How Do You Fix a Prolapsed Uterus?

You can usually fix a prolapsed uterus with medications, home care, or surgery.

Uterine prolapse is when the uterus sags through the pelvic muscles that usually keep it in place. Experts estimate that half of all women experience some degree of bladder or uterine prolapse after giving birth. However, only 10-20% of women have severe enough cases to seek medical treatment.

A “hammock” of muscles and ligaments normally holds the uterus in its usual position. However, these supportive structures may experience some wear and tear that causes the bottom of the uterus to drop through these layers. This may lead to the uterus bulging into or even out of the vagina.

Some cases of prolapsed uterus have no symptoms. Typically, cases that have no symptoms are only a partial prolapse. More severe cases may include symptoms like:

• Feeling of heaviness in the pelvic area
• Pressure in vagina
• Urinary issues, such as painful urination, difficulty urinating, leaking urine, or chronic bladder infections
• Constipation
• The feeling that you are sitting on something, like a ball
• Visible tissue coming from the vagina
• Non-menstrual vaginal bleeding
• Lower back pain
• Increased vaginal discharge
• Painful or uncomfortable penetrative sex

The cause of uterine prolapse is the weakening of the pelvic muscles. If they are not strong enough, they can’t hold the uterus in place, and it drops down into the vagina. Specific causes can include:

• Multiple pregnancies and vaginal deliveries
• Constipation paired with regular straining to pass stool
• Chronic cough

Women who give birth — especially vaginally — are at the highest risk of experiencing uterine prolapse. Other risk factors include:

• Going through menopause
• Obesity
• Smoking

To diagnose a prolapsed uterus, your doctor will perform a vaginal exam. They may ask you to bear down as though you are pushing out a bowel movement. They will look to see how much tissue is prolapsed into or out of the vagina.

After examination, your doctor will determine your degree of prolapse, giving it a “grade” from 1 to 4. A grade of 1 means that the uterus has descended into the upper vagina. A grade of 4 means that the uterus and the cervix have exited the vagina.

To diagnose a prolapsed uterus, your doctor will perform a vaginal exam. They may ask you to bear down as though you are pushing out a bowel movement. They will look to see how much tissue is prolapsed into or out of the vagina.

After examination, your doctor will determine your degree of prolapse, giving it a “grade” from 1 to 4. A grade of 1 means that the uterus has descended into the upper vagina. A grade of 4 means that the uterus and the cervix have exited the vagina.

Treatments for a prolapsed uterus

There are a variety of treatment options for a prolapsed uterus. What works for you may depend on your lifestyle, preferences, and medical history. You may not need medical treatment if your symptoms are mild or not causing you discomfort.

Medications

A pessary is a device inserted into the vagina to help hold the uterus in place. They come in different shapes and sizes to help women with varying severities and types of prolapses. Your doctor can show you how to insert and remove a pessary as needed. A combination of pessary and pelvic floor exercises may help women with uterine prolapse avoid surgery.

Home care

Doctors often recommend pelvic floor exercises for minor cases of a prolapsed uterus. You should work with a physical therapist who focuses on strengthening the pelvic floor. They will give you exercises that can help to strengthen the pelvic muscles so they can hold the uterus in its proper place again.

Surgery

Some more severe cases of uterine prolapse require surgery. Doctors often perform the surgery laparoscopically, where they insert instruments through the navel. They may also go through an abdominal incision. In both cases, they pull the uterus back into place, reattaching the ligaments for support.

Any treatment for a prolapsed uterus may not be effective if you do not address the root cause of the condition, such as a chronic cough or constipation.

Doing pelvic floor exercises and using a pessary are low-risk. However, doing either of these outside of the care of a doctor may be dangerous. You should get proper training on how to perform the exercises and use a pessary to avoid further injury.

Any surgery carries risks, including the surgery for a prolapsed uterus. Surgery may be riskier for you if you:

• Have a medical condition, such as diabetes
• Have heart disease
• Experience breathing problems
• Are a smoker
• Are obese

Experts recommend that women wait until they are done having children to have surgery to repair a prolapsed uterus, because it is likely that giving birth again will cause another prolapse.

This surgery may also cause new problems to arise, like chronic pelvic pain, pain during sexual intercourse, the involuntary leakage of urine.