolapse without surgery?

If you feel that today’s post has really hit home, know that this is part of my mission, but certainly not to keep you in that negative space.  My goal is to educate people about the importance of the pelvic floor and that, even with a prolapse, there is hope to fix things without surgery.  

The first and most important thing to do is to visit your GP and ask to see a pelvic floor physiotherapist to get a diagnosis.  You will be examined, which is important for a proper diagnosis. Please do not put this off. The small discomfort of being examined and diagnosed is nothing compared to the constant discomfort you face if you do not take action.  

Your GP and pelvic floor physio will be able to help, but being proactive and doing your Kegel exercises for the rest of your life, training those pelvic floor muscles, is the best precaution and exercise you can do. Many women struggle with their pelvic floor exercises and some don’t know where their pelvic floor muscles are. 

Do not worry if this is you. Here at Secret Whispers we have designed the right product for you, our award winning Kegel Weights.  Through the 6-step programme, you are gently building your pelvic floor strength and therefore helping your pelvic floor muscles, potentially preventing surgery.

If you have any questions regarding the above, please contact us and join our Facebook Support Group where you can find a helpful and supportive community that will cheer you on on your journey to a stronger pelvic floor.  

We hope you enjoyed this blog, why not check out Breastfeeding Basics or Why All Pregnant Women Should Be Doing Perineal Massage

Fancy a freebie? Download our FREE guide to holistic period pain remedies  or The easy way to get a stronger pelvic floor

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