Have I got a prolapse? Signs and symptoms explained.

With many of us ladies 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

• Surgical removal of the uterus; also called hysterectomy

• Pelvic organ cancers

• Respiratory problems, i.e. a chronic cough

• Constipation (straining when having a bowel movement)

• Obesity

• Excessive weight lifting (bodybuilders are especially at risk)

What are the signs of pelvic organ prolapse? 

Depending on which organ has slipped down you may find you have one or more of the following symptoms. Please note that some prolapses have no symptoms but are discovered during a routine examination at your GP practice or in hospital, for example when having a smear test. Generally speaking, some women report a feeling of increased pressure in the pelvic area, some feel as if something is about to fall out of their vagina, others have back pain and some experience painful intercourse.  Those symptoms are not exclusive and you can have more than one of those at the same time, so let us look closer at each of them.

Symptoms and Types of Pelvic Organ Prolapse (diagrams below)

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 leek 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.

How to tell if you have pelvic organ prolapse

To recap, if you are experiencing one or multiple of the following symptoms, you may be experiencing a pelvic organ prolapse:

• A feeling of pressure in your vagina

• Dryness of the vagina

• Trouble going to the bathroom to urinate or to pass stool

• Problems making it to the bathroom in time

• Leaking urine when exercising, coughing or sneezing

• Pain during intercourse

• Recurring infections

• Protruding organs

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” becomes suddenly 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.  

Disclaimer: Secret Whispers is not a substitute for a GP or Medical Professional. The Kegel weights have been recommended by many GPs and professionals but Secret Whispers is not able to diagnose a prolapse.